Spine Injuries Helping the Victims of Catastrophic Injuries

Houston Spinal Cord Injury Attorneys

The hard bones of the spinal column protect the soft tissues of the spinal cord; however, if vertebrae are broken or dislocated, they can cause traumatic injury to the spinal cord. Injuries can occur at any level of the spinal cord. Depending on which segment of the cord is injured, and how severely, a person may lose some or all of their motor and sensory function beneath the injury. Because the spinal cord is the main conveyor belt for information from the brain to the rest of the body, a spinal cord injury can have significant consequences.

Facts from the National Spinal Cord Injury Statistical Center

  • Approximately 10,000 to 12,000 people sustain spinal cord injuries every year in the United States.
  • 250,000 Americans currently live with spinal cord injuries.
  • Each year, it costs almost $4 billion to manage the care of spinal cord injury victims.

Injuries to the Spinal Cord

Any kind of physical trauma that crushes or compresses the vertebrae in the neck can cause irreversible damage at the cervical level of the spinal cord and below. Injuries occurring this high up will likely cause paralysis throughout the body, including both arms and legs (this condition is called quadriplegia, because it affects all four limbs). Spinal cord damage in the middle back (the thoracic or lumbar area) can cause paralysis that is limited to the lower half of the body and the legs (a condition called paraplegia, because it affects two limbs).

Most injuries don't completely sever the spine. Instead, they cause fractures or compression of the vertebrae and displaced bones destroy axons, which are nerve cell extensions that carry signals through the spinal cord to the brain and the rest of the body. A spinal cord injury can damage some or all of these axons; depending on the number of axons lost, an individual may be able to recover or may be permanently paralyzed.

Spinal cord injuries can be classified as complete or incomplete, depending on how much cord width is injured. An incomplete injury means the ability cord has retained some ability to convey messages to or from the brain. People with incomplete injuries retain some function; a complete injury results in a total lack of sensory and motor function below the level of injury.

What Is the Spinal Cord? Identifying Its Critical Functions.

The spinal cord runs through the back, transmitting messages from the brain to the rest of the body. The soft cord is protected by the spinal column, made up of 33 bones (vertebrae). These are stacked on top of eachother, with holes in the center; the spinal cord runs through the channel created by the holes in the stacked bones. Between the vertebrae are discs of semi-rigid cartilage and between the discs are narrow passages through which the spinal nerves exit to the rest of the body. These are places where the spinal cord is particularly vulnerable to injury.

The spinal cord is organized into segments. Each segment marks locations where spinal nerves emerge from the cord:

  • Cervical spinal nerves (C1 to C8) control signals to the back of the head, the neck and shoulders, the arms and hands, and the diaphragm.
  • Thoracic spinal nerves (T1 to T12) control signals to the chest muscles, certain back muscles, and portions of the abdomen.
  • Lumbar spinal nerves (L1 to L5) control signals to the lower abdomen and back, buttocks, parts of external genital organs, and leg.
  • Sacral spinal nerves (S1 to S5) control signals to the thighs and lower parts of the legs, feet, external genital organs, and area near the anus.
  • The single coccygeal nerve carries sensory information from the skin of the lower back.

Paraplegia & Quadriplegia

Paraplegia is the paralysis of both lower limbs that often happens as a result of spinal cord trauma, most likely the result of some sort of accident, although there are cases when it is caused by illness. Quadriplegia is when the damage is located in the cervical region of the spine and affects all four limbs. Most of these spinal cord traumas involve the loss of sensation and function below the level of injury, including loss of control in the bladder and bowel. Often, these paralyzed individuals end up in wheelchairs and need some form of assisted living.

Given that the average paralyzed victim is male, 31 years of age, and will have to adjust to life in a wheelchair, the damage can be lifelong, especially if the male is considered the breadwinner for the family. In addition to medical expenses that can range into the six and seven figures, victims also face limited earning potential due to their condition. As a result, many who suffer paralysis can face bankruptcy and depression.

