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NINDS Disorders is an index of neurological conditions provided by the National Institute of Neurological Disorders and Stroke. This valuable tool offers detailed descriptions, facts on treatment and prognosis, and patient organization contact information for over 500 identified neurological disorders.

Neurology Now
Expressing Pain. 03.01.2008

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Spinal Cord Injury

A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Most injuries to the spinal cord don't completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy axons -- extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.

Treatment

Improved emergency care for people with spinal cord injuries and aggressive treatment and rehabilitation can minimize damage to the nervous system and even restore limited abilities.  Respiratory complications are often an indication of the severity of spinal cord injury   About one-third of those with injury to the neck area will need help with breathing and require respiratory support. The steroid drug methylprednisolone appears to reduce the damage to nerve cells if it is given within the first 8 hours after injury.  Rehabilitation programs combine physical therapies with skill-building activities and counseling to provide social and emotional support. Electrical simulation of nerves by neural prosthetic devices may restore specific functions, including bladder, breathing, cough, and arm or leg movements, though eligibility for use of these devices depends on the level and type of the spinal cord injury.

Prognosis

Spinal cord injuries are classified as either complete or incomplete.  An incomplete injury means that the ability of the spinal cord to convey messages to or from the brain is not completely lost. People with incomplete injuries retain some motor or sensory function below the injury.  A complete injury is indicated by a total lack of sensory and motor function below the level of injury.  People who survive a spinal cord injury will most likely have medical complications such as chronic pain and bladder and bowel dysfunction, along with an increased susceptibility to respiratory and heart problems. Successful recovery depends upon how well these chronic conditions are handled day to day.Surgery to relieve compression of the spinal tissue by surrounding bones broken or dislocated by the injury is often necessary, through timing of such surgery may vary widely.  A recent prospective multicenter trial called STASCIS is exploring whether performing decompression surgery early (less than 24 hours following injury) can improve outcomes for patients with bone fragments or other tissues pressing on the spinal cord.

Research

The National Institute of Neurological Disorders and Stroke (NINDS) conducts spinal cord research in its laboratories at the National Institutes of Health (NIH) and also supports additional research through grants to major research institutions across the country.  Advances in research are giving doctors and patients hope that repairing injured spinal cords is a reachable goal.  Advances in basic research are also being matched by progress in clinical research, especially in understanding the kinds of physical rehabilitation that work best to restore function. Some of the more promising rehabilitation techniques are helping spinal cord injury patients become more mobile.

View a list of studies currently seeking patients.

View more studies on this condition.

Read additional information from Medline Plus.

Organizations

Christopher and Dana Reeve Foundation

The Reeve Foundation is dedicated to curing spinal cord injury by funding innovative research, and improving the quality of life for people living with paralysis through grants, information and advocacy.

636 Morris Turnpike
Suite 3A
Short Hills, NJ 07078
Tel: 973-379-2690 800-225-0292
Fax: 973-912-9433

National Rehabilitation Information Center (NARIC)

8201 Corporate Drive
Suite 600
Landover, MD 20785
Tel: 301-459-5900/301-459-5984 (TTY) 800-346-2742
Fax: 301-562-2401

Miami Project to Cure Paralysis/ Buoniconti Fund

Supports and conducts research and related programs in the area of spinal cord injury.

P.O. Box 016960
R-48
Miami, FL 33101-6960
Tel: 305-243-6001 800-STANDUP (782-6387)
Fax: 305-243-6017

National Spinal Cord Injury Association

The National Spinal Cord Injury Association is dedicated to improving the quality of life for hundreds of thousands of Americans living with the results of spinal cord injury and disease (SCI/D) and their families. NSCIA, educates and empowers survivors of SCI/D to achieve and maintain the highest levels of independence, health and personal fulfillment.

75-20 Astoria Blvd
Suite 120
East Elmhurst, NY 11370-1177
Tel: 800-962-9629
Fax: 866-387-2196

Paralyzed Veterans of America (PVA)

Non-profit organization dedicated to serving the needs of its members—more than 19,000 veterans paralyzed by spinal cord injury or disease, as well as caregivers and others affected by these disabilities—through advocacy, education, and research programs.

801 18th Street, NW
Washington, DC 20006-3517
Tel: 202-USA-1300 (872-1300) 800-555-9140
Fax: 202-785-4452

Spinal Cord Society

International advocacy organization that supports research, publishes a newsletter, and sponsors an international network of chapters.

19051 County Highway 1
Fergus Falls, MN 56537
Tel: 218-739-5252 or 218-739-5261
Fax: 218-739-5262

National Institute on Disability and Rehabilitation Research (NIDRR)

U.S. Department of Education Office of Special Education and Rehabilitative Services
400 Maryland Ave., S.W.
Washington, DC 20202-7100
Tel: 202-245-7460 202-245-7316 (TTY)

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