Because of legal restrictions, MOMSCIS cannot give specific medical advice. The following information is not a substitute for the personal care or advice of your physician. Please discuss any concerns with your physician regarding your medical care. Physicians in the Physical Medicine & Rehabilitation Department at the University of Missouri-Columbia are available to evaluate patient records, and can set up a clinic visit for a medical evaluation. The PM&R Department does extensive treatment of individuals with spinal cord injuries using a wide variety of physical therapies and state-of-the-art medications. Individuals with spinal cord injuries can be examined and treated on an outpatient or inpatient basis. For more information about the PM&R services available or to schedule a clinic visit, telephone the clinic at (573) 884-0033.

SCI and life expectancy

Q. How will spinal cord injury affect my life expectancy and health?

A. The Model Spinal Cord Injury System of Care program has more than 20 years of information about life expectancy after spinal cord injury. If a person survives the first 24 hours after the spinal cord injury, studies show an impressive average life expectancy depending on the severity of injury and the level of neurologic damage. In general, while the average life expectancy of individuals with spinal cord injuries is shorter than that of the general population, some live to within ten years of the life expectancy of the general population. This is especially true for individuals whose injuries are at the C5 level or below and who breathe without the aid of a ventilator. For example, if the average life expectancy of an able-bodied 20-year-old is 77 years, then a 20-year-old with a complete C7 spinal cord injury could expect to live into her/his 60s or beyond.

The point to keep in mind is that individuals with spinal cord injuries can live into the elderly stages of life because of the availability of good health care as well as advancements in prevention, early identification, and treatment of complications of spinal cord injury.

The decrease in physical activity that one experiences after spinal cord injury can cause health problems. The cardiovascular system becomes less able to respond to increased exertion, although this influences individuals with spinal cord injury less because they are less likely than the general population to overexert themselves. Individuals with spinal cord injuries can experience unhealthy weight gain and/or difficulty losing weight. Other factors influencing the health of individuals with spinal cord injuries include complications related to bowel and bladder management as well as nutrition and skin maintenance. These complications influence level of functioning, type and amount of attendant care needed, and enjoyment of life. If severe, these complications can negatively affect life expectancy. Regular bowel and bladder programs, good nutrition, and good skin maintenance minimize complications of spinal cord injuries.

Q. What are the leading causes of death of persons with spinal cord injuries?

A. Twenty to 25 years ago, the major cause of death of individuals with spinal cord injury was kidney failure. Because of good bladder management programs, screening for complications, and early treatment for complications of neurogenic bladder, kidney failure has been reduced to the point that it is no longer in the top four causes of death for individuals with spinal cord injuries. Today, pulmonary complications including pneumonia, pulmonary embolus, and infection spread from the lungs to the blood stream are the leading causes of death. These causes of death also are prevalent in the general population. For the most up-to-date information on life expectancy and leading causes of death for persons with spinal cord injury, visit the model spinal cord injury system web site at http://www.spinalcord.uab.edu/ and then click on the "Facts & Stats" link.

Q. What can I do to improve my health and life expectancy?

A. Individuals' healthy and unhealthy habits ultimately determine their health and life expectancy. For individuals with spinal cord injuries, healthy habits include physical activity appropriate to their neurologic level of injury. At a minimum, this means performing range-of-motion and, if possible, voluntary muscle exercises. Other healthy habits include maintaining regular, adequate bowel programs and avoiding excessive constipation. A good bladder management program, preventing urinary tract infections, and preventing backup of urine to the kidneys will help sustain healthy kidney function into older age. Healthy diet and proper nutrition also are important. A diet low in fat and processed carbohydrates, high in complex carbohydrates and protein is important. A healthy diet also includes sufficient fiber to promote proper bowel function as well as helping to maintain good bowel programs. For healthy lungs, avoid cigarette smoking and secondhand smoke. Finally, annual checkups with a physician familiar with spinal cord injury issues are beneficial and provide the opportunity to gain additional information about staying healthy.

There are many different factors influencing the health and life expectancy of individuals with spinal cord injuries. Each individual needs to decide how s/he can improve her/his health and take steps to improve it; this can be done individually, in a group setting, or in concert with a health care provider familiar with spinal cord injury. You are on the right track with these questions. I encourage you to continue pursuing information about what you can do to have a healthy life with fewer medical problems. I applaud your decision to take an active role in adopting and maintaining a healthy life style.