Post Spinal Cord Injury Care

Post-spinal cord injury (SCI) care is a lifelong, multidisciplinary process designed to maximize a patient’s independence, prevent complications, and promote overall well-being. This comprehensive care begins immediately after the injury and continues through every stage of life.

Acute Phase (Immediately After Injury)

The initial focus is on medical stabilization at a trauma center. This includes immobilizing the spine to prevent further damage, managing respiratory and cardiovascular function (which can be critically impaired, especially in high-level injuries), and often administering high-dose corticosteroids if within the appropriate time window. Surgical intervention may be required to decompress the spinal cord, stabilize fractured vertebrae with hardware, and clean the wound.

Subacute/Rehabilitation Phase

Once stable, patients transfer to a specialized rehabilitation facility. This is a period of intensive, goal-oriented therapy:

• Physical Therapy (PT): Focuses on strengthening remaining muscles, improving balance, and mobility training. This includes learning to use wheelchairs, walkers, or braces, and, for some, gait training.

• Occupational Therapy (OT): Teaches skills for Activities of Daily Living (ADLs), such as dressing, grooming, and eating. OTs also recommend adaptive equipment and teach techniques for transfers (e.g., from bed to chair).

• Medical Management: A relentless focus on preventing secondary complications is crucial. This includes:

  • Skin Care: Rigorous turning schedules and pressure-relief techniques to prevent life-threatening pressure injuries (bed sores).

  • Bladder Management: Intermittent catheterization or other methods to prevent urinary tract infections and preserve kidney function.

  • Bowel Management: Establishing a regular bowel program to maintain continence and prevent impaction.

  • Spasticity Management: Using medication, stretching, or injections to manage uncontrolled muscle contractions.

Long-Term/Chronic Phase (Community Reintegration and Lifelong Care)

Care shifts to outpatient and community settings, focusing on maintaining health and quality of life. This involves ongoing therapy, routine medical follow-ups (urology, physiatry), and vocational rehabilitation and psychological support to address the emotional impact of SCI. The care team expands to include the individual, their family, and personal care attendants, empowering them to manage their own health proactively.