Specific secondary or associated conditions and complications
Medical complications involving every organ system are common after SCI; genitourinary and respiratory complications and pressure ulcers are common causes for hospitalization.
Loss of lung volumes, impaired cough and difficulty clearing secretions predispose individuals with cervical and high thoracic injuries to respiratory impairment and lung infections. Ventilatory failure due to diaphragmatic paralysis occurs in people with high tetraplegia.
Impaired sensation, nutritional status and mobility, together with bowel and bladder incontinence, can result in skin breakdown and pressure ulcers.
Urinary tract infections are the most common source of infections in individuals with SCI and contribute to other conditions, such as urinary stones and bladder cancer.
Constipation, fecal impaction, and anorectal problems are common consequences of impaired bowel control.
Neurogenic shock is characterized by autonomic dysfunction with interruption of sympathetic tone following SCI. It manifests with hypotension, relative bradycardia and peripheral vasodilatation.
Autonomic dysreflexia is a potentially life-threatening condition associated with SCI above T6. It is characterized by an abrupt rise in blood pressure resulting from a noxious stimulus below the level of injury.
Autonomic impairment results in sexual dysfunction.
Late neurological decline may result from development of post-traumatic syringomyelia or from development of compressive neuropathies.
SCI can result in a variety of endocrine and metabolic conditions including electrolyte dysfunction, impaired lipid metabolism and osteoporosis.
Pain is common after SCI and can be neuropathic or nociceptive in origin. Overuse syndromes are common causes of musculoskeletal pain.
Incidence of depression and substance abuse is increased after SCI.
Concomitant injuries, including traumatic brain injury, may be sustained at the time of trauma.