Contributed by Michael L. Kelly, MD | NeuroSurgery and James Wilson, DO, MetroHealth Rehabilitation Institute
When it comes to spinal cord injuries, time matters.
From moment zero when the injury occurs, the clock starts ticking. The sooner a patient gets into surgery, the greater their likelihood of rehabilitation and recovery.
“How fast we get a patient into surgery matters greatly as we try to preserve injured nerves,” says Michael L. Kelly, MD, Department Chair of Neurosurgery. “That’s why it’s critically important to be at a hospital with a neuro-trauma system in place—a hospital recognized for leadership and its ability to provide the best outcomes for survival and recovery.”
Dr. Kelly says the speed with which the spine can be decompressed is vital for long-term functional improvement. And as one of only 18 Spinal Cord Injury Model Systems in the U.S., MetroHealth Rehabilitation Institute is where you want to be.
“Our ability to respond quickly to spinal cord injuries is among the best—and far above the national average,” says Dr. Kelly.
Speed to Surgery
According to data collected through the Trauma Quality Improvement Program (TQIP), the national registry operated by the American College of Surgeons, MetroHealth is setting the standard for excellence. From the trauma centers that report to TQIP, the national average for getting patients to surgery for an acute spinal cord injury is 22.28 hours*.
MetroHealth’s average is a third of that time: 7.25 hours.
Dr. Kelly says MetroHealth’s ability to respond efficiently and effectively is linked to three key factors:
- Right people: “We have an experienced spine surgery team that is nationally recognized and deeply committed—and on-call 24/7,” he says.
- Right processes: “Our triage/transfer protocol is data-driven,” Dr. Kelly says. “We’re constantly looking at outcomes and assessing quality measures so we can adapt and improve practices as needed.”
- Right places: “We’ve set aside dedicated operating rooms for trauma patients,” he explains. “This space is allocated especially for trauma cases so we can act as quickly as possible.”
Early Rehab Consultation
After surgery, the next speed goal involves the rehabilitation team.
“As a Spinal Cord Model System, we adhere to the protocol of providing a consultation and exam within72 hours,” explains James Wilson, DO, Director, SCI Rehabilitation, Department of Physical Medicine and Rehabilitation (PM&R), and Co-Director, NORSCIS SCI Model System Program. Just like with surgery, MetroHealth surpasses this standard.
The PM&R team gets consulted within 24 hours and sees patients quickly, depending on medical stability.
Whether chronic or acute, the rehabilitation team consults and examines a patient as early as possible to help avoid further complications and make decisions about the next steps. Specifically, Dr. Wilson or Christina V. Oleson, MD—both certified in Spinal Cord Injury Medicine—along with support from the physical and occupational therapy team, provide a prognosis and outline what to expect—not only during the stay in the acute hospital but as a patient moves to the rehab hospital and, eventually, integrates back home.
“The early relationship with the patient is a valuable asset,” Dr. Wilson explains. “We provide information in chunks so as not to overwhelm them but offer enough to help them make medical decisions and anticipate next steps.”
Research and Long-Term Support
Another critical factor in MetroHealth’s ability to provide the best chances for long-term recovery is the strong collaboration between its spine surgeons, trauma surgeons and the rehabilitation team. This close relationship doesn’t just involve the transfer from surgery to rehab but also includes joint research studies that strive to improve functional outcomes. Currently, the neuro-trauma teams and PM&R teams are co-investigators in a study sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The study is assessing the feasibility of administering gabapentin within five days of the spinal cord injury to improve neurologic recovery. It is being done in preparation for a future multi-center efficacy study. Such an effort is only possible given the strong multi-departmental collaborations and further strengthens routine clinical care.
In addition to prioritizing trauma care, early rehab consultation and access to innovative research, MetroHealth stands out as a spinal cord care center for another vital reason: ongoing support for those living with a spinal cord injury. MetroHealth’s clinical teams offer several specialized outpatient clinics to address some of those challenges and help patients live as comfortably and functionally as possible. To better serve the SCI community, MetroHealth offers specialty services (such as the urodynamics clinic, advanced surgeries via the tetraplegia management clinic, advanced technology adaptive life technologies lab, and rehabilitation osteoporosis clinic) as well as wholistic primary care and community engagement (such as the medical home clinic, annual SCI Community Forum, and support of the United Spinal Association of Northeast Ohio).
Full-Spectrum Care for Spinal Cord Injuries
Whether a patient has a new spinal cord injury or is experiencing complications from an existing one, MetroHealth Rehabilitation Institute is where they want to be. From initial surgical response to long-term functionality and quality of life, the MetroHealth team is dedicated to providing a medical home for all needs related to a patient’s care.
*Spring 2023 data
