Burwood Spinal Unit (BSU) provides services for people with Spinal Cord Impairment (SCI) resulting from accident, illness or congenital abnormalities.
We are a recognised tertiary service providing comprehensive, interdisciplinary assessment, treatment and rehabilitation for individuals with SCI who live throughout the entire South Island and lower half of the North Island (Taranaki to Hawkes Bay and below).
We are one of two leading providers of specialist care services providing expert support for individuals with SCI and their families. The Auckland Spinal Rehabilitation Unit provides SCI rehabilitation and assessment services for those in the upper half of the North Island.
The BSU consists of a 26 bed ward and a four bed Transitional Rehabilitation Unit. We offer inpatient services from the acute stage including pre-operative or other early management, through to rehabilitation and discharge planning. A range of outpatient, assessment and arranged admissions for specialised services are also provided. There is limited accommodation onsite for families and outpatients.
We also work in close collaboration with the New Zealand Spinal Trust and the Burwood Academy of Independent Living.
If you have not been seen by the reassessment team for more than 3 years, please contact us.
Recovery and rehabilitation from an spinal cord impairment (SCI) can take a long time. Patients are often in the unit for up to six months (depending on the level and type of injury). The rehabilitation team are there to provide assistance, advice, encouragement and expertise but the patient remains the most important member of the team. Successful rehabilitation depends on the patient committing to their rehabilitation.
Rehabilitation following a spinal impairment is carried out by an inter-disciplinary team together with the patient and their family/whanau. The interdisciplinary team includes doctors, nurses, physiotherapists, occupational therapists, social workers, psychologist, health care assistants, surgeons, dieticians, speech language therapist, Maori health workers and vocational rehabilitation consultants.
Rehabilitation programmes are designed around your specific needs and personal goals. Programmes will include many hours of physical training, learning how to manage your personal care needs, and education about the impact of SCI. This programme will give you the tools needed to gain independence and support self-determination.
Toward the end of the rehabilitation period, some patients may benefit from participating in the Transitional Rehabilitation Programme
Occupational Therapy (OT) outpatient services are available to Christchurch based residents who require specialist assessment for:
Daily living e.g. dressing, showering, toileting, feeding
Wheelchair trials, modification or review
Seating systems – including cushions and backrests
Modifications to home environment
Driving assessment services
Referrals to this service are accepted for ACC or Ministry of Health funded clients by a funder, GP or other health service provider. Clients can self-refer for equipment, housing or wheelchairs. Referrals can be sent by email.
Occupational Therapy: 03 383 6845
Urology (Uro) staff are experienced in bladder management of patients following spinal cord impairment (SCI).
Our staff include: Urologists, Doctors, a Clinical Nurse Specialist, Registered and Enrolled Nurses, and Technicians.
The aims of the service are:
Prevention of over distension of the bladder.
Prevention of infection.
Prevention of local damage to the urethra and bladder by instrumentation and artificial drainage.
Regular assessment and surveillance of the bladder and urinary tract to preserve the function of the kidneys.
The Urodynamics team will provide support and education on how to manage your bladder following a SCI.
The service oversees:
Management of all suprapubic, indwelling urethral and intermittent catheters.
Intermittent self-catheterisation.
Urine specimen collection.
Urinary appliance assessment.
Any other procedure which involves bladder or renal function.
Patients are readmitted to the Spinal Unit some months after discharge for Reassessment, which will include an assessment of current bladder management.
Patients are also readmitted for bladder surgery: including insertion of suprapubic catheter, bladder stone removal, sphincterotomy, flexible cystoscope, Botulinum Toxin, and bladder augmentation.
You will require a referral to the Burwood Spinal Unit from your GP, ACC Case Manager, or District Nurse for a Urology review.
Outpatients are seen for regular reviews of current bladder management.
Cystometry, Flowrates and Ultrasound residuals are performed by the nurses. Assessments of urinary drainage appliances and teaching of intermittent catheterisation may be done as an outpatient.
A Urologist is available for VCMG clinics once a week, Bladder surgery once a fortnight and an Outpatient Clinic once a fortnight. Flexible cystoscopy and Botulinum Toxin may be done as an outpatient.
