SCI Prognosis

[LJH3CRNA2B]

I work in a general adult ICU. We see everything from cabg's to med/surgical to neuro critical patients. I've been taking care of an elderly gentlemen who sustained a cervical contusion at C-5, C-6 secondary to mvc. He has paralysis with no sensation from chest down, with some movement, although spastic, to both upper extremities. He is 1 week post injury, and the neurosurgeon has given a poor prognosis for regaining function. The way I see it is , if the cord is still intact, over weeks -months with iv steroids,as the swelling to the cord improves, I would think that this gentlemen could regain some functioning. I've been reassuring him and his family that " it's still early" and that they should "just wait and see". I don't want to give them any false hope, but I can't find anything else in my heart except to give them hope. Do you feel I'm right? I look forward to your input.

[Elenaster]

It depends - I've seen patients with seemingly minor injuries become complete quads, while others with more severe insults recover quite a bit of function.

I don't think that you're necessarily giving the family false hope, just to be sure and paint the entire picture for them. Working in neuro, I've found that giving everything from worst-case scenario to best possible outcome to the family gives them a better idea of what they're looking at long-term. I try to use words like "he could potentially regain function of xyz, but most people with this type of injury follow abc course of recovery."