SCI Medicine

Spinal cord injury rehabilitation, written for clinicians, trainees, and curious patients. Deeper than the patient-education handouts, lighter than a textbook.

Reading

This week's SCI research roundup — the public version of my weekly literature surveillance.
Patient education library — the same handouts I use on the unit, refreshed monthly.
Durable patient handout library — topic-specific plain-language handouts (autonomic dysreflexia, orthostatic hypotension, spasticity, and more).

By level

Function, common barriers, durable medical equipment, and adaptive sports organized by SCI level group. Helpful for patients orienting to a new injury, family members, and trainees building a mental model of how level dictates rehab strategy.

C1–C4

Highest level of injury. Often ventilator-dependent. Requires 24-hour caregiver support but rich quality of life is fully achievable.

C5–C7

Tetraplegia with progressively more arm function. C5 elbow flexion. C6 wrist extension and tenodesis grip. C7 elbow extension and finger flexion — the level at which manual-chair independence becomes realistic.

T1–T6

Full hand and arm function. Limited trunk control. Autonomic dysreflexia risk is still present. Manual wheelchair user, fully independent in self-care.

T7–T12

Full upper-body and abdominal trunk control. No autonomic dysreflexia risk. Highest-functioning wheelchair-using level — most adaptive sports are within reach.

CE / Conus

Lower-motor-neuron injury below the spinal cord proper. Flaccid paralysis (not spastic), areflexic bladder and bowel, often asymmetric. Many people walk with bracing — many do not.

Topics

Autonomic dysreflexia

Recognition, BP thresholds, acute management.

Orthostatic hypotension after SCI

Therapy progression, abdominal binder, midodrine.

Spasticity

Oral agents, intrathecal baclofen, focal botulinum toxin.

Neurogenic bladder

Intermittent catheterization and bladder management algorithms.

Neurogenic bowel

Building a sustainable program patients actually follow.

Pressure injuries

Prevention, staging, and surgical timing.

DVT prevention

Acute and inpatient rehab — agents, duration, ambulation.

Respiratory care

Quad cough, secretion clearance, ventilator weaning.

Neuromodulation

ARC EX, exoskeletons, diaphragm pacing — what the evidence says.

Program direction

Admissions, IDT, payer dynamics, advocacy.

Long-form articles are being migrated. If something here is a stub, the patient handouts and weekly roundups already cover the core material.