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Spinal Cord Injuries

Spinal Cord Injuries

A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury. Injury can occur at any level of the spinal cord and can be complete injury, with a total loss of sensation and muscle function, or incomplete, meaning some nervous signals are able to travel past the injured area of the cord. Depending on the location and severity of damage, the symptoms vary, from numbness to paralysis to incontinence. Long term outcomes also range widely, from full recovery to permanent tetraplegia (also called quadriplegia) or paraplegia. Complications can include muscle atrophy, pressure sores, infections, and breathing problems. In the majority of cases the damage results from physical trauma such as car accidents, gunshot wounds, falls, or sports injuries, but it can also result from nontraumatic causes such as infection, insufficient blood flow, and tumors. Just over half of injuries affect the cervical spine, while 15% occur in each of the thoracic spine, border between the thoracic and lumbar spine, and lumbar spine alone. Diagnosis is typically based on symptoms and medical imaging.

Efforts to prevent SCI include individual measures such as using safety equipment, societal measures such as safety regulations in sports and traffic, and improvements to equipment. Treatment starts with restricting further motion of the spine and maintaining adequate blood pressure. Corticosteroids have not been found to be useful. Other interventions vary depending on the location and extent of the injury, from bed rest to surgery. In many cases, spinal cord injuries require long-term physical and occupational therapy, especially if it interferes with activities of daily living.

Symptoms

Your ability to control your limbs after a spinal cord injury depends on two factors: the place of the injury along your spinal cord and the severity of injury to the spinal cord. The lowest normal part of your spinal cord is referred to as the neurological level of your injury. The severity of the injury is often called “the completeness” and is classified as either of the following:

• Complete: If all feeling (sensory) and all ability to control movement (motor function) are lost below the spinal cord injury, your injury is called complete.
• Incomplete: If you have some motor or sensory function below the affected area, your injury is called incomplete. There are varying degrees of incomplete injury.
Spinal cord injuries of any kind may result in one or more of the following signs and symptoms:
• Loss of movement
• Loss or altered sensation, including the ability to feel heat, cold and touch
• Loss of bowel or bladder control
• Exaggerated reflex activities or spasms
• Changes in sexual function, sexual sensitivity and fertility
• Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord
• Difficulty breathing, coughing or clearing secretions from your lungs

Emergency signs and symptoms

Emergency signs and symptoms of a spinal cord injury after an accident may include:
• Extreme back pain or pressure in your neck, head or back
• Weakness, in coordination or paralysis in any part of your body
• Numbness, tingling or loss of sensation in your hands, fingers, feet or toes
• Loss of bladder or bowel control
• Difficulty with balance and walking
• Impaired breathing after injury
• An oddly positioned or twisted neck or back

Causes

Spinal cord injuries may result from damage to the vertebrae, ligaments or disks of the spinal column or to the spinal cord itself. A traumatic spinal cord injury may stem from a sudden, traumatic blow to your spine that fractures, dislocates, crushes or compresses one or more of your vertebrae. It may also result from a gunshot or knife wound that penetrates and cuts your spinal cord. Additional damage usually occurs over days or weeks because of bleeding, swelling, inflammation and fluid accumulation in and around your spinal cord. A nontraumatic spinal cord injury may be caused by arthritis, cancer, inflammation, infections or disk degeneration of the spine.

Common causes of spinal cord injuries

The most common causes of spinal cord injuries in the United States are:
• Motor vehicle accidents: Auto and motorcycle accidents are the leading cause of spinal cord injuries, accounting for almost half of new spinal cord injuries each year.
• Falls: A spinal cord injury after age 65 is most often caused by a fall. Overall, falls cause about 31% of spinal cord injuries.
• Acts of violence: Over 13% of spinal cord injuries result from violent encounters, most commonly involving gunshot wounds. Knife wounds also are common.
• Sports and recreation injuries: Athletic activities, such as impact sports and diving in shallow water, cause about 10% of spinal cord injuries.
• Alcohol: Alcohol use is a factor in about 1 out of every 4 spinal cord injuries.
• Diseases. Cancer, arthritis, osteoporosis and inflammation of the spinal cord also can cause spinal cord injuries.
Risk factors
Although a spinal cord injury is usually the result of an accident and can happen to anyone, certain factors may predispose you to a higher risk of sustaining a spinal cord injury, including:
• Being male. Spinal cord injuries affect a disproportionate number of men. In fact, females account for only about 20% of traumatic spinal cord injuries in the United States.
• Being between the ages of 16 and 30. You’re most likely to suffer a traumatic spinal cord injury if you’re between the ages of 16 and 30. The average age at time of injury is 43 years.
• Being older than 65. Falls cause most injuries in older adults.
• Engaging in risky behavior. Diving into too-shallow water or playing sports without wearing the proper safety gear or taking proper precautions can lead to spinal cord injuries. Motor vehicle crashes are the leading cause of spinal cord injuries for people under 65.
• Having a bone or joint disorder. A relatively minor injury can cause a spinal cord injury if you have another disorder that affects your bones or joints, such as arthritis or osteoporosis.


