Spinal Cord Injury Rehabilitation For Irish Patients.
Intensive inpatient rehabilitation for paraplegia and tetraplegia, at a 287-bed Rehabilitation Hospital in Greece. At least 3 hours of therapy a day, robotic gait training and a three-pool hydrotherapy complex. Reimbursed by the HSE.
No referral or paperwork needed for the first call.
Spinal cord injury rehabilitation at Evexia Plus
Evexia Plus is a specialist Rehabilitation Hospital near Thessaloniki, Greece, where people from Ireland come for spinal cord injury rehabilitation as inpatients: paraplegia and tetraplegia, complete and incomplete, after an accident, a fall or an illness. A physician in Physical Medicine and Rehabilitation with a specialism in spinal cord injury leads your programme, with at least 3 hours of therapy a day. If you are waiting for spinal injury rehab in Ireland, there is no waiting list here: admission can be arranged as soon as your medical records are reviewed. Under the EU Cross-Border Healthcare Directive, the cost is reimbursable by the HSE.
- Led by
- A physician in Physical Medicine and Rehabilitation
- Therapy
- At least 3 hours a day, goals reviewed weekly
- Where
- Near Thessaloniki, Greece, about four hours' direct flight from Dublin
- Funding
- Reimbursable by the HSE under the EU Cross-Border Directive
- Start
- No waiting list, once your records are reviewed
Paraplegia, tetraplegia and how rehabilitation helps
Rehabilitation teaches skills that protect your health for life.
The spinal cord carries messages between the brain and the body. Damage interrupts those messages below the injury, which can affect movement and feeling, the bladder and bowel, the skin, blood pressure and, after a neck injury, breathing. A neck injury causes tetraplegia (sometimes called quadriplegia), affecting the arms, trunk and legs, so tetraplegia rehabilitation puts your arms, hands and breathing first. A lower injury causes paraplegia, affecting the trunk and legs, and paraplegia rehabilitation centres on strength, transfers, your wheelchair and, where possible, walking. An injury is incomplete when some movement or feeling remains below it.
How much movement returns depends mainly on how complete the injury is, its level and your age; most of it returns in the first months. Rehabilitation cannot repair the spinal cord. It changes what you can do: moving from bed to chair, managing your bladder and bowel, protecting your skin and, for some people, walking.
How we support your recovery after a spinal cord injury
Bladder, bowel and blood pressure
Urodynamic bladder tests, a routine built around you, and an autonomic dysreflexia protocol, with teaching for you and your family.
Breathing and coughing
Cough assist, tracheostomy care and ventilator care where you need them, with a pneumonologist on our medical team and 24-hour cover.
Skin, seating and your wheelchair
Pressure mapping, wheelchair fitting, wheelchair skills training, practice in transfers and skin care education.
Walking, if you have walking potential
Walking practice with your physiotherapist, heart-rate-monitored treadmill training, and robotic gait training where your physician sees walking potential.
Arms and hands
Occupational therapy for daily tasks with robotic arm and hand systems, and physiotherapy with functional electrical stimulation (FES) and EMG biofeedback.
Water
One-to-one hydrotherapy in three pools with ramps and ceiling hoists, after your physician checks that the pool is safe for you, for example with a wound or a catheter.
Your spinal cord injury rehabilitation programme
Every programme is planned around your goals by a Physical Medicine and Rehabilitation physician with a specialism in spinal cord injury, who leads the team and reviews your progress with you every week. At least 3 hours of therapy a day goes on everything you need to learn. Spasms and stiffness are managed with stretching, positioning, standing on a tilt table, FES cycling and shockwave therapy, and with medicines when they still get in the way. Most people work with several of these services each day:
Physiotherapy and robotics
Transfers, walking, robotic gait training and FES cycling.
See the service
Occupational therapy
Arm and hand function, daily tasks, wheelchair skills and planning for home.
See the service
Bladder, bowel and skin care
Routines built with you, with teaching for your family.
Hydrotherapy
One-to-one sessions in three pools, using the Halliwick and Bad Ragaz methods.
See the service
Psychology and neuropsychology
Adjustment, mood and family support, in fluent English.
See the service
Speech and swallowing
Swallowing and voice after a neck-level injury or a tracheostomy, with FEES swallowing assessment on site.
See the service
Neuromodulation
Non-invasive brain stimulation for selected patients alongside therapy, for example with nerve pain, if your physician recommends it.
See the serviceA typical day
Morning
Physiotherapy for strength, balance and transfers, then occupational therapy for your arms, hands and daily tasks.
Midday
Lunch served at your bedside, with time to rest.
Afternoon
Walking or robotic gait training, hydrotherapy, wheelchair skills or psychology, depending on your plan.
Evening
Time with your family in the gardens, the lounges or your room.
What to expect during your stay
In the first days, the team assesses how you move, your bladder, bowel, skin and breathing, and what matters most to you. Then we agree your goals with you, and with your family if you wish. Realistic goals might be:
Recovery is different for everyone, and we cannot promise walking or any particular result. We track your progress, review your goals every week and tell you honestly what we see. Before you leave, occupational therapy prepares a plan for your home, and we send your doctor in Ireland a full report setting out your routines.
From the first call to coming home
Most people have never arranged care abroad. This is the whole route, so you know what happens next and who does it.
Before you travel
- 1
Talk to us
Call, send a WhatsApp message or use the form. We explain how the Cross-Border Directive works and what we need from you.
- 2
Send your records
A recent medical summary, your medication list and any recent scans. Our physician reviews them and tells you honestly whether a stay is likely to help.
- 3
Referral and estimate
Ask your GP or public hospital consultant for a dated referral letter; we tell you exactly what it should say. We send a written estimate in English before you commit.
