Mediaplanet: Spinal injuries are absolutely devastating to their victims. What are some of the repercussions of a spinal injury?

Steven Kirshblum: Most people see the loss of movement that occurs after a spinal cord injury (SCI). What they can no longer move or the function that correlates with that loss. It is important to recognize that a spinal cord injury causes more than that, but has an impact on the medical, psychological, social and vocational domains of the individual. There is a loss of sensation; loss of bowel and bladder function; changes in sexuality; with increased medical complications that can occur. There is an increased risk of developing depression, decreased involvement in work-related activities and socialization. Spinal cord injury affects not only the individual, but also the family and community around them. The costs to the individual, family and society are significant.

MP: What is one way that treatment of spinal injuries has changed in the last 10 years?

SK: Treatments over the last decade have changed in a number of ways. On the positive side: better management at the scene by emergency medical services, greater awareness by medical personnel of SCI related complications and treatments, better understanding of preventable complications and newer technology and innovative with intensive rehabilitation techniques to foster functional improvement.

"Spinal cord injury affects not only the individual, but also the family and community around them. The costs to the individual, family and society are significant."

Over the last few decades, we have seen greater survival of older individuals after sustaining a spinal cord injury, and an increase in neurologically incomplete (greater prognosis) as opposed to complete injuries. On the negative side, a significant change is less rehabilitation services at times being approved for individuals with SCI, which has an impact on function as well as return to work opportunities.

MP: How do you see treatment changing in the next ten years?

SK: There is a great amount of research currently taking place in the field of SCI that will impact the next decade. What was once considered a field of “doom and gloom,” is now a field filled with some optimism for improved neurological and functional gains. Areas of focus include in the basic sciences—the study of stem cells in the early and later stages after injury, as well as other medication to decrease the injury early after SCI. Modalities in rehabilitation, different exercises and intensity are being studied as well. Technology is also playing a major role in finding ways to increase function. This includes the continued refinement of robotic exoskeleton devices, implanted electrical stimulation devices and brain-computer interfaces.

MP: What are a few ways that our readers can improve the quality of life for their loved ones who are living with spinal injuries?

SK: For most people, quality of life is based upon experiencing limited medical complications and hospitalizations, and increased opportunity for involvement and family, work and social activities. Persons with physical disabilities are often viewed for what they can no longer be involved with. The goal, however, of rehabilitation and family involvement is to focus on what the individual can do and what can be achieved. To recognize the abilities and talents of the individual and engage in active roles as a family member, spouse, parent, etc. We live in a time of great change. There is optimism in the research, care and technology for the future. What will not change is the critical role the family plays in enhancing the life of the person with SCI.