PROGNOSIS AND FACTORS AFFECTING RECOVERY
One of the first questions those injured and their families ask is, “How much recovery is possible?” The honest answer is that it varies greatly from person to person. In this chapter we will look at the factors that determine the extent of recovery.
The severity and level of the injury are the biggest factors. If the injury is complete (no sensation or movement) below the injury, the chances of significant motor recovery are lower than if it’s incomplete. In contrast, incomplete injuries often have better prospects – many people regain at least some function over time, depending on what pathways are intact. The level of injury matters too: injuries lower in the spinal cord mean more of the body is unaffected (e.g., a lumbar injury leaves arms intact, which helps independence). Higher injuries (cervical) involve more critical functions like breathing and arm/hand movements, which are harder to recover fully. Additionally, recovery depends on individual factors such as age, overall health, and any other injuries. Younger people might have more neuroplasticity potential, whereas older individuals may recover slower. Prompt treatment is critical as well – getting pressure off the cord quickly (via surgery) and preventing low blood pressure or further trauma can reduce the extent of permanent damage.
In the early stages, a lot of damage to the spinal cord comes from swelling and secondary injury processes (inflammation, etc.). That’s why intensive care management (like maintaining blood flow to the cord and stabilising the spine) can influence outcomes. One useful measure the doctors use is whether any sensation or movement is present in the first 72 hours after injury. Generally, if a person has some pinprick sensation or toe movement early on, they’re more likely to improve over time than someone with none. But there are always exceptions and please do ask your consultant any questions around your prognosis, this is just a guide to help you have a general understanding of a spinal injury.
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