Frequently Asked Questions
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Spinal Cord Injuries

  1. What is Spinal Cord Injury?
  2. What are the spinal cord and the vertebra?
  3. What are the effects of SCI?
  4. How many people have SCI? Who are they?
  5. Is there a cure for SCI?
  6. Do people with SCI ever get better?
  7. Who can sue for a spinal cord injury?
  8. Who can be held responsible for a spinal cord injury?
  9. What if I was also at fault for the accident, which caused my spinal cord injury?
  10. Is it important to quickly investigate an accident, which results in a spinal cord injury?
  11. Is the existence of insurance coverage important?
  12. Will my attorney need to retain experts to prove liability and damages even though my injury is so obvious?
  13. What damages am I entitled to recover in my spinal cord injury case?
  14. How soon after my accident must I bring a case?
  15. Do I need to retain an attorney?

Questions & Answers

What is Spinal Cord Injury?
Answer:
Spinal Cord Injury (SCI) is damage to the spinal cord that results in a loss of function such as mobility or feeling. Frequent causes of damage are trauma (car accident, gunshot, falls, etc.) or disease (polio, spina bifida, Friedreich's Ataxia, etc.). The spinal cord does not have to be severed in order for a loss of functioning to occur. In fact, in most people with SCI, the spinal cord is intact, but the damage to it results in loss of functioning. 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 after the bones are stabilized.

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What are the spinal cord and the vertebra?
Answer:
The spinal cord is the major bundle of nerves that carries nerve impulses to and from the brain to the rest of the body. The brain and the spinal cord constitute the Central Nervous System. Motor and sensory nerves outside the central nervous system constitute the Peripheral Nervous System, and another diffuse system of nerves that control involuntary functions such as blood pressure and temperature regulation are the Sympathetic and Parasympathetic Nervous Systems.
The spinal cord is surrounded by rings of bone called vertebra. These bones constitute the spinal column (back bones). In general, the higher in the spinal column the injury occurs, the more dysfunction a person will experience. The vertebra is named according to their location. The eight vertebras in the neck are called the Cervical Vertebra. The top vertebra is called C-1, the next is C-2, etc. Cervical SCIs usually cause loss of function in the arms and legs, resulting in quadriplegia. The twelve vertebras in the chest are called the Thoracic Vertebra. The first thoracic vertebra, T-1, is the vertebra where the top rib attaches. Injuries in the thoracic region usually affect the chest and the legs and result in paraplegia.
The vertebra in the lower back - between the thoracic vertebra, where the ribs attach, and the pelvis (hip bone), are the Lumbar Vertebra. The sacral vertebra runs from the pelvis to the end of the spinal column. Injuries to the five Lumbar vertebra (L-1 thru L-5) and similarly to the five Sacral Vertebra (S-1 thru S-5) generally result in some loss of functioning in the hips and legs.

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What are the effects of SCI?
Answer:
The effects of SCI depend on the type of injury and the level of the injury. SCI can be divided into two types of injury - complete and incomplete. A complete injury means that there is no function below the level of the injury; no sensation and no voluntary movement. Both sides of the body are equally affected. An incomplete injury means that there is some functioning below the primary level of the injury. 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. With the advances in acute treatment of SCI, incomplete injuries are becoming more common.
The level of injury is very helpful in predicting what parts of the body might be affected by paralysis and loss of function. Remember that in incomplete injuries there will be some variation in these prognoses. Cervical (neck) injuries usually result in quadriplegia. Injuries above the C-4 level may require a ventilator for the person to breathe. C-5 injuries often result in shoulder and biceps control, but no control at the wrist or hand. C-6 injuries generally yield wrist control, but no hand function. Individuals with C-7 and T-1 injuries can straighten their arms but still may have dexterity problems with the hand and fingers.
Injuries at the thoracic level and below result in paraplegia, with the hands not affected. At T-1 to T-8 there is most often control of the hands, but poor trunk control as the result of lack of abdominal muscle control. Lower T-injuries (T-9 to T-12) allow good truck control and good abdominal muscle control. Sitting balance is very good. Lumbar and Sacral injuries yield decreasing control of the hip flexors and legs.
Besides a loss of sensation or motor functioning, individuals with SCI also experience other changes. For example, they may experience dysfunction of the bowel and bladder. Sexual functioning is frequently affected: men with SCI may have their fertility affected, while women's fertility is generally not affected. Very high injuries (C-1, C-2) 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.

