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Secondary conditions complicate recovery from spinal trauma

There is no question that spinal cord injuries can be some of the most devastating types of survivable trauma. But what many don't consider is that the spinal cord injury itself is just one facet of a very complex condition involving almost every system of the human body.

After an accident that injures the spinal cord, patients can suffer from a host of secondary conditions related to their paralysis. These problems may include all or some of the following:

-- Loss of bladder and bowel control

-- Sexual dysfunction

-- Deep vein thrombosis

-- Autonomic dysreflexia

-- Spasticity of the limbs

-- Breakdown in skin integrity

-- Sepsis

-- Respiratory difficulties

While all are serious and can affect the quality of a SCI patient's life, some can be life-threatening. The problems can be present from the onset of the paralysis, or may develop over time due to the condition. Some secondary conditions like pressure sores can be avoided by meticulous attention to the care of the patient's skin, but others, such as autonomic dysreflexia, can develop suddenly and rapidly become fatal.

In the above case, the trigger is some type of irritation or blockage below the level of spinal paralysis. If the patient had feeling in that area, they would experience pain, but the pain receptors are disabled. Therefore, the body reflexively activates the sympathetic part of the body's autonomic nervous system. The blood vessels constrict, causing the blood pressure to skyrocket.

When the nerve receptors detect the increased blood pressure, the brain causes the heartbeat to diminish while the blood vessels that are higher than the injury level dilate. These messages send erratic signals that can cause a fatal health crisis.

Proper monitoring of the SCI patient by medical professionals should be ongoing to prevent these kinds of secondary conditions from developing. This can lead to a lifetime of continual care and medical bills, so any settlement or judgment should reflect the need for future care for the SCI patient.

Source: Christopher & Dana Reeve Foundation, "Secondary conditions," accessed July 22, 2016

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