Spinal Injury Compensation Claims

What are the effects of spinal injury?

Tetraplegia

Tetraplegia, which is a complete loss of function and sensation in the arms, body and legs, typically happens when there has been a severe injury to the neck.

Symptoms can include:

• Complete paralysis of arms, body and legs
• Inability to breath without assistance
• Loss of bower and bladder function
• Inability to transfer independently

When the damage to the spinal cord is lower down the neck, there may be some limited use of limbs.

There are several secondary symptoms following tetraplegia:

• Deep vein thrombosis
• Fertility problems
• Frozen joints
• Pressure sores
• Pneumonia
• Spasticity
• High blood pressure

Initial treatment will be in a specialist spinal hospital, such as at Oswestry, for up to 12 months. Afterwards you will need an extensive care regime, with an emphasis on avoiding secondary symptoms is required, for example regularly moving the patient to prevent pressure sores from occurring.

Paraplegia

Paraplegia is the complete damage to the spinal cord below the neck and typically occurs when the spine in the upper back or below is damaged.  This causes complete loss of movement and feeling in the legs, whereas the arms and hands can still be normal. 

Injury to the spine in the upper back causes a complete loss of function and sensation below the mid-chest, meaning you have little or no trunk control and have poor balance when sitting.  Bladder and bowel functions may also no longer work properly.

Damage in the mid-spine area causes a loss of function and sensation in the legs, although there is good balance when sitting along with some general movement of the trunk.

There are also a number a secondary effects following paraplegia including:

• Chronic nerve pain
• Deep vein thrombosis
• Fertility problems
• High blood pressure
• Osteoporosis
• Pressure sores
• Spasticity

Initial treatment is in a specialist spinal hospital for up to five months when extensive rehabilitation is given to help the patient adapt to their injury.  After leaving hospital, someone with complete paraplegia can usually achieve a level of self-care using a self-propelled wheelchair.  In some cases, walking a short distance is possible with aids and equipment.

Incomplete spinal cord injury

Incomplete spinal cord injuries mean that the spinal cord remains intact, and some limited mobility or sensation can remain.  If spinal shock has occurred, immediate symptoms including paralysis may improve, with some movement and sensation returning in time.  Incomplete spinal cord injuries are typically classified into the following categories:

Anterior cord syndrome

This is when an impact damages the artery that runs along the front of the spinal cord, perhaps by a fragment of broken bone or a slipped disc.  This can lead to a loss of feeling of temperature and vibration.

Central cord syndrome

This is an injury to the nerves at the centre of the spinal cord preventing the brain sending information down the spinal cord to the rest of the body.  Damage to the central cord can impact on arm function, bladder and bowel control.

Posterior cord syndrome

This is an injury to the back of the spinal cord which often means that a person can continue to move, but lacks limb control and coordination.

Brown-sequard syndrome

When an injury occurs to one side of the spinal cord, it can often lead to a complete loss of movement on one side of the body, but with preserved sensations of pain and temperature.

Cauda equina syndrome

The cauda equina is a group of nerves in the lower back area, shaped like a horse’s tail.  If there is an injury in this area, swelling can cause the nerves to become compressed often causing severe lower back pain.  If not treated with emergency surgery to relieve the compression, it can cause permanent bladder and bowel dysfunction.

Common symptoms of spinal injury

At the most extreme level, someone with a spinal cord injury in the neck may need a ventilator to breathe, or if they are able to breathe independently may still depend on help from others for the rest of their needs.  If the spinal cord injury is lower down the spine, then someone may have use of their shoulders or arms, but still lack control of their upper body.   And even lower down, there may be full use of the upper body and in some cases even some use of the legs.  

Other symptoms include muscles spams and jerking, which can affect sleep and make normal activities of daily living or moving from a chair or bed difficult.  There can also be pain symptoms, that need to be managed with medication or physiotherapy. 

A significant symptom for many people with spinal cord injury is managing their bowels.  They can experience incontinence or constipation, or lack total control and need a stoma, which is a surgical hole in the abdomen, so that the body waste can collect into a bag.  Others may also need a catheter fitted, which is a tube in the urethra to drain urine from the bladder into a bag.  This can increase the risk of infections.

There can also be a loss of sexual function for men and women.

