Patient Care

Individuals with spinal cord injury fall into two basic groups: Traumatic spinal injuries, typically due to an accident, fall or violence such as gunshot or stab wound, and Non-traumatic spinal injuries or illnesses, typically due to a tumor, infection, or vascular event affecting the spinal cord. During its fiscal year ending June 30, 2010, 63% of individuals with SCI served by Madonna had traumatic injuries, which is significantly higher than the nation (31%) and region (29%).

In addition to the type of injury, spinal injuries are also broken down into levels. The following are commonly referred to:

Paraplegia - An injury to the thoracic or lumbar spine, resulting in paralysis and/or decreased sensation of the lower trunk and legs.

Quadriplegia or Tetraplegia - An injury to the cervical spine, resulting in paralysis and/or decreased sensation of the neck, trunk as well as arms and legs. Tetraplegia is often separated out between C1-4 and C5-8 because of the differences in abilities between those levels of injury.

Spinal injuries also may be described as "Complete" where the communication of nerve impulses are completely interrupted below the level of injury, or "Incomplete" where there are some fibers still intact, allowing some movement and/or sensation below the level of injury. Like many other rehabilitation providers, Madonna uses the ASIA scale to help set functional goals based upon the level of injury.

A final group of patients who are combined in the category of people spinal cord injury include individuals with musculo-skelatal disease of the spine with associated nerve impingement, often seen in rehabilitation hospitals after undergoing a surgical procedure called a laminectomy. These are referred to as "Other SCI."

Inpatients
Volumes: Madonna served 168 inpatients during its most recent fiscal year ending June 30, 2010. Most of the inpatients (109) were served in Madonna's acute rehabilitation unit. 51 patients with SCI who had additional complex medical needs such as ventilator weaning or wound care, were served on the Long Terms Acute Care Hospital (LTACH) and 8 patients, all who fell in the "Other" category of patients were served on Madonna's Transitional Care Unit (TCU) .

Level of Injury: In comparison with other rehabilitation providers, Madonna serves a larger number of patients with tetraplegia (60%) than the nation (43%)or region (54%).

Extent of Paralysis: 49% of patients with SCI had complete paralysis compared with 31% for the nation and 27% for the region.

	MRH	Nation	Region
Paraplegia	39%	32%	48%
Tetraplegia	32%	23%	28%
Other	29%	45%	24%

Madonna is one of the only rehabilitation hospitals in the region who serve patients with SCI who are ventilator-dependent. Madonna has an excellent track record for Ventilator weaning, but also provides very effective programming for persons with high level quadriplegia for whom ventilator weaning is not feasible.

Ages: Madonna served individuals ages 9 to 88 last year. 26% of the inpatients with SCI served were age 20 or younger. There are multiple opportunities for young adults to interact with peers.

Geographic Area: Madonna serves patients with SCI from multiple states. In fact, 50% of the patients admitted to Madonna's inpatient SCI Program last fiscal year lived outside Lincoln including 25 from out of state.

OUTPATIENT

Volumes: 46% of the 98 outpatients with SCI served annually are individuals who began their rehabilitation as an inpatient at Madonna and chose to continue to receive services in the Rehabilitation Day Program, had single service or one of many specialty services offered at Madonna TherapyPlus such as Assistive Technology, Wheelchair seating & Mobility, Driver Rehabilitation or came back to attend the Spinal Cord Clinic.

Geographic: Many patients who live out of town choose to stay in Lincoln for outpatient services because of the as well as special technology available at Madonna that is so vital to successful rehabilitation. To assist our patients from out of town, Madonna offers affordable on-campus housing.