Spinal Cord Injury Resource Center

Our lawyers’ at Keller & Keller advance these cases everyday and are familiar with the specific needs of spinal cord injury litigation. We have summarized the type of injury, its classification and prognosis based on the severity of the injury. We have also gathered vital information on coping with the personal and financial effects of a spinal cord injury, which may be difficult to deal with without the proper preparation.

Spinal Cord Injuries (SCI) occurs when a traumatic event results in damage to cells within the spinal cord or severs the nerve tracts that relay signals up and down the spinal cord.

Spinal cord injuries occur in approximately 12,000 to 15,000 people per year in the U.S. About 10,000 of these people are permanently paralyzed, and many of the rest die as a result of their injuries. Most spinal cord trauma occurs to young, healthy individuals. Males between 15 and 35 years old are most commonly affected.

As a spinal cord injury is very serious it is important to examine your medical treatment options. The Treatment Options section describes the different types of treatments such as medication, rehabilitation, and clinical trial information. In our Financial Assistance section, we discuss how patients and their families may be helped with medical bills and financial concerns. Keller & Keller has been helping families cope with serious injuries since 1936.

Helping the Spinal Cord Injury Community
The tragic events that forever changed Samantha's life and that of her family also changed the life of Indianapolis lawyer Jim Keller. Jim represented Samantha following the car accident that caused her spinal cord injury. Like everyone that meets Samantha and her loving family, Jim was touched by their situation and wanted to help make a difference. Many Indianapolis business and civic leaders joined forces to build a new home for Samantha equipped with the access and technology necessary to meet her medical needs.

The Samantha’s House Foundation is an organization that helps seriously injured people in Central Indiana improve their surroundings and make their everyday life just a little easier. This community wide effort started when little Samantha Allen was involved in a tragic accident.

Samantha was hit by a car crossing the street and is confined to a wheelchair with the same type of spinal cord injury suffered by the late Christopher Reeve. She requires 24-hour medical care and needed a house that would meet her significant medical and daily living needs.

Thus, the Samantha’s House Foundation was born. With the help of community leaders and everyday people, money was raised to that would meet the everyday challenges that any other little girl or boy would take for granted. Learn more about her story at: www.samanthashouse.com

The spinal cord does not have to be severed in order for a loss of functioning to occur. In fact, in most people with SCI, the spinal cord is intact, but the damage to it results in loss of functioning. SCI is very different from back injuries such as ruptured disks, spinal stenosis or pinched nerves.

A person can "break their back or neck" yet not sustain a spinal cord injury if only the bones around the spinal cord (the vertebrae) are damaged, but the spinal cord is not affected. In these situations, the individual may not experience paralysis after the bones are stabilized.

Classification & Terminology

The effects of SCI depend on the type of injury and the level of the injury. SCI can be divided into two types of injury - complete and incomplete.

Complete: A complete injury means that there is no function below the level of the injury; no sensation and no voluntary movement. Both sides of the body are equally affected.

Incomplete: An incomplete injury means that there is some functioning below the primary level of the injury. A person with an incomplete injury may be able to move one limb more than another, may be able to feel parts of the body that cannot be moved, or may have more functioning on one side of the body than the other. With the advances in acute treatment of SCI, incomplete injuries are becoming more common.

The following terminology has developed around classification of SCI:

• Tetraplegia (replaced the term quadriplegia) - Injury to the spinal cord in the cervical region with associated loss of muscle strength in all 4 extremities
• Paraplegia - Injury in the spinal cord in the thoracic, lumbar, or sacral segments, including the cauda equina and conus medullaris

Other terms you may encounter include:

ALIF
Anterior Lumbar Interbody Fusion - is the placement of bone or cages between vertebrae from an anterior approach.

Annulus
The outer portion of a disc in the spinal column, the annulus provides structure and strength to a disc and is comprised of a complex series of interwoven layers of fibrous tissues, which hold it's nucleus in place.

Anterior
Refers to the frontal or ventral surface of the body.

Arthroscopic Lumbar Discectomy
PLD using an endoscope for visualization.

Autograft
This refers to bone taken from the patient, usually the hip, to be used as graft.

Bone Graft
An option for fusing the spine. This requires either moving bone from one part of the body (autograft) or using bone from an outside source (allograft).

Cat Scan
Computerized x-ray system which provides cross-sectional images of the spine or other parts of the body. Sometimes is done following a myelogram or discogram.