It is important to have a urine specimen for culture and sensitivity done the week before an outpatient appointment, and have the results sent to Urodynamics. This is so you can have appropriate antibiotics if required.
If you are unable to attend the appointment, please let us know as soon as possible.
If you are being admitted for a Reassessment and are having problems with your bladder management, it is a good idea to contact the Urodynamics Department as soon as you receive your admission letter. This will allow us to discuss your problems and try to have any further investigations booked for when you are admitted.
It is also a good idea to fill out a bladder diary for a week before you come to see us.
A Flowrate is a non-invasive test to check the flow when you are passing urine.
An ultrasound residual is performed following the flowrate to check the bladder has emptied completely.
Renal Ultrasound Scan (USS) and X-Rays are recommended regularly to check for bladder and kidney stones.
They are usually requested prior to an admission for Reassessment.
They may also be recommended if catheter blockages are a problem.
A Cystometrey (CMG) is a bladder test which is performed by the Urodynamics Technician and Nurses.
This test will show any bladder contractions or high pressures in the bladder as it fills.
It enables the medical staff to check whether your current form of bladder management is the most appropriate.
VideoCystometrography (VCMG) is a bladder test very similar to the Cystometrey, but also involves the Urologist and an X-Ray Technician.
The bladder is filled with an x-ray contrast, which enables the Urologist to see what happens as the bladder fills. The test will show weakness or tightness of the bladder opening, or reflux back up to the kidneys.
This test allows the Urologist to assess whether your current form of bladder management is the most appropriate for you.
A cystoscopy is a procedure that uses a flexible fibre optic telescope (very tiny camera) to look inside your bladder. This procedure can be done as an outpatient or may be done with general anaesthetic if the doctors feel this is more appropriate.
The Urologist will be able to see inflammation or changes in the bladder wall, bladder stones, and strictures (blockages) in the urethra.
Botulinum Toxin can be injected into the bladder wall via a flexible cystoscope to partially “paralyse” the bladder and decrease bladder contractions and high pressures.
This may be done with local anaesthetic as an outpatient or you may be admitted for a general anaesthetic if the Urologist feels this is more appropriate.
Intermittent Self Catheterisation (ISC) is the insertion and removal of a catheter several times a day as required. It is a safe effective way to completely empty your bladder, and means you will not have a catheter permanently in your bladder.
Intermittent Self Catheterisation can be overwhelming to begin with. With guidance from the Urodynamics Nurses, practice and patience, you will gain confidence and independence.
For those with indwelling catheters, the BSU recommends fortnightly catheter changes and weekly bladder washouts.
It is important not to let the catheter become blocked. If the bladder fills with urine and stretches it may cause systemic infection, which will require antibiotic treatment.
Autonomic Dysreflexia may also develop in a tetraplegic patient when the catheter becomes blocked – this is a life threatening situation and requires immediate intervention.
If the urine is treated with antibiotics, it is important to change the catheter 24hrs after the first dose with a new catheter.
to order
Prior to discharge from the Spinal Unit, the Urodynamics Nurses will prepare a “script” of all the consumables required for your bladder and bowel care e.g. catheters, gel, tape.
This is faxed to your ACC Case Manager, who approves it and sends it to their contracted distributor, who then couriers the consumables to you every 3 months.
If you are not on ACC, a letter is sent to the District Nursing Service requesting the appropriate supplies.
You will require a referral to the Burwood Spinal Unit from your GP, ACC Case Manager, or District Nurse for a Urology review. You are welcome to contact the Urodynamics Dept. for information:
Phone: 03 383 9850 or 03 383 9483
Ext: 99683 or 99483
Kaleidoscope is a specialist vocational rehabilitation program based at Burwood and Auckland Spinal units and providing services at Middlemore Hospital.
The service provides specialised education, career planning and work support to both newly injured/ill persons and to those in the community, who have been living with an SCI for a period of time; recognising and valuing the inclusion of family and employers from the outset.
