Spinal Cord Injury

What is it?

Gives back ache a whole new meaning

Spinal cord injury (SCI) involves damage to the spinal cord that results in a loss of function such as mobility or feeling. In order for the loss of function to occur, the spinal cord does not have to be completely severed. In most individuals with SCI, the spinal cord is intact, but it is the damage to it that results in the loss of functioning.

The resulting damage to the cord is known as a lesion, and the paralysis is known as quadriplegia or tetraplegia if the injury is in the cervical region, or as paraplegia if the injury is in the Thoracic, Lumbar or Sacral region.  The effects of spinal cord injury depend on the type and level of the injury.  Injuries can be divided into two areas:

  • Complete – means that there is no function, (no sensation or voluntary movement) below the level of the injury.
  • Incomplete – there is some function below the level of injury.  A person may be able to feel parts of the body that cannot be moved, they may be able to move one limb more than the other

Also, a person can break their back or neck yet not endure a SCI if only the bones around the spinal cord (the vertebrae) are damaged, not the actual spinal cord. In these cases, the bones usually heal and the person does not experience paralysis.  SCI is very different from back injuries such as ruptured disks or pinched nerves.

Frequent causes

Super cool spine

Your Back in hyper colour

The most common causes of damage to the spinal cord are traumas such as motor vehicle accidents, motor bike accidents, falls, sports injuries (particularly diving into shallow waters), gunshot wounds, assault and other injuries; and disease such as polio and spina bifida.

Direct injury such as cuts can occur to the spinal cord, particularly if the bones (vertebrae) are damaged. Fragments of bone or fragments of metal (for example from a car accident) can cut or damage the spinal cord causing injury.

If the head, neck or back are twisted abnormally, the spinal cord can be pulled, compressed or pressed sideways, also possibly causing direct damage. The accumulation of blood or fluid can cause swelling within the spine or spinal cord causing compression of, and damage to the spinal cord, resulting in an SCI.

Who is affected?

Anyone can be affected by spinal cord injury. The majority of SCI accidents involve young people aged between 17 and 30 years, with 28 per cent of spinal cord injuries occurring in the 15-24 year old age group with males making up roughly 80 per cent.

Who put the jelly beans there?

What are the spinal cord and the vertebra?

The spinal cord is about 45cm long and extends from the base of the brain, down the middle of the back, to about the waist. The nerves that lie within the spinal cord are upper motor neurons (UMNs) and their function is to carry the messages back and forth from the brain to the spinal nerves along the spinal tract. The spinal nerves that branch out from the spinal cord to the other parts of the body are called lower motor neurons (LMNs). These spinal nerves exit and enter at each vertebral level and communicate with specific areas of the body. The sensory portions of the LMN carry messages about sensation from the skin and other body parts and organs to the brain. The motor portions of the LMN send messages from the brain to the various body parts to initiate actions such as muscle movement.

Spending winter indoors doesn't help your tan.

The spinal cord is the major bundle of nerves that carry nerve impulses to and from the brain to the rest of the body. The brain and the spinal cord constitute the Central Nervous System. Motor and sensory nerves outside the central nervous system constitute the Peripheral Nervous System, and another diffuse system of nerves that control involuntary functions such as blood pressure and temperature regulation are the Sympathetic and Parasympathetic Nervous Systems.
The spinal cord is surrounded by rings of bone called vertebra. These bones constitute the spinal column (back bones). In general, the higher in the spinal column the injury occurs, the more dysfunction a person will experience. The vertebra are named according to their location. The eight vertebra in the neck are called the Cervical Vertebra. The top vertebra is called C-1, the next is C-2, etc. Cervical SCI’s usually cause loss of function in the arms and legs, resulting in quadriplegia. The twelve vertebra in the chest are called the Thoracic Vertebra. The first thoracic vertebra, T-1, is the vertebra where the top rib attaches.
Injuries in the thoracic region usually affect the chest and the legs and result in paraplegia. The vertebra in the lower back between the thoracic vertebra, where the ribs attach, and the pelvis (hip bone), are the Lumbar Vertebra. The sacral vertebra run from the Pelvis to the end of the spinal column. Injuries to the five Lumbar vertebra (L-1 through L-5) and similarly to the five Sacral Vertebra (S-1 through S-5) generally result in some loss of functioning in the hips and legs.

What are the effects of SCI?

Mortal Combat finishing move

The effects of SCI depend on the type of  injury and the level of the injury. SCI can be divided into two types of injury – complete and incomplete. A complete injury means that there is no function below the level of the injury; no sensation and no voluntary movement. Both sides of the body are equally affected. An incomplete injury means that there is some functioning below the primary level of the injury. A person with an incomplete injury may be able to move one limb more than another, may be able to feel parts of the body that cannot be moved, or may have more functioning on one side of the body than the other. With the advances in acute treatment of SCI, incomplete injuries are becoming more common.
The level of injury is very helpful in predicting what parts of the body might be affected by paralysis and loss of function. Remember that in incomplete injuries there will be some variation in these prognoses.

Cervical (neck) injuries usually result in quadriplegia.  Injuries above the C-4 level may require a ventilator for the person to breathe. C-5 injuries often result in shoulder and biceps control, but no control at the wrist or hand. C-6 injuries generally yield wrist control, but no hand function. Individuals with C-7 and T-1 injuries can straighten their arms but still may have dexterity problems with the hand and fingers. Injuries at the thoracic level and below result in paraplegia, with the hands not affected. At T-1 to T-8 there is most often control of the hands, but poor trunk control as the result of lack of abdominal muscle control. Lower T-injuries (T-9 to T-12) allow good truck control and good abdominal muscle control. Sitting balance is very good. Lumbar and Sacral injuries yield decreasing control of the hip flexors and legs.

Besides a loss of sensation or motor functioning, individuals with SCI also experience other changes. Very high injuries (C-1, C-2) can result in a loss of many involuntary functions including the ability to breathe, necessitating breathing aids such as mechanical ventilators or diaphragmatic pacemakers. Other effects of SCI may include low blood pressure, inability to regulate blood pressure effectively, reduced control of body temperature,   inability to sweat below the level of injury, and chronic pain


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