Vertebrae Fractures & Spinal Injuries

A fracture of one or more spinal vertebrae is a serious medical condition. Unless a victim suffers from an underlying disease that weakens the bones, the trauma necessary to fracture vertebrae is usually quite severe. Typical traumas that may result in the fracture of a vertebra include falls from elevated heights, blunt force traumas such as a car accident, sports accidents, or violent acts such as gunshots. Most compression fractures occur in the mid or lower back. Some fractures occur at the junction between the mid and lower back (thoracolumbar junction). There are different types of vertebral fractures, classified by the pattern of the injury and the presence or absence of a complicating spinal cord injury.

There are three main types of vertebra fracture patterns:

Flexion Fractures

  • Compression: The front of the vertebra breaks and sags, but the back doesn't.
  • Axial Burst: The vertebra loses height on both its front and back sides.

Extension Fractures

  • Flexion / Distraction: The vertebra is pulled apart.

Rotation Fractures

  • Transverse Process: Rotation or extreme lateral bending of the vertebra (this type of fracture is extremely rare).
  • Fracture-Dislocation: An unstable injury where a vertebra is broken and ligaments are torn.

Symptoms of fractured vertebrae include:

  • Pain
  • High fever
  • Numbness, tingling or weakness in the outer extremities
  • Loss of control over bodily functions

Effects of an Injury to the Spinal Cord

  • Breathing - An injury to the spinal cord at or above the C3, C4, and C5 segments can stop or impair breathing. People with these injuries will likely need to be placed on a ventilator. Injuries at the C5 level and below still tend to affect breathing, usually resulting in rapid and shallow breaths, as well as difficulties with coughing or clearing the lungs.
  • Irregular Heartbeat & Low Blood Pressure - Spine injuries in the cervical region often result in unstable blood pressure and/or heart arrhythmias (irregular heartbeat). Irregularities usually emerge in the first two weeks after injury; in more severe injuries, these problems are worse. Low blood pressure also often occurs due to loss of tone in blood vessels, which widen and cause blood to pool in the small arteries far away from the heart. IV infusions can help correct this problem by restoring blood volume.
  • Blood Clots - People with spinal cord injuries are at an increased risk for blood clots.
  • Spasms - When the spinal cord is damaged, information from the brain stops regulating reflexes, allowing them to become exaggerated and spastic. If spasms become severe enough, they may require medical treatment.
  • Autonomic Dysreflexia - A life-threatening reflex affecting people with injuries in the neck or upper back. When a stimulus appears below the level of injury, the affected region tries to send a signal to the brain, but since it can't get through, a reflex occurs without regulation. These types of reflexes can affect blood flow, organ function, and any other process controlled by the sympathetic nervous system. The result can be anything from increased blood pressure or rapid heartbeat to strokes, seizures, or even death.
  • Pressure Sores - Skin tissue can break down if it is under constant pressure. Since people with paralysis can't move easily on their own, they can develop pressure sores if not rotated or offered appropriate diets to encourage healthy skin development.
  • Pain - Nerve damage in the spinal cord can cause neurogenic pain. Overuse of certain muscles can result in muscular pain.
  • Bladder & Bowel Problems - Most spinal cord injuries affect bladder and bowel function because the nerves that control those organs begin near the base of the cord. Most people will need to have a catheter implanted to control bladder function and prevent infections. Since bowel function is difficult to regulate, spine injury victims are usually put on a regularly scheduled bowel program.
  • Reproductive & Sexual Function - Spinal cord injury has a greater impact on sexual and reproductive function in men than in women. Most women with these injuries can still conceive and carry a pregnancy. Men may have problems achieving erections or experiencing ejaculation, and most will become less fertile as sperm motility declines.

