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B - What Does the E-Scan Tell Us

What Does the E-Scan Tell Us About SCI Rehabilitation in Canada? M Verrier, MHSc; C Craven, MD, MSc; C Balioussis, PhD; and the E-Scan Investigative Team What is Spinal Cord Injury (SCI)? A traumatic blow to the spine that fractures or dislocates vertebrae is often the cause of an SCI. The injury is likely to cause fractures of the vertebrae, and displace bone fragments or disc material. Ligaments may bruise or tear into the spinal cord tissue, crushing nerve cells that carry signals up and down the spinal cord, between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these cells. Some injuries allow almost complete recovery while others result in complete paralysis. The consequence is that SCI can result in diverse sensory, motor and autonomic impairments. The types of impairments individuals with SCI develop can include pain, mobility impairment, bowel and bladder incontinence, difficulty breathing, controlling body temperature and blood pressure, muscle weakness, increased muscle tone (spasticity), loss of sensation and sexual dysfunction, as well as associated secondary health conditions. The frequency and severity of spinal cord impairment varies with the cause of injury and location in the spinal cord. The majority of these impairments persist over time, and represent challenges to the individual, his or her extended family, and the healthcare system. What are the Most Common Causes of SCI? Common traumatic causes of injury include falls, motor vehicle collisions, being struck by an object, and unintentional transport incidents.1 Conversely, non-traumatic causes include transverse myelitis, vasculitis, degenerative central nervous system (CNS) diseases, neoplasms, vascular or inflammatory disease and spinal stenosis.2 Currently, there is no internationally accepted standard for defining the cause of disease or disability for the non-traumatic SCI population, although there is an international group working to refine the definitions. Who Gets SCI? In Canada, Ontario data suggests that the traumatic SCI incidence rate ranges from 20 to 26 cases per million, per annum.1 Using these numbers, 897 new cases of traumatic SCI, per annum, are estimated. The typical age of SCI onset is 51.3 years, with the majority of cases (over 70%) occurring in males.1 Unfortunately, there are no good systems for tracking the incidence of non-traumatic SCI nationally, due to difficulties with case identification, but Ontario data demonstrate twice as many non-traumatic cases per annum, as traumatic SCI. These individuals are older at injury onset (61.6 years), with more co-morbidities, and twice as likely to be female.3 The average age for both groups has increased, over the last decade, and rehabilitation centres are now serving individuals with a complex array of health and life issues, in addition to the neurological injury. 36 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


B - What Does the E-Scan Tell Us
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