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Spinal cord injury (SCI)

Complications

If you recently experienced a spinal cord injury, it might seem like every aspect of life just became a lot more complicated. After all, adapting to life with a disability — often in a wheelchair — is no easy task.

You'll likely experience many thoughts and emotions after injury. And you'll likely have concerns about how your injury will affect your lifestyle, your financial situation and your personal relationships. Grieving and emotional stress are normal and common. However, if your grief and sadness are affecting your personal care, causing you to isolate yourself from others, or prompting you to abuse alcohol or other drugs, it's time to seek help. People with a spinal cord injury abuse alcohol at about twice the rate that the general population does. Depression also is common.

• Depression

• Incontinence, bowel

• Incontinence, fecal
• Incontinence, urinary

Other complications of a spinal cord injury may include:

• Urinary tract problems. A spinal cord injury that affects nerves that run to the bladder can cause urinary incontinence — the inability to control the release of urine from your bladder. Loss of bladder control increases your risk of urinary tract infections. It may also cause kidney infection and kidney or bladder stones. Drinking plenty of clear fluids and using a catheter — a thin, soft tube that you insert into your urethra and bladder to drain your urine — several times a day may help.

• Bowel management difficulties. After a spinal cord injury, voluntary control of the bowels may be lost or impaired. This can make it difficult for stool to move through your intestines, or it can result in fecal incontinence — the inability to control your bowel movements. Eating a high-fiber diet can help regulate your bowels. Medications and other products are also available to manage waste elimination.

• Pressure sores. Sitting or lying in the same position for a long period of time can cause pressure sores, which are also called decubitus ulcers or bedsores. People with a spinal cord injury are particularly susceptible to pressure sores because the injury reduces or eliminates sensations, making it difficult to know when a sore is developing. Changing positions frequently — with help, if needed — is the best way to prevent these sores.

• Deep vein thrombosis and pulmonary embolism. Sitting for long periods of time can also decrease blood flow through the veins and cause blood clots to form. These blood clots can develop in a vein deep within a muscle (deep vein thrombosis), and they can lead to a blocked pulmonary artery in the lungs (pulmonary embolism). Large clots that block blood flow can be fatal, so people with spinal cord injury may need devices or medications to try to prevent clotting.

• Lung and breathing problems. It's more difficult to breathe and cough with weakened abdominal and chest muscles, so people with cervical and thoracic spinal cord injury may develop pneumonia, asthma or other lung problems. Medications and therapy can treat these problems. In some instances, people with spinal cord injury may also need a yearly flu shot or other immunizations.

• Autonomic dysreflexia. Spinal cord injury above the middle of the chest may cause a condition called autonomic dysreflexia. This dangerous condition occurs when an irritation or pain below the level of the injury and the irritated area sends a signal that fails to reach the brain, producing a reflex action that can constrict blood vessels. The result is a rise in blood pressure and a drop in heart rate that can result in stroke or seizure. Changing positions or eliminating the cause of the irritation — which can be something as simple as a full bladder or tight clothes — can help.

• Spasticity. Some people with spinal cord injury develop muscle spasms and jumping of their arms and legs. Unfortunately, this doesn't mean that they're recovering. These exaggerated reflexes occur because some of the nerves in the lower spinal cord become more sensitive after injury and cause muscle contractions. However, because of the spinal cord injury, the brain can no longer send signals to the lower nerves to regulate the contractions. Medical treatments may be needed if spasms become severe.

• Weight control issues. After a spinal cord injury, weight loss and muscle atrophy are common. But the change in lifestyle and activities may eventually cause weight gain, which can make it difficult for you to lift yourself — or be lifted — from place to place and put you at risk of heart disease and other problems. It's a good idea to develop an exercise and diet plan with assistance from a dietitian and rehabilitation therapist.

• Sexual dysfunction. Many men with a spinal cord injury still have erections, even men with little sensation in the genital area. But the erections may not be firm enough or last long enough for sexual activity. Fertility also can be affected. Ninety percent of men with a spinal cord injury aren't able to ejaculate during intercourse. However, this doesn't mean that men with a spinal cord injury can't be sexually active or father a child. Doctors, urologists and fertility specialists who specialize in spinal cord injury can offer options for better sexual functioning and fertility. Women with a spinal cord injury also may benefit from seeing a doctor about changes in their sexuality and fertility. There's usually no physical change in women with a spinal cord injury that inhibits sexual intercourse or pregnancy. But women may lose the ability to produce vaginal lubrication or have orgasms, and any pregnancy will likely be considered high risk. It's important to talk with a doctor before becoming pregnant.

• Pain. You may experience pain as a result of damage to your spinal cord or other parts of your body during your accident. It's even possible to feel pain in areas of your body where there's little or no sensation. People with lower spinal cord injuries and those who were injured by gunshot tend to experience more pain than others do. Anyone with a spinal cord injury can also experience pain from overusing muscles in one part of the body. Many people develop shoulder tendinitis from manually operating a wheelchair for a long period of time. Any kind of pain can have a negative impact on daily living. Medications and modified activities can help manage pain.

• New injuries. People with a spinal cord injury are susceptible to injury of any part of the body that has impaired sensation. Someone with a spinal cord injury may even receive a burn or cut without realizing it. Take steps to prevent new injuries and to inspect your body for any cuts or sores that need medical attention.

• Asthma

• flu

• Pneumonia

• Pulmonary embolism

• Stroke

• Urinary tract infection - (UTI)

• Urinary incontinence

Spinal cord injury (SCI) > 1 > 2 > 3 > 4

 

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