UPDATE 2001 and 2002

Modern medicine and an improved standard of living can give new hope to people 
who have spent all, or a greater part, of their life living with a disability. 
Now for the first time in history, we can expect to live approximately as long
as the rest of the population. Individuals that have been living 30 - 50 years 
with a disability, now experience new problems through the combinations of the 
problems connected with their disability and those that come with normal aging 
- that neither they, nor their Doctors have been taught to handle. 

Some research has been undertaken recently as it became clear that this is a 
major challenge in the future. The emerging of "secondary conditions" has been 
shown in several diagnosis (including Spinal Cord Injury, Polio, Rheumatoid 
Arthritis, Cerebral Palsy). Common secondary conditions for these disability 
groups are: lower bone-mineral density/osteoporosis, cardiovascular problems,
glucose-intolerance/diabetes, wear and tear, fatigue, weakness, and depression. 

Attention must be focused on "over-use"/"over-load" syndromes: Disabled people 
use more energy performing certain tasks than non-disabled people. Some work 
on maximum energy level all the time, just like a sports-athlete running in a 
marathon. In time, this will result in decreasing capacity. Spastic Cerebral 
Palsy is an example of such a condition.

To those of us with Spastic Cerebral Palsy this means a great deal more than 
just mobility limitations. The extended excessive load factor on each of these 
affected subsystems of our body can exceed the total lifetime capacity of the 
system. 

The main subsystem to be described in this report is the upper spinal column 
and its associated neural network. 

WHAT IS THE SPINE

Your spine is one of the body's major weight bearing structures. It 
is unique in how it allows many types of motion to occur by 
connecting as a chain of motion segments, while still supporting 
your upper torso. 

The front (anterior) part of your spine consists of the discs and 
vertebral bodies. These structures are the primary load bearing 
parts of a healthy spine. The back (posterior elements) of your 
spine has multiple bony protrusions (bony processes) and two joints 
(facets) which the body uses to connect one vertebra to another 
with ligaments. 

The gaps in the spine (foramen) are as important as the solid 
portions of the spine. These foramen are the portholes through which 
the nerves exit from the spine and go out to the rest of the body. 

The annulus of a disc, through your repetitive motions, can wear out 
and over time may permit small tears or leaks. This can allow the 
nucleus to escape (herniation), like the air from a tire. 

When this herniation occurs the nerves were previously free and 
mobile in the spine can become trapped and pinched by the nucleus, 
this narrows the spaces for nerves and is commonly called stenosis. 
When the nerves are pinched in this way, patients commonly report 
pain not only in their backs but also in their legs (sciatica). 

As we age, discs can also become dehydrated and shrink. The result 
is a narrowing of the disc space and potentially a disruption of 
normal motions, load bearing characteristics and sometimes alignment 
that becomes spondylolisthesis (forward slip) or retro-listhesis 
(backward slip). It is commonly believed that these changes are the 
primary reasons DDD (Degenerative Disc Disease) causes back pain. 

When the disc shrinks, the posterior elements may also cause pain by 
sliding together and narrowing the foramen (stenosis). Just like a 
herniation, it can pinch the nerves and can cause leg pain, too. 

WHAT IS SPINAL DEGENERATION?

SPINAL DECAY

Spinal decay or degeneration is often such a painless problem that by the time 
a person notices its effects or feels any pain, the vertebrae may have been 
deteriorating for many years!

The damage is caused in a number of ways. The vertebral misalignment alters 
the spine's centre of gravity, putting more stress on some vertebrae than others, 
and the bone responds to the extra stress by remodelling and distorting its shape 
so as to keep the spine as stable as possible.

When misalignment causes nerve stress or nerve pressure, this wears away the 
vertebrae and surrounding soft tissue - the discs, ligaments and tendons.

THE CHIROPRACTIC APPROACH

Spinal degeneration is a barometer of spinal health. Yet we need not sit and 
passively await our spine's destruction. Chiropractic spinal adjustments can 
decrease the rate of degenerative joint disease and improve the chances of the 
joints, nerves, discs and other tissues remaining healthy and strong throughout 
our lifetime.

Spinal degeneration affects the body in many ways; the bodies chemistry is 
changed by the longstanding stress, the organs begin to suffer from loss of 
nerve supply - the overall ability to adapt to the pressures of life is 
compromised. In time the person afflicted loses the spring to his/her step and 
the chronic fatigue sets in.

The spinal column is subject to many stresses throughout a lifetime; - disease, 
accidents, emotional tension, falls and other injuries.

Over time the spinal column's many complex parts - intervertebral discs, 
ligaments, tendons, and the very bone itself - deteriorate.

Stress often causes the spinal vertebrae to shift from their proper places, or 
become misaligned and irritate the surrounding nerves, bones, discs, ligaments 
and other soft tissues.

