Rehabilitation times for a spinal injury vary widely because every individual is unique, and every spinal injury is different. However, rehabilitation time for spinal cord injury usually lasts 12-18 months. This is because spontaneous recovery time tapers out then. The largest spikes in spontaneous recovery occur three to six months post-injury. A few patients see recovery after years.
What Is the Spinal Cord?
The spinal cord, together with the brain, makes up the central nervous system. The spinal cord is a large cluster of nerves that descends along the spinal column. It’s about 18 inches long and extends from the brain to the waist. It includes motor, sensory, and involuntary nerves that direct, monitor, and regulate numerous things in the body, such as blood pressure.
What Types of Spinal Cord Injuries Are There?
The American Association of Neurological Surgeons says there are about 17,000 spinal cord surgeries in the U.S. each year. About 250,000 to 450,000 people with spinal cord injuries live in the U.S. today.
Named by the Vertebra
Spinal cord injuries are named after the vertebra where the injury is located (https://www.shepherd.org/programs/spinal-cord-injury/about). The vertebrae in your neck are called cervical vertebrae, so an injury to the spinal cord at the second cervical vertebra is called a C2 injury.
At the spot where the top rib attaches the vertebrae become thoracic vertebrae. An injury to the spinal cord at the first thoracic vertebra would be a T1 injury. The lumbar vertebrae run between the ribs and the pelvis. The sacral vertebrae run from the pelvis to the end of the spinal column.
The level of the injury marks the spot on the spine below which there is no function. Therefore, the parts of the body that connect to that spot and lower will lack voluntary movement and sensation.
Divided by Severity
Spinal cord injuries are categorized as either complete and incomplete. A complete spinal cord injury will cause a total lack of voluntary movement and sensation below the injury site. An incomplete spinal cord injury will leave some function below the injury site, such as partial movement or some sensation in a body part that is otherwise paralyzed.
Spinal injuries are also categorized by how many limbs are affected. Tetraplegia happens when all four limbs are paralyzed. Paraplegia is when paralysis affects both legs but the arms are unaffected. Here are the percentages of spinal cord injury by type at the time of hospital discharge:
- Incomplete tetraplegia: 47.4%
- Incomplete paraplegia: 20.0%
- Complete paraplegia: 19.7%
- Complete tetraplegia: 12.3%
- Normal, which is complete neurological recovery: 0.5%
What Are the Common Causes of Spinal Cord Injuries?
The top cause of spinal cord injuries is automobile accidents. Falls are also a leading cause. Behind that come acts of violence, mainly through guns, and sports-related injuries. Non-traumatic causes include a number of diseases and conditions, such as cancer and osteoporosis.
[https://www.nscisc.uab.edu/public/Facts%20and%20Figures%202024%20-%20Final.pdf]
What Rehabilitation Is Available for Spinal Cord Injuries?
Spinal cord injuries are complex, and a team of rehabilitation specialists is needed to meet the challenge. This team can include specialists in the following therapies and more:
- Occupational therapy
- Physical therapy
- Psychological therapy
- Rehabilitation for complications of spinal cord injury
- Dietician
- Speech therapy
By coordinating work and addressing the patient as a whole person, the team increases their chances of success.
How Long Does Rehabilitation Take for Spinal Cord Injuries?
Most times, improvements in spinal cord rehabilitation take up to 12-18 months after the surgery. This is because neuroplasticity, the ability of the spine to easily make changes, tapers off in that period. This time estimate includes living in a subacute rehabilitation center and getting three dedicated hours of rehabilitation each day. A small number of patients can regain functions years after the surgery. Some patients will need a long-term recovery plan and may require these therapies for the rest of their lives.
What Factors Affect the Time Rehabilitation Takes?
The most important factor affecting the time spent in rehabilitation is the time between the accident and the initial surgery. Having surgery within the first 24 hours is of the utmost importance. Immediately after the injury, the spinal cord enters a state of neuroplasticity where it can make changes more easily. Surgery done during that time is likely to have better results and allow for better rehabilitation.
Whether an injury is complete or incomplete plays a major role in the time spent in rehabilitation. People who suffer incomplete spinal cord injuries can recover function through neuroplasticity. They spend more time in care because they have more functions that can be improved through rehabilitation.
The level — cervical, thoracic, lumbar, or sacral — of the injury also plays a major role in the time spent in rehabilitation. The higher the level in the body, the more functions are affected and the more time a patient has to spend in rehabilitation.
Secondary complications also play a role in the time spent. These physical problems can affect motivation and emotional availability as well. Common secondary complications include: [https://www.flintrehab.com/spinal-cord-injury-recovery-time]
- Changes in body composition
- Neurogenic bladder/bowel changes
- Pressure sores
- Changes in mental health
- Breathing problems
- Spasticity
- Autonomic dysreflexia
Patient engagement is another key factor in shortening the time spent in rehabilitation, especially during the first three months. Getting involved in multiple therapies early is important. Practicing the exercises at home and adopting a healthy diet are also factors that are under the patient’s control.
Hopes for Shortening Times in the Future
Research is showing there’s great potential for reducing and repairing spinal cord injuries and possibly lessening the time spent in rehabilitation. On the other hand, more partial cures — as opposed to no cures at all — could lead to more time spent in rehabilitation for some patients. Here are some areas where progress is being made:
- Neuroprotection: Protecting cells from further damage
- Neuroplasticity: Preserving plasticity and retraining cells for new jobs
- Repair and regeneration: Spinal cord self-repair and regrowth
- Cell-based therapies: Replacing damaged nerve cells with other cell types
Rapid advancements in new therapies could change the time spent in rehabilitation significantly.
References
American Association of Neurological Surgeons. “Spinal Cord Injury.” https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Cord-Injury
Dvorak, Marcel, et al. “The Influence of Time from Injury to Surgery on Motor Recovery and Length of Hospital Stay in Acute Traumatic Spinal Cord Injury: An Observational Canadian Cohort Study.” J Neurotrauma. 2015 May 1; 32(9): 645–654. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410758/
Flint Rehab. “Spinal Cord Injury Recovery Time: How to Promote a Quicker Recovery.” https://www.flintrehab.com/spinal-cord-injury-recovery-time/
Medical News Today. “What Is Recovered in Spinal Cord Injury Recovery?” https://www.medicalnewstoday.com/articles/spinal-cord-injury-recovery#recovery-stages
NINDS. “Spinal Cord Injury.” https://www.ninds.nih.gov/health-information/disorders/spinal-cord-injury
NSCISC. “Spinal Cord Injury Facts and Figures at a Glance.” https://www.nscisc.uab.edu/public/Facts%20and%20Figures%202024%20-%20Final.pdf
The Shepherd Center. “Spinal Rehabilitation Center: Injury and Paralysis Information.” https://www.shepherd.org/programs/spinal-cord-injury/about
