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Spinal cord injury

Spinal cord injury

Because of the immense impact that a spinal cord injury (SCI) has on children and their families, specialized care is essential for a child impacted with a spinal cord injury to achieve the best outcomes. In 1980, Shriners Hospitals for Children — Philadelphia launched the nation's first pediatric SCI rehabilitation program. Since then, the Philadelphia Shriners Hospital has delivered expert specialty care to hundreds of children and young adults with SCI.

The primary goal of the SCI program is to ensure that young people with a SCI participate fully in their communities, attain independence and live satisfying lives free from medical complications. In order to achieve these goals, the program provides a wide range of services, including activity-based rehabilitation, locomotor training, robotic assisted gait training (i.e. ReWalk), exercise programs, aquatic therapy and multidisciplinary care. These activities build strength and stamina, increase social interaction and build confidence and independence to the fullest extent possible.

The setting

Comprehensive inpatient and outpatient services are provided in a family-centered and culturally sensitive environment. Each patient has a care manager who will assist with all aspects of the visit to our hospital, including lodging and transportation arrangements. We provide care at the appropriate levels including:

  • Intensive care
  • Inpatient rehabilitation
  • Outpatient rehabilitation
  • State of the art facilities and equipment

The medical team

The rehabilitation/spinal cord injury treatment team consists of:

  • Child life therapists
  • Dietitians
  • Hand surgeons
  • Neurosurgeons
  • Nurses and nurse practitioners
  • Nurse care managers
  • Occupational therapists
  • Orthotists and prosthetists
  • Pediatric orthopaedists and spine surgeons
  • Physical medicine and rehabilitation physicians
  • Physical therapists
  • Plastic and reconstructive surgeons
  • Psychologist
  • Speech therapist
  • Recreational therapist
  • Respiratory therapists
  • Social worker care managers
  • Surgical specialists
  • Urologists
  • Wound care team

Advanced therapies, advanced medicine

Activity-based rehabilitation strategies include body-weight-supported manual treadmill training (Therastride), ReWalk (robotic assisted gait training) and functional electrical stimulation (FES) cycling. Management of youth with tetraplegic SCI includes FES, upper extremity reconstructive surgery and assistive technology. A motion analysis center (gait lab) assists in evaluation of gait in youth with SCI who ambulate. Wheelchair users are assessed with pressure mapping. In addition, we have a phrenic pacing program, for children with a high level SCI; it is a type of breathing pacemaker – also called phrenic nerve pacing, to help children who are ventilator dependent.

A strong focus on research

The spinal cord injury program includes a strong emphasis on research. Projects center on quality of life issues, long-term outcomes and the impact of SCI on the family. Although participation in research studies is not required, knowledge gained from these studies may improve clinical practices and enhance the lives of young patients with spinal cord injuries.