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Workshop on Disability in America A New Look: Summary and Background Papers (2006) / Chapter Skim
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Appendix M Secondary Conditions with Spinal Cord Injury--William A. Bauman
Pages 222-233

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From page 222...
... T he secondary consequences of spinal cord injury may be medical, neurological, musculoskeletal, or urological. This paper discusses the medical consequences of spinal cord injury and describes a few of the pulmonary, cardiac, body compositional, metabolic, gastrointestinal, and dermatological issues confronting individuals with such injuries.
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From page 223...
... Heart and lung diseases may not be an immediate cause of death, but they potentially cause further functional impairment and require additional expenditures of resources in those with greater disabilities. Individuals with spinal cord injuries are classically described as having restrictive ventilatory dysfunction, although in those with higher cord lesions, there is also evidence of airflow obstruction.
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From page 224...
... Members of my research unit will address this question in collaboration with Henry Gong, Chief of Environmental Health Service, Rancho Los Amigos National Rehabilitation Center. METABOLIC SYNDROME Those with spinal cord injuries have an increased tendency to develop what is now commonly referred to as the "metabolic syndrome." These individuals become insulin resistant, have associated carbohydrate and lipid abnormalities, and tend to be relatively overweight.
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From page 225...
... is under way to investigate the effect of Niaspan, a long-acting niacin preparation, on increasing HDL cholesterol levels and reducing the rate of vascular disease among individuals with spinal cord injuries. Smoking cessation is also associated with a rise in serum HDL cholesterol levels.
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From page 226...
... Changes in body composition in individuals with spinal cord injuries occur immediately after the acute injury in a dramatic fashion and continue insidiously for years. There is an obvious and immediate loss of muscle tissue after an acute spinal cord injury, but for decades after the injury there is also a progressive, incremental loss of lean body tissue and a relative gain of adiposity.
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From page 227...
... Is there a greater risk of developing insulin resistance and problems with carbohydrate handling in those with the greatest neurological impairment? Those with high and complete spinal cord injuries have a 73 percent chance of having an abnormality in the ability to handle oral carbohydrates, either impaired glucose tolerance or diabetes mellitus, whereas other groups with spinal cord injuries (incomplete tetraplegia, complete paraple
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From page 228...
... Serum HDL cholesterol may be raised by increasing the level of activity. The maintenance of a steady exercise routine is inherently difficult in able-bodied persons, and it is certainly no less difficult in those with spinal cord injuries.
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From page 229...
... . BOWEL EVACUATION Individuals with spinal cord injuries often have difficulty with bowel evacuation.
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From page 230...
... . Increased gut motility and bowel evacuation after administration of a cholinergic agent have been reported in individuals with spinal cord injuries.
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From page 231...
... D] in 40 individuals with spinal cord injuries who received supplementary vitamin D (800 units per day for 12 months)
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From page 232...
... The primary objective is to determine if inpatients with spinal cord injuries who have a full-thickness pressure ulcer of the pelvic region and who receive optimized clinical care and an oral anabolic agent for 24 weeks or less have a greater percentage of full healing than those who receive placebo and the same clinical care. The expectation is to learn the percentage of full-thickness ulcers that healed completely; the healing rate; and the effects of nutrition, inflammatory, and endocrine factors on pressure ulcer healing.
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From page 233...
... Bauman WA, Adkins RH, Spungen AM, Waters RL. The effect of residual neurological deficit on oral glucose tolerance in persons with chronic spinal cord injury.
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Key Terms

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  • hdl cholesterol
  • serum hdl
  • chronic spinal

  • cholesterol levels
  • cord lesions
  • medical consequences
  • cord medicine
  • rancho los

  • forced vital
  • clinical care
  • body composition
  • ablebodied population
  • vital capacity

  • cholesterol concentration
  • los amigos
  • pressure ulcer
  • plasma homocysteine
  • secondary consequences

  • amigos national
  • cholesterol level
  • falls below
  • national rehabilitation
  • rehabilitation center

  • include diet
  • complications soon
  • direct vascular
  • residual neurological
  • mount sinai


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