At first, changes in the way your body functions may be overwhelming. However, your rehabilitation team will help you develop the tools you need to address the changes caused by the spinal cord injury, in addition to recommending equipment and resources to promote quality of life and independence. Areas often affected include:
• Bladder control. Your bladder will continue to store urine from your kidneys. However, your brain may not be able to control your bladder as well because the message carrier (the spinal cord) has been injured. The changes in bladder control increase your risk of urinary tract infections. The changes may also cause kidney infections and kidney or bladder stones. During rehabilitation, you’ll learn new techniques to help empty your bladder.
• Bowel control. Although your stomach and intestines work much like they did before your injury, control of your bowel movements is often altered. A high-fiber diet may help regulate your bowels, and you’ll learn techniques to optimize your bowel function during rehabilitation.
• Skin sensation. Below the neurological level of your injury, you may have lost part of or all skin sensations. Therefore, your skin can’t send a message to your brain when it’s injured by certain things such as prolonged pressure, heat or cold. This can make you more susceptible to pressure sores, but changing positions frequently — with help, if needed — can help prevent these sores. You’ll learn proper skin care during rehabilitation, which can help you avoid these problems.
• Circulatory control. A spinal cord injury may cause circulatory problems ranging from low blood pressure when you rise (orthostatic hypotension) to swelling of your extremities. These circulation changes may also increase your risk of developing blood clots, such as deep vein thrombosis or a pulmonary embolus. Another problem with circulatory control is a potentially life-threatening rise in blood pressure (autonomic hyperreflexia). Your rehabilitation team will teach you how to address these problems if they affect you.
• Respiratory system. Your injury may make it more difficult to breathe and cough if your abdominal and chest muscles are affected. These include the diaphragm and the muscles in your chest wall and abdomen. Your neurological level of injury will determine what kind of breathing problems you may have. If you have a cervical and thoracic spinal cord injury, you may have an increased risk of pneumonia or other lung problems. Medications and therapy can help prevent and treat these problems.
• Muscle tone. Some people with spinal cord injuries experience one of two types of muscle tone problems: uncontrolled tightening or motion in the muscles (spasticity) or soft and limp muscles lacking muscle tone (flaccidity).

• Fitness and wellness. Weight loss and muscle atrophy are common soon after a spinal cord injury. Limited mobility may lead to a more sedentary lifestyle, placing you at risk of obesity, cardiovascular disease and diabetes. A dietitian can help you eat a nutritious diet to sustain an adequate weight. Physical and occupational therapists can help you develop a fitness and exercise program.
• Sexual health. Sexuality, fertility and sexual function may be affected by a spinal cord injury. Men may notice changes in erection and ejaculation; women may notice changes in lubrication. Physicians specializing in urology or fertility can offer options for sexual functioning and fertility.
• Pain. Some people experience pain, such as muscle or joint pain, from overuse of particular muscle groups. Nerve pain can occur after a spinal cord injury, especially in someone with an incomplete injury.
• Depression. Coping with all the changes a spinal cord injury brings and living with pain causes some people to experience depression.
Prevention
Following this advice may reduce your risk of a spinal cord injury:
• Drive safely: Car crashes are one of the most common causes of spinal cord injuries. Wear a seat belt every time you drive or ride in a car. Make sure that your children wear a seat belt or use an age- and weight-appropriate child safety seat. To protect them from air bag injuries, children under age 12 should always ride in the back seat.
• Check water depth before diving. To make sure you don’t dive into shallow water, don’t dive into a pool unless it’s 12 feet (about 3.7 meters) or deeper, don’t dive into an aboveground pool, and don’t dive into any water of which you don’t know the depth.
• Prevent falls. Use a step stool with a grab bar to reach objects in high places. Add handrails along stairways. Put nonslip mats on tile floors and in the tub or shower. For young children, use safety gates to block stairs and consider installing window guards.
• Take precautions when playing sports. Always wear recommended safety gear. Avoid leading with your head in sports. For example, don’t slide headfirst in baseball, and don’t tackle using the top of your helmet in football. Use a spotter for new moves in gymnastics.
• Don’t drink and drive. Don’t drive while intoxicated or under the influence of drugs. Don’t ride with a driver who’s been drinking.