Find out more at www.nzspinaltrust.org.nz
Sexuality is complex; it includes physical, psychological, and social issues. Sexuality is unique to each individual and continues to evolve through your life. The goal for anyone with a SCI, as for all people, is to have a fulfilling and productive life.
This clinic is specifically for the support of patients with changes in sexual function following SCI. This is not a clinic for sexual health issues such as sexually transmitted infections.
Intimacy needs can be tailored to each individual’s specific needs and comfort level. Discussion, education and possible interventions are provided by Spinal Consultants and a Clinical Nurse Specialist.
This clinic addresses issues such as:
The Burwood Spinal Unit provides reassessment for people with spinal cord impairment.
There are three types of reassessment: Advanced, Basic and Remote.
Many patients will be booked for an advanced reassessment. It usually takes place approximately 6 months following discharge and is undertaken over 3 days. This is typically the first reassessment for an individual following their discharge from their inpatient rehabilitation at the BSU. The time period between discharge and reassessment allows the patient enough time in the community to identify any issues following discharge.
The individual may stay:
Advanced reassessment admissions usually occur on a Sunday. A nurse who is part of the reassessment team will undertake an initial assessment and find out what issues need to be addressed by the rest of the team.
The team meets with the patient on the Monday morning to address any issues identified by the nurse as well as any others that come to light during the discussion. At this meeting there will be a nurse, doctor, physiotherapist and occupational therapist present. Family members or support persons are also welcome to attend. Over the next 2 days a series of appointments and tests may be scheduled. These tests may include blood tests, X-rays and urology investigations. In addition, further assessments with the physiotherapist, occupational therapist, psychologist and social worker may be undertaken. The team meets again with the patient on the Wednesday morning to summarise findings and discuss recommendations or future planning needs before the patient goes home. In rare instances we may decide to extend the inpatient stay in order to complete some further investigations or assessments.
For those requiring specific investigations or trial of equipment, advance notice is required.
Basic reassessments generally occur approximately 12 months following the initial advanced reassessment and again thereafter at approximately 3 yearly intervals unless issues identified indicate more frequent reassessment is required.
Reassessment is undertaken either at the Burwood Spinal Unit or at another centre, depending on where the patient lives. (See list below).
A basic reassessment involves representatives from medical, nursing, physiotherapy and occupational therapy. Appointments are typically 45-60 minutes duration. The team can travel to other regional centres where outpatient appointments can be accommodated.
Basic reassessments occur at the following locations:
Prior to the appointment, routine blood tests and renal investigations are undertaken. Details of the tests required and where to have them done are provided along with the booking letter. It is important that these tests are done sufficiently in advance so the results will be available for discussion during the appointment.
A remote reassessment comprises of a health questionnaire that is sent approximately every 12 -18 months. The questionnaire is designed to address broad health issues as well as more specific concerns that commonly affect people with an SCI.
The questionnaire provides an opportunity for those with an SCI to raise concerns that may require more in depth assessment or attention. All returned questionnaires are reviewed by a member of the reassessment team for appropriate action. In some cases, the person may be brought forward for a Basic or Advanced assessment.
It is important that the Burwood Spinal Unit has your up to date contact details. If you are moving house or changing phone numbers please notify the unit so that we can inform you about future appointments.
If you, or someone you know, have not been seen by the reassessment team for over 3 years please contact the unit. Contact can be made personally or by your ACC support co-ordinator or GP.
The Burwood Spinal Unit (BSU) accepts patients into their service as soon as it is medically safe and practical to do so. Early transfer to the care of a specialised spinal cord impairment (SCI) team is important to ensure optimal treatment, reduce complications and maximise rehabilitation outcomes.
An acute referral is made by the referring hospital consultant to the on call rehabilitation consultant at Burwood. This may be from any hospital in the catchment area from Taranaki across to Hastings and further south. Arrangements are then made to transfer the patient to Christchurch Public Hospital, if appropriate. All acute patients are admitted to BSU via Christchurch Public Hospital ICU, Orthopaedic Trauma Unit or the Neurology ward. Patients are then transferred to BSU as soon as they are medically stable.
