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. 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 serves approximately 100 inpatients and 50 outpatients with SCI per year. Most of the inpatients receive care in Madonna's acute rehabilitation unit. A smaller number of patients, who often have complex medical needs such as ventilator weaning or wound care, are served on the Long Term Acute Care Hospital (LTACH) Most of the patients who fall in the "Other" category of patients are served on Madonna's Sub-Acute Rehabilitation (SAR) Unit.
Level of Injury: In comparison with other rehabilitation providers in the national database, Madonna serves a larger number of patients with true spinal cord injury versus those in the "other" category.
|
MRH |
Nation |
| Para |
39% |
31% |
| Quad |
47% |
25% |
| Other |
14% |
44% |
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: 41% of the inpatients with SCI served were age 30 or younger, as the graph shows. 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 Nebraska: 19% from Kansas, 17% from Missouri, and 7% each from Iowa and South Dakota.
OUTPATIENT
Volumes: Approximately half of the 55 outpatients with SCI served annually are patients 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 expertise 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.
