Problem:
Miles and his friends were out on a Sunday afternoon riding motorcycles. They had a homemade track with many hills for jumping and obstacles to maneuver. On his third lap around the track, he lost control and was thrown from the bike. When his friends reached him, Miles was conscious but was unable to move. The 911 operator walked them through assessing Miles' condition. He showed no evidence of bleeding, but they were told not to move him. They were advised just to talk to him and try to keep him coherent. By the time the ambulance arrived, 25 minutes had passed. The EMT's rushed Miles to the emergency room, where doctors found him with no feeling from the neck down. Miles was unable to move his arms or his legs, however he was breathing on his own. At what spinal level did Miles' injury likely occur? After three weeks in the hospital, Miles gained some sensation in his hands and after months of therapy he regained "some" use of his arms. If after one year, Miles has not made any additional progress, is he likely to regain any more movement in his upper extremities? Since Miles is now wheel-chair bound, what musculoskeletal changes will he see in his legs? Does Miles still have control over his bowels? Will Miles now have the longevity that he once did, prior to sedentary confinement?