This is from the Telegraph in the UK: “I felt an extraordinary pain. I couldn’t move my legs at all’

“I was at home in the kitchen and I was just turning to dry my hands when it happened,” says Jane Morley. She was 65, in the midst of a full and active life in Highgate, north London, busy with her children, grandchildren, beloved garden, volunteering in the local Oxfam shop and supporting her Bafta award-winning documentary-maker husband, Peter. But in that apparently unremarkable instant, everything changed. She suffered a spinal cord injury and is now in a wheelchair.

Morley is one of the rapidly growing number of older people who have suffered spinal cord injuries. Until recently it was seen, by and large, as an affliction of the 18-35 age group, usually sustained in sporting or road accidents. But at the London Spinal Injury Centre, at the Royal National Orthopaedic Hospital, one of the 11 specialist units serving the estimated 40,000 people with spinal cord injuries in Britain, the proportion of over 60s admitted has risen from 2 per cent in 2004 to 20 per cent last year. And other centres report a similar steep rise. It is, they say, a hitherto unreported consequence of people living longer, more active lives.

What Is The Spinal Cord?

The spinal cord can be likened to a column of wires (nerve fibres) transmitting signal from the brain to the rest of the body. It is protected by the of bones the back, the spine and vertebrae, and by the discs, circular pads of cartilage with a tough fibrous cover and soft, gel-like interior, that lie between the vertebrae. If the bones fracture or splinter, or the discs slip, they can slice into nerve fibres in the spinal cord, causing paralysis. Depending on where in the spinal cord the damage occurs, this can affect the arms, legs, and even the respiratory muscles.

“In older people,” says Angela Gall, a consultant at the London Spinal Centre, “the bones in the neck and back are more brittle because of age and so fracture more easily in domestic falls. Also the central canal that encases the cord grows narrower as you get older. That makes any injury to the neck or back more likely to result in damage to the cord.”

Spinal Cord Injury, Not Sciatica

“I was using crutches to walk at the time of my injury,” says Morley. “I’d broken my leg and I suppose I must have been moving about in an awkward way. As I turned to dry my hands, I felt this sudden, extraordinary pain. I couldn’t move my legs at all, but I still had some feeling in them. I assumed it was a severe form of sciatica.” Instead of calling an ambulance right away, the family GP was summoned. Painkillers were prescribed and it was only 24 hours later, alarmed that a feeling of numbness was moving up her body, that Morley was admitted to hospital. It was discovered that one of the discs between her back bones had slipped out of place and pushed into her spinal cord, interrupting the nerve connections to her legs. While slipped discs in younger people do not usually cause such serious damage – around 20 per cent create no noticeable symptoms – they are more common in older people and, because the discs degenerate with age, they pose a greater risk of damaging the spinal cord.

Delay Is Disastrous

There is, as yet, no viable way of repairing damaged spinal cords, though some research is now under way using stem cells. The emphasis is on achieving a good quality of life for those affected. One key factor in minimising the extent of paralysis is, immediately after the damage occurs, to keep the patient absolutely still until the back can be stabilised, often by operating. In Morley’s case, though, it was 48 hours before she underwent surgery. This is not uncommon: spinal cord injury is still seen as unlikely to happen to older people and often goes undiagnosed in those first crucial hours.

Patients usually spend a minimum of three to six months at a specialist centre, though many of the new wave of older admissions are tending to stay longer.because it takes them more time to adjust to their new circumstances and learn how to cope with life from a wheelchair. Half of all patients will retain some feeling and movement in the affected limbs – the proportion is higher in older patients – so rehabilitation programmes work on maximising that. There are also often problems with bladder and bowel control, as well as the broader challenge of mastering new ways to do everyday tasks from a wheelchair.

“I do sometimes wonder how much more movement I might have if they had realised at once what had happened to me,” says Morley, “but there is no point thinking that way. I can still do things from my chair around the house, though gardening is frustrating.”

Instead of her daily walks on Hampstead Heath, she now goes swimming and uses the gym each week at a sports centre in north London run by the spinal injuries charity Aspire. The building is adjacent to the London Spinal Injury Centre. While Morley tries out a specially adapted rowing machine, in the main sports hall Derek Bryan, a 76-year-old clockmaker, is rediscovering table tennis. When younger, he played at county championship level. Now, after a spinal cord injury, he is learning how to wield his bat from a wheelchair.

Bryan, from Borehamwood in Hertfordshire, is an in-patient on the spinal centre. He had thought his backache was one of those ailments of old age to be endured, but just before last Christmas he woke in agony and called an ambulance. He didn’t know it at the time, but he too had had a disc slip out of place, which pushed into his spinal cord. “I was told that if it was chest pain, they’d come right away,” he recalls, “but for back pain it would be up to an hour. I then spent seven hours waiting in accident and emergency before a scan revealed that a disc in my back had popped. It was a bloody disaster.” The resulting damage to his spinal cord has left his legs paralysed. He has now all but completed his rehabilitation, but his discharge is dependent on adaptations being made to his home so that he can get around it. “I have had to use my savings to pay for the building work,” he says.
…

Don’t Despair

There is also a challenging psychological side to deal with. “Everyone is an individual, but often we are working with people who were just setting out on retirement, full of plans and hopes, and suddenly all that has been taken away,” says Gall. “Some question whether they want to go on.”

Jane Morley knows all about such thoughts. “If I don’t get out a lot, I can get low, but I always try to keep a positive perspective and maintain my sense of humour. As my son said when he first visited me in hospital. ‘Just think, this could have happened to you when you were 20 not 65.’ It made me realise I was very fortunate.”

Spinal Cord Injuries

The spinal cord, which is about as thick as an index finger, is a bundle of nerve fibres, descending from the brain down the back. It is encased in the vertebral canal and transmits signals from the brain to the rest of the body.

The cord is very sensitive to injury from fragments of fractured bones or slipped intervertebral discs, resulting in nerve damage and possible paralysis. Injuries most often occur where the spine is most flexible, in the neck, and base of the rib cage, and paralysis occurs below the injury. The spinal cord does not have the ability to repair itself.