Your stay
- 4
Choose your date
There is no waiting list. You choose the date. We meet you at Thessaloniki airport, and plan safe travel for neck-level injuries.
- 5
Consultation and admission
The outpatient consultation with our physician the day before admission, then your programme starts.
- 6
Your stay
At least 3 hours of therapy a day, with your goals reviewed every week.
Back home
- 7
Home and your claim
You go home with a plan for home, your bladder and bowel routine, and every document the HSE claim needs.
How the HSE reimburses spinal cord injury rehabilitation
Spinal cord injury rehabilitation at Evexia Plus is reimbursable by the HSE under the EU Cross-Border Healthcare Directive. You don't need a medical card or private insurance.
You pay the hospital
You pay Evexia Plus directly for your stay.
You claim from the HSE
With the documents we give you at discharge.
The HSE repays you
What you paid, up to what the same care would cost in the Irish public system.
What the HSE needs
- 01
A referral letter from your GP, or from a hospital consultant who sees you as a public patient.
- 02Our recommendation
An outpatient consultation, in person, dated after the referral. Have it with our physician in Greece the day before admission: one trip, and no wait for a clinic appointment in Ireland.
- 03Optional
Prior Notification gives an indicative figure, not a guarantee, and with current delays the HSE's reply can take months. We usually advise going ahead without it, because the HSE assesses every claim after treatment either way.
Reimbursable
- The inpatient programme (therapy, nursing care and your stay in the hospital)
- Medicines and tests during the stay
- The outpatient consultation at the HSE's rate
Not reimbursable
- Flights and other travel
- Family travel and accommodation outside the hospital
- Medicines you take home
Before you commit, our team sends a written estimate in English. At discharge, we give you every document the claim needs.
Your family can stay with you
Rehabilitation goes better with the people you love close by. One family member can stay with you free of charge, in your room or in nearby accommodation we arrange.
More relatives can stay in seaside hotels in Kallikratia, five minutes away, and a free shuttle bus runs to Thessaloniki. We collect you and your family from Thessaloniki airport, and take you back, at no cost.
Every member of our staff communicates in English. Meals are cooked in our own kitchen and planned by a dietician.
See Evexia Plus before you travel.
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Questions about spinal cord injury rehabilitation
Will I walk again after a spinal cord injury?
It depends mostly on how complete the injury is, its level and your age. People with an incomplete injury have the best chance. After a neck injury from a fall (central cord syndrome), walking often returns before full use of the hands. With a complete injury, walking rarely returns. You don't need to be walking to be admitted. Our physician gives you an honest view, and we never promise walking.
Is robotic gait training right for me?
It helps people with some movement in their legs practise stepping safely, many times over. We use it alongside walking practice with your physiotherapist, not instead of it. With a complete injury, it gives exercise, not recovery, so the effort goes into transfers, your wheelchair, and your arms and hands.
How long does recovery from a spinal cord injury take?
It is different for everyone. Most recovery of movement happens in the first months, and what you can do keeps improving long after, through skills, equipment and routines. The length of your stay is set by the consultant at your outpatient consultation and reviewed every week with you. The HSE does not limit the number of weeks it reimburses; it caps the rate.
Is it too late if my injury was years ago?
Often it is not, if you have a clear goal. Recovery of the spinal cord itself slows, but what you can do can keep improving for years. People come to us years after an injury to work on transfers, wheelchair skills, strength, walking or a new bladder and bowel routine. Our physician will tell you honestly whether a stay is likely to help.
Can I come after a broken neck, or with a tracheostomy or a ventilator?
Yes. Tetraplegia rehabilitation is part of our programme, with cough assist, tracheostomy and ventilator care, a pneumonologist on our medical team and 24-hour medical and nursing cover. For neck-level injuries, we make safe travel arrangements from Ireland with you and your doctors; travel costs are not reimbursable by the HSE. The main goals are usually your arms, hands, breathing and self-care.
What does bladder and bowel care involve?
It starts with tests, including urodynamic bladder tests. We build a routine that suits you, and teach you and your family to recognise autonomic dysreflexia and act quickly. Your discharge report sets out the routine for the people caring for you at home.
Do you treat spinal cord injury that did not come from an accident?
Yes. The spinal cord can also be damaged by a narrowed spinal canal (myelopathy), a tumour, an infection, a problem with its blood supply (a spinal stroke) or inflammation such as transverse myelitis. We also provide rehabilitation after spinal surgery, with goals set from your consultant's reports.
Can I come for spinal cord injury rehabilitation from Galway, Cork or Waterford?
Yes, from anywhere in Ireland. Your own GP or public hospital consultant writes the referral, whether you live in Galway, Cork, Waterford, Limerick or Dublin, and our physician reviews your records by email before you travel. We plan the journey with you and your doctors, and we meet you at Thessaloniki airport.
Does the HSE pay for spinal cord injury rehabilitation abroad?
Yes, under the EU Cross-Border Healthcare Directive. You pay the hospital directly, then the HSE repays what you paid, up to what the same care would cost in the Irish public system. You need a referral from your GP or a public hospital consultant and an outpatient consultation. Flights and family accommodation outside the hospital are not reimbursable.
Where does the outpatient consultation take place?
You can have it in Ireland with a public hospital consultant, or with our physician in Greece on the day before admission. We recommend the second: you make one trip and avoid waiting for a clinic appointment. Either way, it must take place after the date on your referral letter.
Can my family stay with me?
Yes. One family member stays free of charge, in your room or nearby accommodation we arrange. More relatives can stay in seaside hotels five minutes away, family can visit every day, and airport transfers are free for you and your family. Our psychology team supports your family too.
