Spinal Cord Injury in the Geriatric Population: Risk Factors, Treatment Options, and Long-Term Management

Geriatric Orthopaedic Surgery & Rehabilitation, 2017 · DOI: 10.1177/2151458517696680 · Published: April 1, 2017

Simple Explanation

Spinal cord injuries (SCIs) disproportionately affect the elderly, especially men, and are often caused by falls but can also result from nontraumatic causes like infections or tumors. Treatment for SCIs varies, with surgery becoming more common to reduce spinal cord compression and pain, while new pharmacological agents show promise in reducing cellular damage and aiding recovery. Long-term management of SCIs includes rehabilitation and exercise to improve functionality and reduce pain, though the effectiveness of rehabilitation on functional outcomes remains inconclusive.

Study Duration

Not specified

Participants

Over 200 000 people live with SCIs in the United States.

Evidence Level

Not specified

Key Findings

1
Falls are the most common cause of trauma-related SCIs in the geriatric population, accounting for 60% of cases.
2
Preexisting conditions like ankylosing spondylitis and DISH can increase the risk of SCIs in the elderly after minor falls.
3
Prompt surgical management of SCI (within 24 hours) has increased significantly in the past few years and has been shown to be both beneficial and effective in alleviating pain and reducing spinal cord compression.

Research Summary

SCIs are a significant concern in the geriatric population, often resulting from falls and exacerbated by preexisting conditions, leading to high health-care costs. Treatment strategies involve surgical intervention, hemodynamic monitoring, and rehabilitation, with emerging pharmacological options showing potential for improved outcomes. The goal of treatment is to decompress the spinal cord, provide stability, and reduce pain, while rehabilitation aims to improve functionality, though its efficacy varies.

Practical Implications

Prevention of Falls

Targeted interventions to reduce falls in the elderly can decrease the incidence of traumatic SCIs.

Early Surgical Intervention

Prompt surgical decompression (within 24 hours) can improve outcomes for SCI patients.

Comprehensive Rehabilitation

Multidisciplinary rehabilitation programs are crucial for improving functionality and managing long-term complications in SCI patients.

Study Limitations

1
Inconclusive evidence regarding the efficacy of rehabilitation following an SCI.
2
Long-term complications of SCI depend on the nature of the injury.
3
Treatment is patient specific and needs to account for the nature of injury.

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