Cervical
Pertains to the neck.

Conservative Therapy
Method of relieving pain with bed rest, analgesics and chiropractic and physical therapy.

Degenerative Disc Disease
Deterioration in disc structure and function, which commonly causes pain and loss of function.

Diagnostic
Test or process used to determine the source of a problem, i.e., a diagnosis.

Disc
Discs serve as shock absorbers between the vertebrae of the spinal column. The center of the disc is known as the nucleus and the outer ring of the disc is called the annulus.

Discectomy
The procedure where a disc is removed surgically.

Discogram
Provocative discography is the instillation of sterile saline (not dye) into the disc to try and reproduce the patient's pain.

Dorsal
Refers to a position toward the posterior or back side of the body.

Fusion
Growth of bone where bone does not normally grow, as in replacing a disc with a bone graft. The bone graft is normally taken from the patient or a donor.

Herniated Disc
AKA a slipped disc, is a condition in which nucleus tissue is moved from the center of a disc into the spinal canal. Herniated discs cause great pain in the low back and leg or the neck and arm and they create pressure against one or more of the spinal nerves. Other names for herniated discs are prolapsed discs or ruptured discs.

Interbody Fusion
Placing of a graft or cages between vertebral bodies.

Kyphoplasty
A surgical procedure designed to stop the pain caused by the bone fracture, stabilize the bone, and to restore the lost vertebral body height due to the compression fracture.

Laminectomy
Surgery technique in which part of the back of the vertebra is removed in order to reach to the nerves and discs. This may or may not require the disc be removed as part of the procedure.

Ligaments
This is bands of fibrous tissue that connect bones or cartilages that support and strengthen the bone joints. Ligaments surround the spine on all sides.

Lumbar
This refers to the lower back.

Microdiscectomy
Surgical technique for removal of a disc via a small opening using a microscope.

Morbidity
Refers to postoperative pain and complications from to surgery.

MRI Scan
Computerized magnetic imaging system that provides cross-sectional images of the spine or other body parts.

Myelogram
Diagnostic procedure in which an iodine is injected as a dye into the spinal canal and shows up on x-rays that are taken.

Nucleus
The center part of a disc and is made of a soft, rubber-like material that takes the shock of movement such as standing, walking, running, etc.

Pedicle Fixation
Invlolves placing bone screws into the spine from a posterior approach through what is known as the pedicle. Screws are then used with a rod or plate to keep the spine stable following bone grafting.

Percutaneous Cervical Discectomy
An outpatient procedure that uses minimally-invasive suction to remove herniated cervical discs.

Percutaneous Lumbar Discectomy
PLD using an endoscope for visualization.

PLIF
Stand for Posterior Lumbar Interbody Fusion, which is the placement of bone or cages between vertebrae from a posterior approach.

PLITF
Stands for Posterior Lateral Inter-Transverse Process Fusion, which involves the placement of bone graft on and between transverse process of vertebrae to promote bone fusion.

Porous
Surface area amount which allows for bone growth from the implant.

Posterior
This term refers to the back or dorsal surface of the body.

Prolapsed Disc
AKA a slipped disc, is a condition in which nucleus tissue is moved from the center of a disc into the spinal canal. Herniated discs cause great pain in the low back and leg or the neck and arm and they create pressure against one or more of the spinal nerves. Other names for herniated discs or ruptured discs.

Ruptured Disc
See above

Sacrum
This is the lower portion of the spinal column.

Slipped Disc
See Ruptured Disc.

Spinal Cord
This is the primary nervous system, that runs from base of the skull to the lower back via the spinal canal. Problems or impingement of bony or soft tissues on cord or nerve roots is primary reason for spine surgery.

Spinal Fusion
Surgical treatment for back pain in which the disc between two adjacent vertebrae is removed. Then two vertebrae are fused using bone graft and instrumentation methods.

Spine
This is the structure composed of vertebrae, discs, and ligaments. It contains 26 vertebrae in five separate regions. There are 7 cervical, 12 thoracic, 5 lumbar, 1 sacral, and 1 coccygeal vertebrae. The primary function of the spine are body support and spinal cord protection.

Spinal Column
Longitudinal skeletal axis of the human body that is composed of 26 distinct bones which are called vertebrae.

Therapeutic
A procedure which is related to the treatment of disease in the human body.

Thoracic Spine
The twelve vertebrae in mid-torso that are attached to the rib cage.