The medical team will decide in conjunction with the patient whether surgery is required to stabilise the spine. If surgery is not needed, then bed-rest or bracing may be indicated. These services may be provided at Christchurch Hospital or Burwood Hospital under the care of the BSU team or Orthopaedic surgeon.
Patients then requiring comprehensive rehabilitation will be transferred to the BSU to begin a rehabilitation programme.
The BSU is the only centre in New Zealand which provides rehabilitation to individuals with SCI who require ventilation. Patients in this situation will be transferred to the BSU, via Christchurch Public Hospital ICU, regardless of where they live in New Zealand. If a patient lives outside of the BSU catchment area and is able to be successfully weaned from the ventilator, they will usually be transferred back to the Auckland Spinal Rehabilitation Unit for continuing rehabilitation and discharge planning.
Further information about early management, the rehabilitation process, and hospital facilities is available in the Burwood Spinal Unit – All You Need to Know Handbook.
Physiotherapy is an integral part of the rehabilitation process. Working in partnership with the multidisciplinary team members, the patient and their family to achieve the goals of maximising independence, mobility and fitness. Physiotherapists work with patients on the Burwood Spinal Unit from the day they arrive and provide input at all stages of someone’s rehabilitation journey.
Respiratory techniques and interventions
Functional activity retraining e.g.
Bed mobility
Sitting up
Transferring from a bed to a wheelchair
Balance retraining
Gait re-education
Bodyweight support treadmill training
Passive movements and stretching
Strengthening exercises
Electrical stimulation of muscles
Functional electrical stimulated cycling
Functional electrical stimulation to assist gait
Wheelchair skills
Cardiovascular and fitness training
Manual therapy techniques
Hydrotherapy
Liaison with orthotists regarding provision of orthoses to assist function and gait
Patients who are having difficulty with spasticity may be referred to the Spasticity Clinic for assessment.
In this clinic assessment will be made of the client’s spasticity and how it impacts on their function and ability to participate in daily life. This will include assessments with both the physiotherapist and doctor.
This assessment as well as consideration of previous management will inform further treatment options. These options will be discussed with the client.
A review of the treatment interventions is usually planned for 1-6 months following the initial appointment.
Referrals to the spasticity clinic can be made by GP’s or may be recommended following a BSU reassessment.
A patient may be referred to the Spasticity Clinic in regard to the potential use of Botulinum Toxin. Botulinum Toxin is an expensive intervention that requires pre-approval for funding. It is also an invasive procedure and requires careful planning to ensure the best outcomes are achieved.
The Spasticity Clinic also provides opportunities where required for the potential use of Intrathecal Baclofen.
The upper limb surgery team (based at the Burwood Spinal Unit) is devoted to improving arm and hand function in people with tetraplegia. Reconstructive techniques involve the transfer of active upper limb muscles and tendons to restore/improve functions lost following a spinal cord injury.
The team consists of surgeons, rehabilitation doctors, physiotherapists and occupational therapists with expertise in different aspects of treatment and care of people with tetraplegia. People with tetraplegia living in NZ have surgery performed at the BSU, but post-surgical rehabilitation can be provided at either the BSU or the Auckland Spinal Rehabilitation Unit (ASRU), dependent upon individual preferences. Upper limb surgery has been performed at the Burwood Spinal Unit since 1984 with over 200 people in NZ having had at least one upper limb procedure during this time.
Optimal timing for surgery is when the individual is physically, mentally and socially ready to undergo surgery and the demanding post-operative rehabilitation. One year following SCI is normally the earliest it is undertaken and it can be successfully performed as long as 30 years after the spinal cord injury. Options for reconstruction depend on the specific needs of the person and spare active muscles they have available for transfer.
The most common operations are:
Restoration of elbow extension
Restoration of pinch / grip function in the hand.
Referral for an assessment is via spinal unit consultant or outreach team.
Assessment for surgery is available at the BSU (clinics held fortnightly) or the ASRU (clinics held twice a year).