SCOLIOSIS CAUSED BY MEDICAL DISORDERS 

Scoliosis may also be a result of muscle paralysis or deterioration from 
diseases such as muscular dystrophy, polio, or cerebral palsy. Other diseases 
that can cause scoliosis are Marfan's syndrome, Friedreich ataxia, Albers-
Schonberg disease, rheumatoid arthritis, and osteogenesis imperfecta. Injury 
to the spinal cord may also cause scoliosis. 

Spondylosis. Nearly all individuals with untreated scoliosis at some point 
develop spondylosis, an arthritic condition in the spine. The joints become 
inflamed, the cartilage that cushions the disks may thin, and bone spurs may 
develop. If the disk degenerates or the curvature progresses to the point that 
the spinal vertebrae begin pressing on the nerves, pain can be very severe and 
may require surgery. Even surgically treated patients are at risk for 
spondylosis if inflammation occurs in vertebrae around the fusion site. 

SUMMARY

All of this information was cut-and-paste from about a dozen websites dealing 
with spinal degeneration. Using these keywords as a guide, you should be able 
to fill in any gaps to whatever degree of detail you desire. Or print it out 
and take it to a qualified Medical Professional for confirmation. 

HOW I GOT HERE

I am 67 year old and I have had Spastic Cerebral Palsy all of my life. Sometime 
in my twenties I sought and recieved the best information available at that time 
on the expected lifetime progression of this condition. Based on the assumed 
Stability of Cerebral Palsy and an expected early death around age 50, I charted 
and lived a very good life. When I reached age 50 I had retired and I had my life 
in order such that my early death would not unduly harm anyone I loved. 

I then gradually became aware of two unexpected trends. One, I was still as alive 
as ever, and two, my physical ability was eroding or degenerating at an excessive 
rate. I was mentally prepared for normal aging on any extra years that I was 
lucky enough to recieve, but this excessive degeneration was totally unacceptable. 
Over about a dozen years I went from a walking range of two or more miles to 
being completely confined to a wheelchair. The use of my arms and some other body 
functions was also compromised to a similar degree. 

I sought more answers and the best information I could find was that there was an 
unexpected degenerative phase in Spastic Cerebral Palsy that had been masked by 
the limited lifespan of the typical subject with this condition. Modern Medical 
Advances made me a member of the first generation to statistically pass the 50 
year age limit. I continued Library Research on this subject and correspondance 
with the few Medical Professionals that seemed to have expert knowledge on this 
subject, but noone seemed to really know what was happening. My best guess was 
that it was some form of overuse syndrome around the Anterior Horn Cells of the 
Spine. 

In order to explicitly identify the mechanism of the degeneration, I took my body, 
which I now view as a medical asset, to a Neurologist for medical diagnosis. When 
he stuck to the old definition of Cerebral Palsy as a stable condition, I asked 
him to find what was wrong with my body to cause this degeneration. From the 
muscle bulk, the Muscles seemed to still be OK. We did a 

 to check my 
overall health. The results came back negative, (that there was nothing wrong 
with my blood.) Nerve Conductance Tests on my arms verified that these nerves 
were normal, (not degenerated.) My logic was that if we eliminated all possible 
causes of degeneration except the brain and the catch-all diagnosis of ALS, we 
would have a strong inferrential case supporting a degenerative phase of Cerebral 
Palsy. The next step was an MRI of the head, neck and upper spine, to eliminate 
the possibility of a tumor or similar problem. 

The 

 showed "severe spinal degeneration," The Neurologist informed me 
that the expected symptoms of this condition were exactly what I had described. 
After some thought I could see that this diagnosis means that we were both right.
Spastic Cerebral Palsy has caused an identifible secondary condition that in turn 
caused my physical degeneration. This is similar to the classic statement that 
AIDS does not kill anyone. It just leaves the body vulnerable to many diseases 
that would be harmless to a normal Immune system. 

The years of Stress from Spastic Cerebral Palsy caused Spinal Degeneration, which 
caused the functional degeneration. Other potential causes or secondary conditions 
include diabeties, tumor, several nerve conditions, and some joint diseases. 

In my case surgery could stabilize the spinal column, stopping the excessive 
degeneration, but there is no medical procedure to repair the damage already done 
to the spinal cord. 

THEREFORE ...

Therefore, if you have Spastic Cerebral Palsy, and you feel that you are aging 
at an excessive rate, I strongly recommend that  you seek medical attention to 
determine if you have any treatable "Secondary Conditions." My limited research 
done in the three or four weeks since my MRI results, seems to indicate that 
spinal degeneration is a fairly common condition in older subjects with Cerebral 
Palsy. 

If you have difficulty getting an MRI you may be more comfortable with a CAT Scan.

Also, here is the data sheets on 

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FUTURE PLANS

I intend to expand this website again. I have a new domain Name, 
     

that goes well with:
     

I am also adding many goodies that are not disability related. 
      

I am also considering adding a collection of indexed biographies of other 
subjects with cerebral palsy that can help us explore more completely the 
theme of aging.  Each subject would have an individual address like:

      http://www.cerebral-palsy.net/members/yourname/

Do you have any suggestions?

email wallingford@usa.net