Numerous aspects of spinal cord injury have undergone extensive research over the years. However, amid this comprehensive exploration, one crucial aspect remains insufficiently emphasized: sexuality. Despite its paramount importance to individuals' holistic well-being, sexuality often receives inadequate attention within rehabilitation programs. In this article, we aim to underscore the significance of addressing this dimension comprehensively, especially given its increasing recognition and exploration in recent years.

The individual with spinal cord injury is the most important member of the interdisciplinary team of health care professionals who provide care and researchers who progress treatments. The consumer voice is critical to understanding priorities and preferences. A literature search was conducted to identify consumer-level contribution, yielding 68 articles. Functional recovery priorities of motor and bladder/bowel function were universal. Priorities of secondary complications mirrored functional recovery, highlighting the impact that mitigating secondary complications can have on functional recovery. Imbedded within interventional preferences are those priorities, balanced between risks and benefits. Improving independence was consistently weighed against fear of functional decline.

Women encompass about 20% of all the traumatic spinal cord injury (SCI) population and there is increased incidence and prevalence of women with SCIs. The most recent data estimate that approximately 40,000-45,000 women with SCI are living in the United States, increasing from previous years, with the most common cause still being motor vehicle collisions. Throughout their lifespan, women with SCI present with unique healthcare needs compare to the male population. Therefore we present a comprehensive summary to empower and equip all providers with awareness of these needs and recommendations of care.

Autonomic dysfunctions are a major challenge to individuals following spinal cord injury. Despite this, these consequences receive far less attention compared with motor recovery. This review will highlight the major autonomic dysfunctions following SCI predominantly based on our present understanding of the anatomy and physiology of autonomic control and available clinical data.

The transition to adulthood is a complex and dynamic process for youth with spinal cord injury (SCI). A key goal of SCI rehabilitation is to develop the skillsets necessary to successfully transition to adulthood, lead a meaningful life, engage in one's community, and maintain a good quality of life. This article provides an overview of transition outcomes and interventions within a biopsychosocial framework, with regard to physiologic functioning, participation in education and employment, emotional and social well-being, and the health care system.

This article focuses on identifying how health care providers can support a person with spinal cord injury to pursue and maintain involvement in adaptive sports. Benefits and barriers of sport participation, equipment considerations, and recommendations on how to determine sport appropriateness for a person with spinal cord injury will be provided. The authors emphasize through appropriate medical management and consideration of level of disability, functional performance, psychological readiness, and individual preference, a health care provider can play a valuable role in connecting individuals with spinal cord injury to adaptive sports and recreation.

Spinal cord injuries (SCI) affect the anatomy and physiology of the spinal cord and result in characteristic changes. Identifying the impairments resulting from SCI is vital for the health care provider. Specifically, this article focuses on neurologic decline after SCI in the subacute to chronic stages. This includes changes in spasticity and its management over time, management of neuropathic pain after SCI, the development of spine complications (posttraumatic syrinx, spinal cord tethering, and so forth), management of dual-diagnosis traumatic brain injury and SCI, and other neurologic complications in chronic SCI management, such as upper-extremity entrapment mononeuropathies.

Musculoskeletal pain occurs in 50% to 81% of people living with spinal cord injury. Pain can have a significantly limiting impact. Pain can lead to decreased mobility, endurance, social participation, and depression. Additionally, many people living with spinal cord injury (SCI) rely on their upper body for ADLs (activities of daily living) which may result in decreased independence in cases of severe pain. Musculoskeletal impairments associated with spinal cord injury include decreased muscle mass and bone density, spasticity, contractures, as well as overuse injuries in muscles, tendons, and joints. These issues can contribute to pain and morbidity in patients with SCI. However, there is a lack of research on the risk of developing these conditions in the SCI population. This article aims to investigate and outline the common MSK conditions after SCI. Other musculoskeletal impairments that can often be found in patients with SCI include but are not limited to muscle atrophy, osteoporosis, fractures, spasticity, heterotopic ossification, tendinopathies, and mononeuropathies.

