Spinal cord injuries create ongoing vulnerability to numerous medical complications. Secondary complications significantly increase lifetime medical costs and must be accounted for in damage calculations.

Common Secondary Complications

Respiratory Complications

Leading cause of death and hospitalization in SCI:

  • Pneumonia—impaired cough reflex increases infection risk
  • Atelectasis—collapsed lung sections from weak breathing
  • Respiratory failure—may require ventilator support
  • Sleep apnea—common after SCI

High cervical injuries carry greatest respiratory risk. Even thoracic injuries impair cough effectiveness.

Urinary Tract Complications

Bladder dysfunction affects nearly all SCI survivors:

  • Urinary tract infections—most common complication, recurring frequently
  • Kidney stones—from chronic catheterization and immobility
  • Bladder stones
  • Kidney damage—from repeated infections and high bladder pressure

UTIs cause most ER visits and many hospitalizations for SCI survivors.

Pressure Ulcers (Pressure Sores)

Inability to feel pressure leads to skin breakdown:

  • Develop from prolonged pressure on skin
  • Common sites: sacrum, heels, ischial bones
  • Advanced pressure sores require surgical treatment
  • Can become life-threatening if infected

Treatment costs for serious pressure ulcers can exceed $100,000.

Deep Vein Thrombosis (DVT)

Blood clots form in legs due to immobility:

  • Highest risk in first year after injury
  • Requires blood thinners for prevention and treatment
  • Pulmonary embolism (clot traveling to lungs) can be fatal

Cardiovascular Complications

  • Autonomic dysreflexia—dangerous blood pressure spikes
  • Orthostatic hypotension—low blood pressure when upright
  • Heart disease—higher rates due to sedentary lifestyle

Gastrointestinal Complications

  • Neurogenic bowel—requires daily management program
  • Constipation and impaction
  • Bowel accidents
  • Gallstones—increased risk

Musculoskeletal Complications

  • Spasticity—involuntary muscle contractions
  • Contractures—permanent joint tightening
  • Osteoporosis—bone loss from disuse
  • Fractures—brittle bones break easily
  • Heterotopic ossification—abnormal bone growth around joints

Impact on Legal Damages

Increased Medical Costs

Life care plans must account for:

  • Expected hospitalizations for complications
  • Emergency department visits
  • Surgical procedures
  • Additional medications
  • Preventive equipment (pressure-relieving surfaces, compression stockings)

Hospitalization Projections

Average SCI survivor experiences multiple hospitalizations annually:

  • First year: 2-4 hospitalizations typical
  • Subsequent years: 1-2 hospitalizations average
  • Each hospitalization: $10,000-$100,000+ depending on severity

Quality of Life Impact

Complications contribute to:

  • Pain and suffering damages
  • Lost time from work or activities
  • Reduced life expectancy

Prevention and Management

Proper care reduces but cannot eliminate complications:

  • Pressure relief—weight shifts, specialized cushions and mattresses
  • Bladder management—clean catheterization technique, adequate hydration
  • Skin checks—daily inspection for early breakdown
  • Respiratory care—cough assist, respiratory exercises
  • Activity—movement within limitations

Prevention requires ongoing vigilance and proper equipment—all compensable expenses.

Reduced Life Expectancy

Secondary complications reduce life expectancy for SCI survivors:

  • Respiratory complications are the leading cause of death
  • UTIs and sepsis contribute to mortality
  • Cardiovascular disease rates are elevated

Life expectancy reduction varies by injury level but must be considered in damage calculations.

Conclusion

Secondary complications are an inevitable aspect of life with spinal cord injury. Comprehensive damage calculations must include expected complication costs—hospitalizations, surgeries, increased care needs, and preventive measures. Life care plans should specifically address complication management expenses.