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Spinal Cord Injury

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Spinal Cord Injury (SCI)

What is Spinal Cord Injury Disease

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Spinal cord injury (SCI) is damage to the spinal cord that results in a loss of functional mobility or feeling.

An SCI can occur as a result of a trauma such as a fall, car accident, medical condition such as spina bifida, stroke or Friedreich’s Ataxia, or as a result of other back and spine conditions.
The spinal cord does not have to be severed in order for a loss of functioning to occur. In fact, in most people with spinal cord injury, the spinal cord is intact, but the damage due to compression or bruising to it results in loss of function. SCI is very different from back injuries such as ruptured disks, spinal stenosis or pinched nerves.
A person can “break their back or neck” yet not sustain a spinal cord injury if only the bones around the spinal cord (the vertebrae) are damaged, but the spinal cord is not affected. In these situations, the individual may not experience paralysis if bone damage is treated correctly..

WHAT are the effects of spinal cord injury

The effects of spinal cord injury depend on the type and level of the injury

SCI is commonly referred to as either complete or incomplete. In a complete spinal cord injury there are no signals below the point of injury between the brain and the body— no sensation and no voluntary movement. A person with an incomplete injury may be able to move one limb more than another, may be able to feel parts of the body that cannot be moved, or may have more functioning on one side of the body than the other..

Injuries below T1 result in paraplegia. At T1 to T8 there is most often control of the hands, but lack of abdominal muscle control leaves poor trunk control. Lower T injuries leave good control of the trunk and abdominal muscles. Injuries at the lumbar and sacral vertebra reduce control of the hip flexors and legs. A person with an SCI above C4 may require a ventilator to breathe. A C5 injury often leaves shoulder and biceps control, but no control at the wrist or hand. C6 injury leaves control of the wrist, but not the hand. C7 and T1 injuries leave the ability to straighten the arms, but have only limited hand and finger dexterity. As well as a loss of sensation or motor function, an SCI produces other changes. There can be bowel and bladder dysfunction and sexual functioning is also frequently affected. Men may have their fertility affected, while women’s fertility is generally not affected. Very high injuries (C1, C2) can result in a loss of many involuntary functions including the ability to breathe, necessitating breathing aids such as mechanical ventilators or diaphragmatic pacemakers..

Other effects of SCI may include low blood pressure, inability to regulate blood pressure effectively, reduced control of body temperature, inability to sweat below the level of injury, and chronic pain..

Single administration therapies with relatively high upfront cost require more evidence to support their value for pricing and reimbursement than other health care products, and orthopedic cell therapies must do so based on patient quality of life and health care resource use, as opposed to improved survival, which is especially challenging.
In addition, alternative financing and reimbursement models may be needed to support ongoing patient access and innovation. In the current article, we discuss global health policy issues and considerations for orthopedic cell therapy development and adoption.

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