Member May 2026: Working Outside the Model: Pearls for SCI Practice Outside of the Model System-Session Recording

Video Transcription

Video Summary

The session opened with housekeeping reminders about professionalism, recording, muting, and using the hand-raise feature. Dr. Christopher Bow then presented on spinal cord injury (SCI) care outside of SCI model systems, drawing on his experience as a fellowship-trained SCI physiatrist practicing in San Diego.<br /><br />He explained that SCI model systems have been foundational to SCI medicine, improving outcomes through comprehensive, interdisciplinary care, research, and lifelong follow-up. However, they capture only a small fraction of SCI patients, leaving many people to receive care in fragmented, resource-limited settings. He highlighted major gaps in outpatient SCI management, acute rehab access, and continuity of care, especially in large regions without dedicated SCI centers.<br /><br />Dr. Bow shared three cases illustrating real-world challenges: a patient with chronic SCI and severe autonomic dysreflexia caused by undiagnosed bladder stones; an incarcerated patient whose dehydration was addressed with a makeshift adaptive drinking device; and a young woman with chronic paraplegia who had never received appropriate rehab, bowel/bladder care, or wheelchair support until she was admitted to his acute rehab unit.<br /><br />He emphasized solutions such as education for staff, improved equipment access, outpatient SCI clinics, and collaboration with community nonprofits. Triumph Foundation founder Andrew Skinner then discussed peer mentorship, adaptive sports, equipment loaner programs, and the value of lived experience in helping newly injured patients navigate life after SCI.<br /><br />The talk concluded with a call to strengthen partnerships between clinicians and advocacy organizations to improve access, education, and long-term outcomes for people living with SCI.

Keywords

spinal cord injury

SCI model systems

autonomic dysreflexia

bladder stones

acute rehabilitation

outpatient SCI care

wheelchair support

peer mentorship

adaptive sports

advocacy organizations