Return of function/feeling

[Shawn]

If a person receives some return of function or feeling below the level on injury, is it possible that it could fade away? If so, what causes this and how can it be prevented? What happens as one get's older? http://sci.rutgers.edu/forum/images/smilies/rolleyes.gif

[Shawn]

SCI-Nurse or Dr. Young - please provide some answers or information to my question's on return of function/feeling. Everybody else is also welcome to respond. Thank you in advance. http://sci.rutgers.edu/forum/images/smilies/wink.gif

[Wise Young]

Shawn,

There is relatively little data on the subject of recovery and loss of function after spinal cord injury. Traditional medical dogma holds that recovery of function does not occur after spinal cord injury. Much of rehabilitation is designed to make the most of remaining function rather than restoring function that has been lost.

However, we know that many people do recover substantial function after spinal cord injury, often many years after injury. The reasons for such spontaneous recovery, often without any significant therapy, are unclear.

Almost every person with spinal cord injury that I have met can describe some functional change that have occurred to them beyond a year after injury. Some get motor or sensory function far below the injury site. It may show up in the form of better postural control, changes in temperature control, sweating in parts of the body that did not before, a change in spasticity or spasms...

There is some data that suggest that a majority of people with spinal cord injury lose some kind of function. There was a study (I will try to find it) that did electrophysiological studies to assess the causes of such loss. The study showed that peripheral nerve injuries account for a substantial number of such changes.

The statistics are not clear but , in my experience, a substantial number (perhaps as many as 15%) of people with spinal cord injury lose function due to continued damage to the spinal cord from syringomyelic cyst expansion and possibly tethering and adhesions.

An expanding cyst below the injury site may cause a loss of spasticity and spasms. An expanding cyst above the injury site may be associated with an ascent of the sensory level and increasing weakness in muscle groups close to the injury level. You should be fairly aggressive about finding out the cause of any change in your function, particularly if you are losing any function.

In my opinion, people should be getting regular MRI's of their spinal cords for the following reasons. First, multiple MRI's will allow doctors to evaluate the time course of changes. A syrinx that was there for five years and did not change would be viewed differently from a syrinx that has just appeared or is enlarging over a period of several months, associated with neurological changes. Second, changes of your spinal cord can occur. For example, parts of the spinal cord above and below the injury site should get narrower. Third, people with spinal cord injury have a much higher incidence of back and spinal problems.

There is a tendency for doctors and people themselves to assume that everything that happens to them is due to the spinal cord injury. Be careful not to fall into this trap. People with spinal cord injury have other health problems. They can get cancer, heart disease, diabetes, digestive problems, infections, aging, colds, flue, etc. that other people do. These can contribute to loss of function. Likewise, many of the problems may arise from medication that people with spinal cord injury take.

Finally, I strongly believe that people with spinal cord injury can and should be healthy. Most people assume that spinal cord injury is some form of illness. It is not an illness. Health is an important step to recovery of function. By taking care of your body, eating well, and exercising regularly, you should get more functional recovery.

Wise.