Neurogenic bowel is often overshadowed by other medical complications of spinal cord injury (SCI) but can significantly impact one's quality of life. This article aims to illustrate the intricacies of anatomy and physiology within the gastrointestinal (GI) tract as it pertains to SCI and how to navigate neurogenic bowel management-from the acute postinjury phase through the lifelong journey of adaptation and care in outpatient settings.

The majority of individuals with neurogenic lower urinary tract dysfunction will have complicated urinary tract infections (UTIs) that will qualify as recurrent. Existing inconsistencies and challenges contribute to its subjective diagnosis. Thus, there is a pressing need for a reconceptualization of our understanding of UTI, accompanied by a paradigm shift in diagnosis and treatment approaches.

A marked decrease in bone mineral density is a well recognized, if not always fully addressed, spinal cord injury-related comorbidity. The bone loss starts shortly after paralysis onset, and the loss rate is steep. The diverse etiology includes mechanical, neurologic, endocrine, vascular, and pharmacologic factors. Dual x-ray absorptiometry is available and affordable to quantify the degree of bone loss and follow changes related to treatment. Fragility/low impact fractures occur frequently and can induce significant morbidity. Physical modalities and pharmacologic interventions can be employed to stave off and/or reverse bone loss with variable success rates.

PM&R plays an essential role in managing the individual with a spinal cord injury (SCI). Receiving care at an acute hospital and a rehabilitation center familiar with SCIs is critical. PM&R can guide the health care team and the patient/family through such a potentially life-changing event. Early consultation can help prevent complications and decrease stay length and mortality. A life-long relationship with the rehabilitation team is often recommended; team members such as navigators and multiple inpatient rehabilitation stays can help enhance care and opportunities for individuals with SCI.

This article describes the differences and similarities in post-acute care for patients with spinal cord injuries in Canada, the United States, and Mexico. It provides a comprehensive description of the current state of spinal cord injury post-acute care in each country, including the prevalent practices, rehabilitation continuum of care, as well as challenges and opportunities related to clinical services, psychosocial factors, economic considerations, and cultural influences.

Limb loss is a common and disabling experience for patients, frequently caused by critical limb ischemia or deterioration of chronic wounds. Disparities in outcomes for prevention of amputation, level of amputation, and postamputation outcomes have been described. Understanding the nature of these disparities and the populations most affected can help clinicians and policymakers target interventions and programs. This article reviews existing literature regarding disparities in amputation care, including prevention methods, surgical outcomes, and postamputation outcomes. The authors identified several potential racial, socioeconomic, and gender disparities, particularly affecting Black, Native American, and Latino/a/x patients, female gender, and those in rural settings.

Reintegration back into one's life following limb loss is heavily influenced by the interaction among the individual's mental health, environment, and physical factors (eg, pain and prostheses). While many patients experience posttraumatic growth and successfully reintegrate back into their lives, others have a more difficult adjustment. Interdisciplinary teams can best facilitate reintegration through early screening for barriers to reintegration such as depression, pain, body image, and inaccessible environments, to intervene early after amputation. With these barriers addressed, amputees may be able to return to driving and other valued activities more quickly, resulting in improved reintegration across life domains.

This article reviews emerging surgical techniques and prosthetic innovations related to amputation rehabilitation. Osseointegration is discussed from conception to modern implant designs. Motor and sensory reinnervation techniques are reviewed and compared. Prosthetic socket casting, interface, and design innovations are discussed, including direct molded sockets, water casting, adjustable sockets, and magnetic suspension. Advanced components with hydraulic and microprocessor control, power and crossover prosthetic feet are described.

Much of the burden of living with a disability is concentrated among those populations least financially able to bear the burden. As the price of 3 dimensional (3D) printing decreases, individual access to this technology increases. 3D-printed prostheses can be designed specifically for use in resource-poor settings, including developing countries, to minimize the cost of consumable parts while optimizing durability in harsh environmental conditions.