More information can be found in the Upper Limb Surgery Booklet or by contacting the BSU Surgery Team
Transitional Rehabilitation (TR) is a programme designed to bridge the gap between being in hospital and returning home. We focus on independence and autonomy and work with you towards the goals you want to achieve.
Transitional Rehabilitation is part of the Burwood Spinal Unit but located in the adjacent spinal hostel. Each participant has their own room. There is a shared kitchen, dining room and quiet room. We go out into the community to work on skills important for your return to your own community. Transitional Rehabilitation has a maximum of four participants and is usually the last four weeks of an acute inpatient stay.
Rehabilitation in a home like environment, and in the community.
Learning sessions to increase knowledge about your spinal cord injury.
Independent living coaches who will share their skills and experiences.
Occupational Therapist, Physiotherapist and nursing staff to assist in meeting your rehabilitation goals.
Carer training for both family and paid carers, with support from the Transitional Rehabilitation team.
The Transitional Rehab Team consists of:
Nursing staff and health care assistants.
Occupational therapist and coordinator.
Physiotherapist.
Independent living coaches.
Independent Living Coaches are people with spinal cord injury who have experience living in the community. There are two part time independent living coaches.
Although you will primarily work with the TR team, you will still have access to other members of the multi-disciplinary team as required i.e. medical, social work, urology, psychology etc.
The New Zealand Spinal Cord Injury Registry (NZSCIR) collects information about people who have had a Spinal Cord Injury (SCI) to help improve our understanding of SCI in NZ. This can help to improve how we support people with an SCI and how we prevent SCI and related medical complications.
This nationwide registry covers participants from both supra-regional spinal services in NZ (Auckland and Christchurch) with either traumatic or non-traumatic SCI.
A range of information is collected including age, gender, ethnicity, basic SCI data and where treatment was received. If consent is given, we add details about participants’ treatment, complications, rehabilitation, and medical conditions.
We follow consenting participants into the community to see how SCI affects those in the community and what services are needed to ensure ongoing community participation.
You can join the registry or find more information, reports and contact details on the NZ Spinal Trust website
You can be referred for treatment to the Spinal Unit by your Doctor, ACC case manager, community service provider or other DHB. A patient cannot refer themselves directly to the service. Following discussion the Spinal Unit will then contact your referrer about what the next step will be.
Note: Clinicians can make referrals via Canterbury HealthPathways website.
Due to the major redevelopment of the Burwood Hospital Campus, the accommodation options are limited. We regret any inconvenience this may cause, and will update you with any changes as they arise. Please contact the Accommodation Manager for current availability.
Free internet access is available to all visitors to Burwood Hospital. This can be found under the DHB Public Wi-Fi network.
See the Free Public Wi-Fi page for more information and further technical instructions.
The nearest shops can be found at Parklands Mall, only 3 minutes by car from the hospital. Parklands Mall includes a supermarket, pharmacy and ATM. Further shopping can be accessed by bus at The Palms and Northlands shopping malls.
The New Zealand Spinal Trust is a support organisation for everyone with spinal cord injuries; their families, friends, caregivers and health professionals. They believe that independent living is the ultimate goal of rehabilitation, and their mission is to make sure you have all the information, resources and support you need to make that possible.
SpinalHub is an information and education tool developed as part of the Victorian Spinal Cord Injury Program (VSCIP).
SCI Intimacy Forum for consumers, partners and health professionals to discuss and learn from each other about sex, intimacy and spinal cord injury.
Spinal Essentials is an introductory course designed to help patients understand the anatomy of the spine, what the different medical terms mean, and information about the issues that all people with a spinal cord injury have to face.
Burwood Academy of Independent Living (BAIL) is an organisation committed to improving the life experience of people recovering from serious injury and illness. The Academy is dedicated to building a vibrant culture of research and learning devoted to independent living and the new rehabilitation.
The New Zealand Spinal Cord Injury Registry (NZSCIR) collects information about people who have had a Spinal Cord Injury (SCI) to help improve our understanding of SCI in NZ. This nationwide registry covers participants from both supra-regional spinal services in NZ (Auckland and Christchurch).
Page last updated: 5 December 2018
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