Methodist Rehabilitation Center - Areas of Expertise

The highest possible level of independence—that’s what spinal cord injured patients want. For some that means walking again, while for others it means learning to gain maximum mobility and function in real world settings.

No matter the severity or level of injury, patients and their families want to know they’ve done all they can to ensure the best possible recovery.

That’s where we come in.

After more than 30 years and thousands of patients, we have the proven expertise needed to help SCI patients reach their goals. In 2006, our Spinal Cord Injury Program treated 180 patients—far more than any other hospital in the state and more than the 14 largest Mississippi hospitals combined.

This level of experience sets us apart.

Our Patients

Our Spinal Cord Injury Program treats patients—from teenage to adult—who have injuries resulting from trauma, vascular accidents, infections, postoperative complications, cervical disc conditions, neuromuscular diseases or other medical conditions and who are able to participate in intense therapy sessions.

Because the spinal cord serves as the channel for the body’s motor and sensory message system, most patients with spinal cord injuries lose some or all of their ability to move and feel.

The paralysis, sensory loss and resulting complications demand the intervention of specialized rehabilitation physicians and staff, an intensive spinal cord treatment program, state-of-the-art rehabilitative medicine and a strong commitment to research. All of these can be found at Methodist Rehabilitation Center.

Our Team

People who come to a rehabilitation hospital rarely face just one challenge. That’s why our staff includes a wide variety of health professionals who coordinate care and determine goals for each patient. Through regularly scheduled meetings and daily interaction, the team stays abreast of each patient’s progress and works together to achieve therapy objectives.

Our multidisciplinary team is led by Dr. Sam Grissom, a physiatrist who is board-certified in physical medicine and rehabilitation and in spinal cord injury medicine. Dr. Grissom provides medical care for complications that may occur, prescribes medications, treats spasticity and contractures and recommends surgical consultation when necessary. Before coming to Methodist, he served as associate medical director at Kessler Institute for Rehabilitation in Chester, N.J., and as medical director of inpatient rehabilitation at Virginia Mason Medical Center in Seattle, Wash.

The SCI team also includes neuropsychologists, researchers, certified rehabilitation nurses, physical therapists, occupational therapists, therapeutic recreation specialists, speech-language therapists, respiratory therapists, vocational rehabilitation counselors, clinical dietitians and biomedical engineers. The referring physician is encouraged to stay involved in the patients care. Other physicians, including neurosurgeons, plastic surgeons, urologists and orthopedists are available to assess and treat special medical problems related to spinal cord injury.

Our Program

Our Spinal Cord Injury Program begins with a comprehensive evaluation of each patient which is used to develop an individualized treatment plan based upon the level of injury and functional ability. The team then collaborates with the referring physician, patient and family to set goals.

Once the spine is stabilized, a mobility training program begins. Our goal is to achieve the highest level of function possible. Exercise programs focus on strengthening intact muscles, maintaining or gaining mobility and building confidence to perform functional activities. Equipment needs are also assessed and obtained to maximize mobility.

SCI patients may benefit from Methodist’s Motion Analysis Laboratory, a part of the Center for Neuroscience and Neurological Recovery. It is uniquely equipped and capable of precise kinetic and kinematic analysis of any kind of human motion. SCI patients often come to the lab after treadmill gain training, a therapy that has helped many patients make significant gains in their walking ability. While the treadmill’s harness, pulleys and pneumatic system support the patient’s weight, therapists can assist the person with a stepping motion.

Sufficient respiratory function is essential to the rehabilitation process. For this reason, we work with spinal cord patients to strengthen respiratory muscles, improve volume and cough force, provide pulmonary hygiene and oxygen therapy if needed. We are also skilled in providing rehabilitation care to ventilator-dependent patients.

Because a spinal cord injury usually involves sensory impairments, skin complications are often a problem. The team implements an individual skin care program for each spinal cord patient that includes turning and positioning, bridging, pressure relief raises, skin checks and teaching patient and family how to prevent pressure ulcers.

Learning how to meet daily needs is an essential part of rehabilitation for those with spinal cord injuries. Individual and group treatment programs involve re-learning and managing daily tasks associated in personal self-care, home management, leisure, community, work, school and driving. The team prescribes assistive equipment if needed. Home and work site assessments are provided and recommendations for modifications are given to patient, family and employers.

Education sessions help both patient and family understand the consequences of spinal cord injury and how roles, relationships and responsibilities are affected. Through counseling, the team helps patients and their families deal with these changes and make plans for the future. We also offer sexual counseling and encourage participation in spinal cord injury support groups as well as paraplegic and quadriplegic reorientation programs.

Since our goal is to return spinal cord injury patients to their home, work, school and community, each treatment plan includes a comprehensive discharge plan that prepares the patient for life after rehabilitation. To provide continuity of care, a follow-up program is prescribed which may include outpatient rehabilitation treatment.

