Spinal Cord Injuries

What is a spinal cord injury (SCI)?

A spinal cord injury occurs when there is a disruption of the nerves of the spinal cord. This can happen in a variety of ways; some examples are:

Trauma (ex. motor vehicle accident)
Tumor
Infection
Inflammation (ex. transverse myelitis)
Neurologic disorder (ex. multiple sclerosis)

What happens to your body after SCI?

The spinal cord sends signals from your brain to the rest of your body and from your body to your brain. When there is an injury to these pathways, these signals may not get through. This can lead to changes in how the body works and you might see:

Paralysis (weakness or inability to move certain muscles)
Sensory changes (decreased or absent sensation in certain areas)
Neurogenic bladder (change in bladder control)
Neurogenic bowel (change in bowel control)
Respiratory difficulties (trouble breathing or coughing)

How is SCI treated?

Children or adolescents with a new spinal cord injury require emergent management and are usually treated first in an intensive care unit. Rehabilitation begins early to maximize neurologic recovery and prevent complications. Once more stable, aggressive rehabilitation begins with a focus on physical and psychological recovery with the goal to return to everyday life as independent as possible.

Key components of SCI treatment include:

Physical therapy for strengthening, early mobility, positioning, and neurorecovery
Occupational therapy for strengthening, activities of daily living, self-care, and neurorecovery
Speech therapy for diaphragm exercises and breath control
Respiratory therapy to maintain lung health
Medical management of bladder and bowel function, cardiovascular changes, and skin changes
Psychological support for coping and adjustment
Nutritional support to maximize muscle recovery and maintain bone health
Social work involvement for resources in the community, assistance with funding/insurance, and family support

SCI programs at Children’s Mercy

Inpatient Rehabilitation Program

The inpatient rehabilitation program provides intensives therapy and medical services after an acute spinal cord injury. Our program is individualized to meet each child/adolescent’s and family’s needs with a focus on recovery and overall wellbeing. The team works with each child and family to develop goals and a comprehensive plan for rehabilitation.

Patients participate in at least three hours of intensive therapies each day, five days per week with an additional half day on Saturdays. Our experienced medical team manages the changes in the body’s function and provides education with a child- and family-centered approach. While admitted, children have access to pediatric medical specialties and diagnostic testing for a thorough assessment and comprehensive care plan.

Your child’s progress will be tracked weekly using the WeeFIM and SCI-M functional measures. These tools help measure improvements and help establish areas for continued focus. Scores are also obtained after discharge to ensure your child continues to progress to his or her full potential.

Our therapists are educated and trained in spinal cord injury and pediatrics. Specialty therapy services may include:

Functional electrical stimulation bikes
Heated, zero-entry therapy pool
Tobii® eye gaze system for environmental access
Partial body-weight supported treadmill training
Seating evaluation, including power mobility trials
Pet therapy

Currently, we are not able to accept children who require mechanical ventilation or do not have some movement at C6-7 (elbow and wrist muscles). If this is the case, we are happy to discuss appropriate referrals and follow your child as an outpatient after his/her acute rehabilitation stay.

Learn more information about our Admission and Discharge Criteria for SCI or Inpatient Rehabilitation Program at Children's Mercy.

Outpatient Clinics

We follow patients with different spinal cord disorders, including spina bifida and spinal cord injury, until the transition to adult care.

Inpatient Follow-up Clinic: multi-disciplinary clinic involving Rehab Medicine, PT, OT, Speech, Neuropsychology, and Social Work. This clinic is to ensure a smooth transition to outpatient therapies and home as well as to monitor functional progress since discharge.
Spinal Differences Clinic: multi-disciplinary clinic involving Rehab Medicine, Urology, PT, OT, Nutrition, Social Work, and nursing. This clinic provides continuity with regular evaluation of medical and functional issues until the transition to adult care.
Physical and Occupational Therapy (including aquatic therapy and functional electrical stimulation)
Speech-language Pathology
Other pediatric medical subspecialty clinics, such as Orthopedics and Neurosurgery

For more information, please call us at: (816) 234-3970.