Course Description:

SCI can result in physiological changes in any body system controlled by the affected nerves, including musculoskeletal, respiratory, urinary, gastrointestinal, and cardiovascular. Complete or incomplete tetraplegia or paraplegia can occur. Loss of supraspinal control can lead to numerous secondary complications, including spasticity, contractures, pain, and pressure ulcers. Cardiovascular and respiratory problems can result from loss of control of the autonomic system as well as from paralysis, immobility, and deconditioning. Prognosis depends on level and completeness of the lesion. In general, the life expectancy of patients with SCI is lower than that of the general population, with respiratory complications being the main cause of the increased mortality. A focus on prevention and early treatment of complications and comorbidities might include patient education, therapeutic exercise, pain management programs, and techniques to maximize pulmonary function. Precautions should include monitoring for signs and symptoms of autonomic dysreflexia, particularly in patients with high thoracic or cervical lesions, monitoring for skin breakdown, and prevention of deep vein thrombosis (DVT).