Spinal Cord Injury Attorney

It is important to know that if the police officer at the scene gives you a ticket, you are not automatically at fault for the accident. You will most likely be found at fault when the insurance company looks at the facts, but know a ticket is not barred to recovery. If you were a pedestrian involved in an auto-pedestrian accident, you can always speak to an attorney.

Police Report

If you have been in an accident you probably received a driver exchange information form from the police officer who came to the scene. That information can be immensely helpful when the case is just beginning because it lists the other driver and his or her insurance information. If your accident required a police investigation your attorney will need a copy of the police report as a pivotal piece of evidence. Your attorney can request a copy of the police report from the agency involved because police reports are public records, but it will save time and money if you already have it.

Accident Reports from Private Parties

If you have been injured on private property like a retail store or a hotel most companies will require management to record and file an accident report. That report could become a key piece of evidence in your case, and your lawyer will definitely need it. If you have a copy, bring it to your first meeting.

Claim Numbers and Insurance Information

Insurance companies are at the center of most personal injury claims. If you have filed a claim on your accident, please bring the documentation to your first appointment so that the attorney can send the insurance company a letter saying the firm represents you and communicate with an insurance company on your behalf.

Any Medical Records and Bills

If you have been injured you cannot receive compensation until you have been diagnosed and treated. Your attorney will need to track down all of your medical records and all of your medical bills before the claim can be settled. Bring any medical records and bills you have acquired since the accident. The most common form is a hospital discharge form. If you are still being treated your attorney will need the names and addresses of all of your medical providers so that they may collect the necessary documents.

Photographs

Personal injury claims are built and destroyed on the strength of the evidence the parties provide. Any evidence, such as photographs of the scene and photographs of injuries, can help your attorney build your case. Your attorney will spend a lot of time tracking down first-hand evidence such as photographs. If you have any bring them with you to your first appointment

Any Other Accident-Related Documents

It seems like attorneys have a love affair with paperwork that is only surpassed by the love affair insurance adjusters have with the stuff. In personal injury claims you will deal with both lawyers and insurance companies, so documentation is key. Any documents related to your accident will be important to your claim. For the first meeting bring your attorney everything you have.

Mistakes To Avoid When Negotiating Personal Injury Settlements

Coming to the Negotiating Table without an Advocate – I am not going to tell you that you cannot settle your personal injury claim alone. You can do what you want, and simple claims can be settled without an attorney, but hiring a personal injury attorney is one of the best things you can do for yourself. Parties who hire representation tend to receive higher settlements and have an easier time managing the personal injury claim process than those who do not. First, an attorney knows all of the procedural hurdles you will face during the process. If you happen to miss a step, it could be disastrous for your claim. Second, attorneys know how much your claim should be worth. They will not let you take a lower settlement than you deserve without warning you first.
Just remember to never admit that the accident was your fault, and never apologize for the accident. Insurance adjusters negotiate settlements for a living. They are very good at it. Do not give them ammunition with which to crush you. Always be pleasant and cooperative, but do not admit that the accident was your fault until the insurance adjuster proves it. It is your job to make the other side prove their claims.
During negotiations, you will want to appear confident, but not mean or condescending. A good attitude will get you everywhere.

If the insurance adjuster makes an offer that appears too good to be true, it is probably going to turn out to be a terrible settlement offer. It is hard to know how much a claim is worth early in the process before you have received most of your medical treatment. It is important not to accept a settlement offer until you have gotten all the facts. Often, an insurance adjuster can spot you as a new negotiator coming and will attempt to placate you with a quick offer that is much smaller than it should be hoping that you will take the bait and save the insurance company time and money.

If you receive a letter, phone call or email from an insurance adjuster or an opposing party, respond as soon as you are able. If you say nothing for weeks or months, the offer may no longer be available when you contact them.

You can turn down an offer that you think is too low. You can reject the offer and make a counteroffer. Do not enter a negotiation without plans to actually negotiate. Be prepared to advocate for yourself.
Posting Details of the Negotiation Process on Social Media
Settlement negotiations are always confidential. Do not speak or post anything about them before or after you reach a settlement. Talking about the settlement and its negotiation can void your settlement.

You cannot come to the negotiating table without being prepared to make concessions. Personal injury settlements are figured along pre-determined lines. If you are hoping to become a millionaire without need a million dollars in compensation. You will fail.

Spinal Cord Injury Attorney

When you need legal help with recovering for spinal cord injuries, please call Ascent Law LLC for your free consultation (801) 676-5506. We want to help you.

Michael R. Anderson, JD

Ascent Law LLC
8833 S. Redwood Road, Suite C
West Jordan, Utah
84088 United States

Telephone: (801) 676-5506

Ascent Law LLC

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