A spinal cord injury (SCI) is damage to any part of the spinal cord or nerves at the end of the spinal canal. This causes temporary or more often permanent changes in strength, sensation and other body functions below the site of the injury.
There are two kinds of spinal cord injury - complete and incomplete. In a complete injury, a person loses all sensory and motor function. In an incomplete injury, there is some functioning below the level of the injury.
A SCI can occur as a result of trauma, such as a road traffic accident, severe assault, or fall from a great height. Diseases such as polio or spina bifida will also cause spinal injury. Depending on the severity of the injury, a person may make a full recovery or become completely paralysed.
Imaging using CT and MRI will be used to determine what level the spinal injury has occurred at.
A neurological examination will be undertaken to determine the physical deficits of the injury.
After a trauma, a patient will be treated in an acute setting to stabilise them before starting a specific programme of rehabilitation. This will include orthotic assessment and provision of appropriate orthoses.
In the acute phase of treatment following injury PRAFOs (pressure relieving ankle foot orthoses) may be prescribed to maintain the range of motion at the foot and ankle while a patient is in hospital. These can also reduce risk of pressure sores.
Spinal injury patients require further more long term orthotic treatment during their rehabilitation and beyond. What is required will depend on the level of injury. Each patient must, therefore, be carefully assessed by one of our experienced clinicians to determine what orthotic treatment is best suited to them. This may include a gait assessment in our video vector Gait Lab to accurately assess dynamic movement. The range of treatments available include:
- a spinal brace, used to maintain the alignment of the spine, and provide stability;
- lower limb orthoses include AFOs (ankle foot orthoses) and KAFOs (knee ankle foot orthoses) to control the foot, ankle, knee and hip to restore and optimise gait;
- resting orthoses, , such as KAFO's gaitors (for arms or legs) and night AFOs, are typically used overnight, or during rest in the day. These maintain muscle length and range;
- FES (functional electrical stimulation), used to stimulate weaker or affected muscles to function in a more normal pattern;
- foot orthoses or shoe adaptations can provide comfort, improve alignment and mobility.