Diagnosing a Spinal Cord Injury

Spine injuries are not always easy to diagnose and delayed / missed diagnoses may lead to more severe injuries. In order to diagnose a spine injury, doctors must conduct careful patient inspections and ask questions on how the accident occurred. If an injured person complains of neck pain, isn't fully conscious, shows signs of weakness, or shows symptoms of neurological injury, emergency diagnostic tests should be conducted:

  • X-Rays: These tests are usually performed on people who are suspected of having incurred a spinal cord injury as the result of a trauma. X-rays can reveal vertebral problems, tumors, fractures, or degenerative changes in the spine.
  • Computerized tomography (CT) Scan: A CT scan usually comes after an X-ray, to provide a better look at noted abnormalities. This scan uses computers to form a series of cross-sectional images that can define bone, disk, and other problems.
  • Magnetic Resonance Imaging (MRI): MRIs use strong magnetic fields and radio waves to produce computer-generated images, and are useful for examining the spinal cord and compressions of the spinal cord.

In addition to initial diagnostic exams, neurological exams should be conducted when some of the swelling has subsided. These tests will help determine the level and completeness of your injury, and usually testing your muscle strength and your ability to sense light touch and pinpricks.

Types of Treatments for Spinal Cord Injuries

Current treatments for spinal cord injuries focuses on preventing further complications and allowing patients to return to as active a life as possible. Immediately after the injury, urgent medical attention is critical to minimize the effects of any head or neck trauma; for this reason, treatment for a spinal cord injury should begin at the scene of the accident. Emergency responders should immobilize the spine as gently and quickly as possible, using a rigid neck collar and a rigid carrying board, which will be used to transport the patient to the hospital.

During the early stages of treatment, care should be focused on maintaining your ability to breathe, preventing shock, preventing further damage, and avoiding complications. Sedation may be necessary to keep a patient immobile and prevent further damage while diagnostic tests are performed. If a spinal cord injury victim is given methylprednisolone within eight hours of an injury, he or she may experience a mild improvement in outcome because the drug helps reduce damage to nerve cells and decrease inflammation near the site of the injury.

Immobilization, Surgery & Rehabilitation

After a spinal cord injury, traction to stabilize the spine or bring it into alignment may be necessary. Traction may involve securing metal braces, attached to weights or a body harness, to the skull to keep the head stable. A rigid neck collar may work in less severe cases. Surgery may be necessary to remove items that are compressing the spine, or to stabilize it to prevent future pain or deformity. Rehabilitation should begin in the early stages of recovery. A rehab team will likely include a physical therapist, occupational therapist, rehabilitation nurse, rehabilitation psychologist, social worker, dietitian, recreation therapist, and a doctor with expertise in physical medicine or spinal cord injuries.

At the beginning, therapists will usually focus on maintaining and strengthening existing muscle function, relearning fine motor skills, and working on techniques that will allow the patient to accomplish daily tasks. Other portions of rehabilitation will include: Oral medications, orthopedic procedures, bracing and splinting, and injectable medications may be used to manage spasticity. These types of treatments are usually combined with therapies, such as stretching, positioning, and movement exercises.

Some new treatment options have also emerged:

  • Injections of medications like phenol and Botox directly into the muscle.
  • Surgical implantation of an intrathecal baclofen pump can deliver medication directly to the brain and spinal cord, targeting spasticity in both the lower and upper limbs. Patients must submit to a trial period to see if they are good candidates.

Restoring Function & Mobility

Therapy can improve some patients' physical function in the upper extremities. Exercises designed to stimulate nerve re-education, muscle strengthening, task training, and others can help reduce long-term complications and regain the ability to perform self-care and other daily activities. Functional electrical stimulation (FES) is a therapy that improves functional abilities by using computer technology to send low-level electrical impulses to contract muscles in the legs, arms, hands, or other areas. This may promote improvements in muscle tone or control.

FES may also improve range of motion, strength, and functional use of hands, arms, or legs. FES may allow patients to grasp or hold an item, or move arms or legs in a cycle or stepping motion. FES can also help patients perform exercise to improve blood circulation, aerobic conditioning, heart health, and overall well-being. FES can also help improve muscle movement patterns, prevent bone density loss, and reduce spasticity. Diaphragm pacing involves a minimally invasive procedure to implant four electrodes into the diaphragm muscle and a fifth just below the skin near the other electrodes. These electrodes are connected to external stimulator, causing the diaphragm to contract and helping with breathing.