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How many people have SCI? Who are they?
Answer:
Approximately 450,000 people live with SCI in the US. There are about 8,000 new SCIs every year; the majority of them (82%) involve males between the ages of 16-30. These injuries result from motor vehicle accidents (42%), violence (24%), or falls (22%). Quadriplegia is slightly more common than paraplegia.

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Is there a cure for SCI?
Answer:
Currently there is no cure for SCI. There are many researchers attacking this problem, and there have been many advances in the lab. Many of the most exciting advances have resulted in a decrease in damage at the time of the injury. Steroid drugs such as methylprednisolone reduce swelling, which is a common cause of secondary damage at the time of injury. The experimental drug Sygen®appears to reduce loss of function, although the mechanism is not completely understood.

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Do people with SCI ever get better?
Answer:
When a SCI occurs, there is usually swelling of the spinal cord. This may cause changes in virtually every system in the body. After days or weeks, the swelling begins to go down and people may regain some functioning. With many injuries, especially incomplete injuries, the individual may recover some functioning as late as 18 months after the injury. In very rare cases, people with SCI will regain some functioning years after the injury. However, only a very small fraction of individuals sustaining SCIs recover all functioning.

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Who can sue for a spinal cord injury?
Answer:
Anyone who is not seriously at fault themselves as long as they can prove that some other person or entity is more at fault and that their fault has caused this serious injury.

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Who can be held responsible for a spinal cord injury?
Answer:
Anyone who has acted in a negligent way and whose negligent acts directly caused the injury.

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What if I was also at fault for the accident, which caused my spinal cord injury?
Answer:
Even if you are at fault, you still may be able to make a claim. It must be established that your fault, if any, is equal to or less than the fault of the person or entity against whom you are making a claim.

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Is it important to quickly investigate an accident, which results in a spinal cord injury?
Answer:
It is always important to quickly investigate an accident, but even more so when there is a very serious injury such as a spinal cord injury. Important facts can disappear very quickly.

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Is the existence of insurance coverage important?
Answer:
It is always important. It is very difficult to collect on a large judgment against an individual or corporation. Thus, it is always very important to determine the existence and amount of insurance coverage.

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Will my attorney need to retain experts to prove liability and damages even though my injury is so obvious?
Answer:
Yes. It is vital to have competent and skillful experts to establish both the responsibility of the person or company that is at fault, and also to have medical support to explain what all a person who has suffered a spinal cord injury has gone through in the past and will go through In the future, both in terms of medical care and complications in their daily lives.

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What damages am I entitled to recover in my spinal cord injury case?
Answer:
You are entitled to both economic and non-economic damage. Economic damages include medical expenses, wage loss and future medical expenses, and loss of earning capacity that results from the injury. Non-economic loss is meant to compensate you for the pain that your injury has caused, the tremendous inconvenience and change in your lifestyle, and your inability to participate in activities that are important o you. It also includes compensation for the emotional harm that the injury has caused.

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How soon after my accident must I bring a case?
Answer:
See Statutes of Limitations. This is determined on a case-by-case basis. It depends upon the complexity of the facts of the accident together with an assessment of when the medical condition has stabilized to the point that the doctors can advise us with some degree of certainty about what the future will hold in terms of ongoing medical care, disability and limitations on lifestyle. A case must be started before the statute of limitations runs. There are numerous statutes of limitation, and it depends upon the nature or type of claim you are making.

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Do I need to retain an attorney?
Answer:
Investigating and developing a claim for a serious injury such as a spinal cord injury is a very complex process. Attorneys who are experienced in handling serious personal injury claims are best situated to make sure that this process is carried out in a way that best protects your interests and maximizes the compensation that you receive.

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