If someone has to spend a prolonged period sitting or lying in a bed, when they cannot easily move, they are at risk of developing pressure sores.  This is when the pressure of being in one position reduces the blood supply.  It can lead to the skin dying and creating an open wound, which is very painful and leads to a risk of infection.  Special seat pads and mattresses can help, as well as awareness of the need to keep moving position.

There is also an increased risk of respiratory symptoms.

People with a spinal cord injury in the neck or upper back can also suffer autonomic dysreflexia. This is potentially life-threatening.  It causes a sudden and severe rise in blood pressure and can be caused by skin damage, bladder or bowel problems.

Recovery and rehabilitation

Rehabilitation takes place whilst a person is in hospital and in cases of severe spinal injury, you may be discharged to a specialist rehabilitation facility. Unfortunately, due to pressures on the NHS, all too often patients are discharged too early with little or no support once they arrive home.

Every spinal injury is different, depending on which part of the spinal column is damaged, so rehabilitation is assessed on a case-by-case basis.  Typical types of treatment include:

• Physical therapies - work on strengthening the muscles and general motor skills.  Later in the rehabilitation, techniques may be used to try to improve your mobility or to retrain the bowel and bladder.  Coping strategies may be developed for spasms and pain symptoms.
• Occupational therapy – focuses on ensuring you are able to meet certain daily living skills and regain as much independence as possible, by adapting to the home environment.  Treatment will often involve learning coping strategies to make activities of daily living easier, like showering, preparing food, getting dressed in addition to identifying equipment which might help.
• Psychological therapies – typically patients suffer from low mood and depression following a spinal injury, so this is essential support for the injured person and their family.  It can help prevent or cope with feelings of low mood and depression which, if left untreated, could in themselves be disabling and reduce the benefit of any physical rehabilitation.
• Employment rehabilitation – helps someone to find work with any necessary adaptations, if they are assessed as fit enough to return to work.
• Recreational therapy – this can help you find activities you can do to keep active and achieve social interaction.

We prioritise rehabilitation for our clients from the very outset and, wherever possible, select the best rehabilitation providers to work with you to identify what treatment you require.  We will appoint a case manager, who will be a health professional with expertise in managing spinal cord injury, to carry out an Immediate Needs Assessment. After this assessment, your case manager will co-ordinate your rehabilitation package and work with you and other professionals to identify what treatment you require.

The Immediate Needs Assessment will often take place in your own home and may identify areas where you need support or more help, such as:

• physiotherapy or hydrotherapy
• occupational therapy
• adapting or buying a home more suited to your needs
• adapting or buying a more suitable vehicle
• psychological therapy
• employment rehabilitation
• recreational therapy.

If your assessment makes recommendations, we will advise you as to how we can help you access and fund them to get the support and care that you need. Our specialist spinal injury case managers will look after your interests to help get you all the support you need as soon as possible. 

How our spinal injury solicitors can help

Our personal injury solicitors are specialists in spinal cord injury.  They understand how stressful it can be to make a legal claim for your spinal cord injury, while at the same time trying to adapt to a spinal cord injury; they also understand the impact that this has on your family.  

We believe that early intervention is the best way to help you maximise your chances of rehabilitation, so we focus, where possible, on arranging case manager support and interim payments, whilst we work to secure the best overall outcome for you and your family.  We always put you at the centre of everything we do.

As we are a broad-based practice we can provide holistic support and work with our colleagues in other legal disciplines to support your case, if needed.  It means you will benefit from a seamless, one-team approach.  You are in safe hands.

We are:

• Spinal Injuries Association trusted legal partner for the West Midlands
• One of three law firms selected by The Queen Elizabeth Hospital Birmingham to support patients at the hospital as part of the 4 Trauma 4 Patients support service
• One of three firms selected by the University Hospital of Coventry and Warwickshire operated by Cardinal Management to support patients as part of the Major Trauma Signposting project
• One of three firms selected by the Birmingham Women’s and Children’s Hospital operated by Cardinal Management to support patients as part of the Major Trauma Signposting project
• Accredited members of Headway’s Head Injury Solicitors Directory
• Serious Injury Guide signatories
• Members of:
  • The Motor Accident Solicitors Society
  • Association of Personal Injury Lawyers
  • Birmingham Law Society
  • Approved Law Society Personal Injury Panel and Law Society Clinical Negligence Panel
  • Approved by Association for Victims of Medical Accidents
  • Recognised in Chambers and Partners Directory
  • Recommended by the Legal 500 as leading personal injury and clinical negligence lawyers.