SCI Program Benefits

SCI patients at Methodist have opportunities to participate in and benefit from clinical trials and other research through the hospital’s Center for Neuroscience and Neurological Recovery. A team of CNNR physician-scientists translate basic neuroscience research into useful therapies that benefit patients suffering from spinal cord injuries. By building on the hospital’s reputation and strong commitment to research, this team is able to quickly move research findings from the laboratory to the patient’s bedside, thus bridging the gap between biomedical discoveries and their clinical application.

This commitment to neuroscience research is a crucial component of a comprehensive spinal cord injury program. Our research team’s mission is to provide objective evidence about what works for whom, when and why, whether evaluating new promising therapies or challenging embraced clinical practices. The goal is to provide clinicians with the best possible evidence to consider when evaluating or modifying practices in spinal cord injury rehabilitation.

In this endeavor, patients and investigators form a partnership, with our patients contributing to knowledge by electing to participate in studies that they hope will benefit themselves or others like them.

Methodist SCI News

Numerous news releases and feature stories have been written about spinal cord injury patients who’ve had successful outcomes or made significant gains following treatment at Methodist Rehabilitation Center. To read those stories, go to the patient profiles section and click “spinal cord injuries.” Many more SCI news releases and links to news coverage about Methodist’s SCI program are available by entering the keyword "spinal" in the search box at the top of this page.

Program Manager
Susan B. Greco, RN, MSN, CRRN
sgreco@mmrcrehab.org
601-364-3480 or 601-497-2070

Nurse Manager
Susan Jefferson Myrick, RN, BSN, MHA, CRRN
sjefferson@mmrcrehab.org
601 364 3498

»	Does Methodist treat a lot of spinal injury patients?

Yes. In fact, Methodist Rehabilitation Center treated 180 patients in 2006. That's more than any other hospital in the state and more than the 14 largest hospitals in Mississippi combined who only treated 159 patients last year. These statistics are from the Mississippi State Department of Health.

»	Who is the typical spinal injury patient?

A lot of people think of a spinal cord injury patient as a 20-something-year-old male, but that is no longer the case. As the general U.S. population has aged, so has the classic victim of SCI. Since 2000, the average age at injury has been 38, which is up 10 years from the average age in the 1970s.

The prevalence of SCI in adults over age 65 has increased from 4.7 percent between 1973 and 1979 to 10.9 since 2000, which is possibly due to falls. In that same time span, the prevalence in the 0-15 year age group has decreased from 6.4 percent to 2 percent. There are some theories that the drop is due to better safety education for children.

As for gender, males account for 77.8 percent of the estimated quarter-million people with SCI. But there has been an increase in female victims since the SCI data base was set up in 1973. There also has been a rise in the number of African Americans and Hispanics sustaining spinal cord injuries, but that may have to do with the opening of SCI Model System sites in more urban areas. (These sites are the primary collectors of SCI data in the U.S.)

»	What are the main causes of spinal injuries?

Motor vehicle crashes still top the list, accounting for 46.9 percent of SCI cases since 2000. Falls are next, followed by acts of violence, primarily gunshot wounds.

»	What's the long-term outlook for people with spinal injuries?

The best news is more people are surviving the initial trauma of spinal cord injury. One reason is emergency medical service staff are doing a better job in the field stabilizing patients. And we’ve become experts in acute medical management and the rehab process by treating and preventing the secondary complications that occur.

As a result, there has been substantial progress over the past 30 years in improving the two-year survival rate from the time of injury.

Unfortunately, the survival rate more than two years post-injury and the overall life expectancy has tended to level off since 1980 with mortality occurring as a result of the causes seen with normal aging but at a higher rate.

»	Is the risk for cardiovascular disease greater for people with spinal injuries?

It is a leading cause of death for SCI patients who have survived more than 30 years and are over 60. What we know is that the incidence of cardiovascular disease is 200 percent higher in SCI patients than in age and gender-matched control populations. And hypertension is almost two times as common in patients with paraplegia.

A contributing factor may be that HDL, the good cholesterol, is lower in patients with SCI. They also have a decreased metabolic rate and a reduced exercise tolerance. We know exercise helps decrease heart disease, so if you’re not able to exercise, it is more difficult to decrease your risk.

Another interesting thing is SCI patients may not present with the same classic heart disease symptoms that would lead them to seek the help of a physician. A quadriplegic — because they are always short of breath — might not recognize shortness of breath and heaviness in the chest as cardiovascular disease symptoms.

»	What progress has been made to improve the health care of spinal injury patients?

The major progress that has been made so far has been in preventing and treating the secondary complications that occur as a result of a spinal cord injury. We are beginning to identify that SCI patients are at an increased risk for certain diseases compared with the general population. In response, we are providing routine annual screenings and followups for patients and providing instruction on health maintenance.

»	How involved should spinal injury patients be in their own care?

It’s critical for SCI patients to be proactive about their health. If people with SCI think it’s enough to see their physician only when they have a problem, they are not looking out for their own best interests. SCI patients should be consistently followed by a clinician who is aware of their potential for developing cardiovascular disease and other common complications and will prescribe medications and therapies to head off such problems.