Research tracks severity—and rise—of spinal cord injuries from older adult falls

Older adults who incur falls are increasingly becoming prone to spinal cord injuries as a result—and research suggests a combination of working or being independent longer and age-related degeneration may be the reason.

Numaira Obaid, a postdoctoral fellow in SFU’s Surrey-based Neurospine Biomechanics Lab, is investigating how age-related degeneration impacts geriatric spinal injuries. She hopes her findings will help develop better fall prevention strategies.

“As more adults work later in life or seek to prolong independent living, they are more susceptible to falls,” says Obaid. “Geriatric spinal cord injuries are different and more complicated, both clinically and mechanically, in terms of how the injury occurs.”

Most commonly, older adults incur cervical spinal cord injuries through fall incidents where the neck extends beyond its normal range, she explains. “The hyperextension of the neck becomes a challenge when the individual has underlying age-related spinal degeneration that pushes against the spinal cord and damages its tissues through an incident, such as a fall.”

Obaid’s research involves simulating injuries through computational models and reviewing data such as MRIs of previously incurred spinal cord injuries, using imaging data from Vancouver General Hospital and a data registry from the Praxis Spinal Cord Institute in Vancouver.

“It turns out that 71 per cent of older adult spinal cord injuries are the result of a low injury fall, like a slip and trip on ground level, which causes a hyperextension of the neck and cervical spine,” she says. According to Obaid, every day one in three older adults in North America will experience a fall and one in seven of those involve spinal injuries.

“In older adults, because of degeneration in the spine, something as simple as hyperextension motion of the neck can lead to tissue damage in the spinal cord. We’re working to understand the damage and the causes of more significant injuries that can result, as well as the risk factors.”

Recent funding, including a $200,000 US Craig H. Neilsen Foundation postdoctoral fellowship through its Spinal Cord Injury on the Translational Spectrum grants—a first for SFU—and a $150,000 Michael Smith Health Research B.C. Research Trainee award, are enabling her to further investigate real-world spinal injuries while assessing a decade of MRI data.

Together with SFU MSE professor Carolyn Sparrey and Dr. Brian Kwon, an internationally recognized surgeon-scientist at Vancouver General Hospital, she is building a human model to simulate what happens to the spinal cord in older people with a hyperextension injury, and in particular, where there may be correlation with degeneration, to identify who may be most at risk for serious or further injuries.

“Geriatric spinal cord injuries are fascinating to me because of the different circumstances and physical challenges that are more unique to older people,” says Obaid, who as a PhD student was part of a health tech start-up team that developed a glove to help individuals with Parkinson’s disease.

“Something as small as a slip-and-fall can have an unfortunate impact if there are underlying issues because of aging,” says Numaira, whose own grandmother recently suffered a fall-related spinal cord injury. “The outcome can be quite severe, causing impairment in everything from general movement to day-to-day tasks, even fine motor skills like signing a name.

“The problem is that once you have such a health issue it can snowball into a bigger one and it makes these older adults more susceptible to further injury. We’re hoping that by better understanding what leads to injury severity, we can help prevent them from happening in the first place.”