Thorax
The portion of the chest composed of the spine, ribs and, breast bone.

Titanium Alloy
This is a very bio-compatible material with great fatigue strength and good imaging characteristics.

Vertebra
This a bone that is used as a building block for the spinal column.

Vertebral Column
The longitudinal skeletal axis of the body that is composed of 26 distinct bones which are called vertebrae.

The level of injury is very helpful in predicting what parts of the body might be affected by paralysis and loss of function. Remember that in incomplete injuries there will be some variation in these prognoses.

Neck: Cervical (neck) injuries usually result in quadriplegia.

C-1 to C-4: These very high injuries (C-1, C-2) can result in a loss of many involuntary functions including the ability to breathe, necessitating breathing aids such as mechanical ventilators or diaphragmatic pacemakers.

C-5: C-5 injuries often result in shoulder and biceps control, but no control at the wrist or hand. C-6: C-6 injuries generally yield wrist control, but no hand function.

C-7 and T-1: Individuals with C-7 and T-1 injuries can straighten their arms but still may have dexterity problems with the hand and fingers. Injuries at the thoracic level and below result in paraplegia, with the hands not affected.

T-1 to T-8: At T-1 to T-8 there is most often control of the hands, but poor trunk control as the result of lack of abdominal muscle control.
T-9-T12: Lower T-injuries (T-9 to T-12) allow good truck control and good abdominal muscle control. Sitting balance is very good. Lumbar and Sacral injuries yield decreasing control of the hip flexors and legs.

Besides a loss of sensation or motor functioning, individuals with SCI also experience other changes. For example, they may experience dysfunction of the bowel and bladder. Men with SCI may have their fertility affected, while women's fertility is generally not affected.

Other effects of SCI may include low blood pressure, inability to regulate blood pressure effectively, reduced control of body temperature, inability to sweat below the level of injury, and chronic pain.

Medication
Corticosteroids, such as dexamethasone or methylprednisolone, are used to reduce swelling that may damage the spinal cord. If spinal cord compression is caused by a mass (such as a hematoma or bony fragment) that can be removed or brought down before there is total destruction of the nerves of the spine, paralysis may in some cases be reduced or relieved. Ideally, corticosteroids should begin as soon as possible after the injury.

Surgery
Surgery may be necessary. This may include surgery to remove fluid or tissue that presses on the spinal cord (decompression laminectomy). Surgery may be needed to remove bone fragments, disc fragments, or foreign objects or to stabilize fractured vertebrae (by fusion of the bones or insertion of hardware).

Bedrest
Bedrest may be needed to allow the bones of the spine, which bears most of the weight of the body, to heal.

Traction / Immobilization
Anatomic realignment is important. Spinal traction may reduce dislocation and/or may be used to immobilize the spine. The skull may be immobilized with tongs (metal braces placed in the skull and attached to traction weights or to a harness on the body).

Physical Therapy / Rehabilitation
Extensive physical therapy, occupational therapy, and other rehabilitation interventions are often required after the acute injury has healed. Rehabilitation assists the person in coping with disability that results from spinal cord trauma.

To find out more about clinical trials, ask your cancer care team. Among the questions you should ask are:

• What is the purpose of the study?
• What kinds of tests and treatments does the study involve?
• What does this treatment do?
• What is likely to happen in my case with, or without, this new research treatment?
• What are my other choices and their advantages and disadvantages?
• How could the study affect my daily life?
• What side effects can I expect from the study? Can the side effects be controlled?
• Will I have to be hospitalized? If so, how often and for how long?
• Will the study cost me anything? Will any of the treatment be free?
• If I am harmed as a result of the research, what treatment would I be entitled to?
• What type of long-term follow-up care is part of the study?
• Has the treatment been used to treat other types of cancers?
  

Car accident / SUV Rollovers

Compensation may be recovered for individuals involved in a SUV rollover accident or in certain car accident cases. Financial security for the patient and the family is often made possible by these efforts which can be in the millions of dollars.

Disability Insurance

Disability claims may be filed if one has such insurance either privately or through an employer.

Social Security Disability

Disability claims can be filed with the federal social security system.

Worker's Compensation

If the injury can be linked to a particular job-site can a worker's compensation claim be filed against an employer. It is also possible that a worker's compensation claim will conflict with the pursuit of other legal remedies, so it is advisable to consult with an attorney before pursuing this or any other avenue of monetary recovery.