Steps to Prevent Complications Following Spinal Cord Injury

Spine Expert Michael G. Fehlings, MD, PhD, provides his opinions and comments.

New research highlights ways to avoid complications following a spinal cord injury, as well information on recovery expectations, as described in the February issue of Current Neurology and Neuroscience Reports.

Common complications of spinal cord injury include pneumonia and other problems related to the lungs, cardiovascular disease, pressure ulcers, and blood clots called deep vein thrombosis (DVT, usually in the legs) and pulmonary embolism (lungs), reported Rochelle Sweis, DO, and José Biller, MD, both from the Loyola University Chicago Stritch School of Medicine.

“Spinal cord injury—whether from traumatic or nontraumatic causes—is quite devastating and can affect almost all the body systems,” commented Michael G. Fehlings, MD, PhD, who is Professor of Neurosurgery and Co-Director of the Spine Program at the University of Toronto in Ontario. Traumatic causes may include a vehicle accident or fall, while nontraumatic causes may include degenerative arthritis, tumors, hemorrhages (bleeding from a ruptured blood vessel), vascular malformation (abnormal clusters of blood vessels), and conditions such as multiple sclerosis.

Preventable Complications

There are many steps that doctors and people with spinal cord injury can take to prevent these complications, including the following:

  • Use of early range of motion and rehabilitation
  • Splinting and using braces and other devices
  • Bowel regimen and bladder program to help patients use the bathroom
  • Clearance of lung secretions
  • Use of mechanical ventilator support
  • Eating a healthy diet
  • Prevent pressure ulcers by moving position ever two hours, use of air mattresses, and periodic weight shifting while sitting

Patients play a vital role in preventing complications of spinal cord injury, Dr. Fehlings said.

“Many of these complications are preventable, and early recognition can improve outcomes,” Dr. Fehlings said. Good bladder care and avoiding pressure sores but not sitting too long in one position are examples of ways that people with spinal cord injury can help take care of their heath, Dr. Fehlings said.
Young boy passes robotic gait therapy in rehabilitation centerActive rehabilitation can help many patients with traumatic spinal cord injury. Photo Source:

Recovery Expectations

Recovery expectations are on the forefront of every person with a spinal cord injury. Among people with spinal cord injury who are not completely paralyzed, 80% stand by 12 months and 50% walk out of the hospital by 12 months, with improvements continuing for 2 years after injury, the researchers reported.

“Outcome really depends on where in the spinal the injury occurred and the degree of sensorimotor dysfunction,” Dr. Sweis said.

People who are younger typically have better expected outcomes than people who are older than 60 years. In general, life expectancy ranges from 1.5 years for patients who are ventilator-dependent and older patients (>60 years regardless of where in the spine the injury occurred) to 52.6 years for younger patients (age 20) with preserved motor function.

Stem Cell Research Shows Promise

“Recovery remains promising given recent results of stem cell implantation for high spinal cord injury patients, with studies showing return of some motor function,” Dr. Sweis said. “Continued research is a must as it can change the lives of patients.”

Updated on: 07/15/19
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