Diaphragm pacing can have the following benefits:

  • Reduce or eliminate the need for a ventilator
  • Help patients breathe and speak more naturally
  • Make daily activities easier to accomplish
  • Decrease the risk of contracting respiratory infections
  • Improve senses of smell and taste
  • Increase mobility
  • Reduce need for external power sources to maintain breath

Treatment from Rehabilitation Centers

Wheelchair programs at rehabilitation centers will assess patients to determine what form of mobility assistance they will require to navigate their environments. A good program should allow the patient to try a wide variety of manual and power wheelchairs in different challenges.

Selecting the appropriate wheelchair will allow a patient to:

  • Maximize independence and safety in the home
  • Improve posture and function in the wheelchair
  • Prevent secondary problems from improper seating

Music therapy is a staple at many rehabilitation centers. A music therapist addresses the cognitive, speech/language, physical, and psychosocial needs of a patient, using Neurologic Music Therapy techniques. Music therapy can help facilitate functional movements and/or cognitive and speech behaviors. Music therapists also use song writing to help individuals cope with their new reality.

Choosing the Right Rehabilitation Facility

Picking an appropriate rehabilitation facility can greatly assist in a patient's return to daily life after a spinal cord injury. While some patients may be lucky enough to have cutting edge centers close to their homes, others may need to travel to find the best possible care available. Regardless of the location, it is important to consider the following factors when choosing where to undergo spinal cord injury rehabilitation.

  • Does the facility have experience with your particular diagnosis? As a general rule, facilities develop higher levels of expertise with practice. Researching the center's track record with your specific injury will help ensure you receive the best available care.
  • Is the place accredited? A facility that can boast accredited expertise with your specific injury is usually a better choice for a spinal cord injury victim than a general rehabilitation program. The Rehabilitation Accreditation Commission spinal cord injury accreditation indicates that a facility meets a minimum offers exceptional rehabilitation programs specifically targeted towards the treatment of your injury.

A good spinal cord injury rehabilitation center should have the following experts on staff:

  • Physiatrist: A doctor who specializes in physical medicine and rehabilitation. Physiatrists can treat a wide range of problems, and help coordinate long-term rehabilitation for patients with spinal cord as well as other injuries. A true physiatrist has completed four years of graduate medical education as well as four years of postdoctoral residency training.
  • Rehab Nurse: Nurses with special training in rehabilitative and restorative principles. These professionals are experts in bladder and bowel issues, nutrition, pain management, bedsore prevention, breathing care, self-empowerment, coordination of medical regimens, and related issues. Their education includes helping patients achieve independence and designing care plans.
  • Occupational Therapists: Occupational therapists (OTs) help individuals perform the daily functions needed for independence. OTs can help patients learn to bathe, dress, make a meal, clean, or even participate in a favorite hobby. OTs also evaluate environments outside of the rehab facility, making recommendations for changes that will help patients navigate these areas.
  • Physical Therapists: Physical therapists (PTs) treat motor and sensory impairments. They help patients improve their strength, endurance and coordination, while working to reduce spasticity, maintain the muscle integrity in paralyzed limbs, protect skin from pressure sores, and gain greater control over elimination. PTs also work with paralyzed people to help them use assistive devices.

Other staff members that indicate a top-notch facility:

  • Recreation therapists to help restore quality and enjoyment of life
  • Vocational therapists to help patients return to their previous jobs or find new ones
  • Mobility experts to help people select the best wheelchair or other mobility assistant
  • Psychologists to help patients adjust to the realities of post-injury life
  • Sex and family counselors to help patients understand what options are still available to them

Cutting-Edge Spinal Injury Research: Discovering a Cure for Paralysis

To help discover a cure for the paralysis caused by spinal cord injuries cause, the Christopher & Dana Reeve Foundation supports a variety of cutting-edge research projects. Current areas of focus include neuroprotection, axon growth, growth inhibition, and stem cell research. In the first weeks and even months after a spinal cord injury, cellular damage continues as the immune system and other processes triggered by trauma kill off cells that survived the initial injury. This problem, known as apoptosis, can sap a victim of additional function. If this biological ripple effect could be prevented or contained, the injury might wreak less havoc. Research is currently being conducted into ways to curb apoptosis.

Axon Growth

Spinal cord injuries destroy axons, but often the neurons of which they are extensions remain intact. While these neurons don't produce new axons or repair damaged ones, researchers are now studying methods that might cause the neurons to do just that. One approach attempts to reboot neuron development so new axons grow and recreate nerve circuits that have been disrupted. Once damaged, cells in the central nervous system don't repair themselves, unlike cells in other parts of the body. After extensive research, scientists believe they have discovered the reason for this anomaly: the body's trauma responses prevent the growth of new axons by making the area surrounding an injury hostile to cellular growth. Treatments will likely soon be developed to block growth-inhibiting molecules or prevent them from gathering at the injury site so the body can repair its axons. The good news is that scientists are getting better at regenerating axons. The bad news is that these new axons must still travel long distances to rebuild nerve circuitry and restore function. Even if that occurs, neurotransmitters must also be restored. Because of these challenges, many researchers are studying the function of guidance molecules that help axons connect with the rest of the neural circuitry.

The Possibility of Stem Cell Research

If doctors can restore the functioning circuits, injured spinal cords could in theory be repaired. Embryonic stem cells can be formed into any type of tissue. Neural progenitor stem cells could repair damaged spinal cords if researchers can learn how to control their development. Researchers are working on understanding the basic functions of these stem cells so that they might one day restore function to people with these injuries.

Working with a Lawyer to Get Treatment

Anyone who has sustained a spinal cord injury or is helping a loved one recover from this type of trauma must face many difficult choices during an extremely tumultuous time. Patients and family members must often make quick medical decisions that will affect the injured person's long-term prognosis, even as they struggle to accept the reality of the situation. When a spinal cord injury is the result of another person's negligence, it is vitally important to hire a lawyer with a track record of winning these type of cases. It is important to have a lawyer who can help make sure that the injured person receives the top medical care and hold the responsible people accountable. During such difficult times, consulting with a top-ranked attorney can help the victim's family make the choices that will result in that individual receiving the best available care.

Attorneys who represent paralysis victims are aware of experimental procedures and top tier care facilities that victims and families may not know about. They also act as advocates for victims, dismissing pressure from outside parties to choose less effective care options. A good attorney will deal with any legal or insurance related problems, allowing the victims and their families to focus on rehabilitation and recovery. It is particularly important to consult an attorney as soon as possible after sustaining a spinal cord injury, as many of the medical decisions must be made within the first few hours following an accident. At Arnold & Itkin, our personal injury attorneys have won billions of dollars for personal injury victims, helping them receive the best available care to ensure optimal quality of life in the wake of a devastating injury.

Receiving Compensation for Traumatic Spinal Cord Injuries

We at Arnold & Itkin dedicate our practice to advocating for the wrongfully injured. If you or a loved one has innocently suffered paralysis or catastrophic injury related to the spinal cord at the hands of someone else’s wrongdoing, we want to help. Our legal team will identify the responsible parties and seek extensive damages for the tragedy that has befallen your or loved one. If diagnosed with a spinal cord injury, you could be facing extensive medical bills related to tests and treatment. Furthermore, you are likely debilitated to the point that you cannot work, meaning that the hospital bills will continue to be more and more difficult to pay. If the incident causing this spinal cord injury was not your fault, you may be eligible for receiving financial compensation not just for your immediate bills but also for your future care.

Our legal team wants to help you identify the liable party and begin fighting for the retribution you deserve. Call (888) 493-1629 to begin fighting for the financial security that you need and deserve.

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