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Understanding Spinal Cord Injuries

There are few things that can compete with the stressful and life-altering nature of a spinal cord injury. If you or a loved one has a spinal cord injury, a lot of emotions and stress can come into the equation and make it difficult to stop and think logically about the situation. Right after an injury occurs, there can be a lot of questions buzzing through your head. What will the damage be? Will there be a full recovery? What do we do now?

For many people, worst-case scenario situations immediately plague their thoughts. When it comes to spinal cord injuries, although their effects can be severe, the best thing to do to minimise those effects is to take quick action. This can prevent the injury from getting worse and causing more damage than has already been done – thus preserving as much of the body’s functions as possible.

The time immediately after an injury is critical, especially one of this nature. What you do with this time can be defining for the rest of the patient’s life. For best results, it’s good to understand what you are dealing with and have basic knowledge regarding spinal cord injuries.

The most important step you can take is to fully understand the injury and what it entails. By understanding this, you can pursue your best options for treatment and rehabilitation, giving yourself or your loved one the best chance of success.

When it comes to seeking out treatment options for spinal cord injuries, it all begins with an understanding of precisely what is going on in your body.

Below is everything you need to know to gain the necessary understanding.

Anatomy of the Spine and Spinal Cord

When someone sustains a spinal cord injury, movement and sensation can be interrupted, sometimes in ways you wouldn’t expect. These functional impairments can be temporary or permanent, and spinal cord injuries can result in loss of sensations and paralysis.

Vertebrae surround your spinal cord, which are rings of bone that go all along it. The spinal cord is protected by the backbone. The backbone begins at the base of your skull and descends to just above your hips.

Typically around 18-inches in length, the spinal cord extends from the base of your brain, stretches down the middle of your back, and ends just below the final rib in your waist region.

Your spinal cord’s primary function is to serve as the communication centre between your body and your brain. It transmits messages that allow you to move and experience sensations throughout your body. These messages are delivered via spinal nerve cells called neurons, travelling along the spinal cord and leaving the cord through openings in the vertebrae. From your spinal cord, spinal nerve roots branch off in pairs, each going to one side of your body.

Every nerve along your spinal cord fulfils a specific function for feeling and mobility. They communicate with the muscles in your hands, fingers, legs, arms, toes, chest, toes, and other parts of your body. They tell these parts of the body when and how to move. In addition, they transmit messages right back to your brain, regarding sensations such as temperature, pain, and touch.

Spinal Cord Injury Causes

You might be wondering what sort of things cause spinal cord injuries. As it happens, there are numerous things that can result in spinal cord injuries occurring, whether it’s a minor injury or one that can result in permanent paralysis.

Spinal cord injuries are classified as either traumatic or non-traumatic. Some causes of traumatic injuries include the following:

  • Sports injuries
  • Motor vehicle accidents
  • Falls
  • Violence
  • Diving into shallow water

More men than women are affected by spinal cord injuries. Most people who experience such an injury are younger people between the years of 16 and 30. This higher rate of injury is because they tend to participate in riskier behaviours.

As far as non-traumatic injuries go, these are some injuries and illnesses that can result in spinal cord injuries:

  • Osteoporosis
  • Cancer
  • Inflammation of the spinal cord
  • Arthritis
  • Multiple Sclerosis

If you or a loved one experience a spinal cord injury, some of the effects may include the following:

  • Loss of sensation
  • Loss of movement
  • Loss of bladder and/or bowel control
  • Changes in sexual sensitivity, function, and fertility
  • Exaggerated spasms or reflex actions
  • Intense stinging sensation or pain

If you have experienced anything like the above, then it is possible that you are suffering from a spinal cord injury. If so, the next thing to do is to identify what type of spinal cord injury it might be and pursue appropriate treatment and rehabilitation options.

Some spinal cord injury symptoms, on the other hand, are indicative of an actual emergency. Regardless of your spinal cord injury, it is never a bad idea to go to the hospital and get a diagnosis or an opinion from a medical professional. However, if you are experiencing any of the following symptoms, this may indicate an emergency and should result in your departure to the hospital immediately for medical assistance:

  • Extreme pain in the back
  • Extreme pressure in the back, head, or neck
  • Paralysis, weakness, or incoordination in any of your body parts
  • Tingling, numbness, or loss of sensation in toes, feet, fingers, or hands
  • Loss of bowel or bladder control
  • Difficulty with walking and balance
  • Impaired breathing in the aftermath of the injury
  • A twisted or improperly positioned back or neck

With any of the above symptoms, you should seek immediate help from a medical professional. In addition, any person who experiences a significant amount of trauma to the neck or head should immediately seek medical evaluation. In fact, the best course of action is to assume that a person who has experienced an injury is suffering from a spinal injury until expressly proved otherwise. The reason for this is because a serious spinal injury doesn’t always make itself known right away.

Spinal Cord Injury Infographic

Spinal Cord Injury Infographic

If it isn’t found and treated in a timely manner, the injury could become even more severe. In addition, while paralysis or numbness sometimes occur immediately, these effects can appear gradually as swelling and bleeding occurs around or in the spinal cord. The time that passes between the occurrence of the injury and treatment being administered is critical. Lessening this time can also decrease the severity and extent of the recovery, complications, and more.

Spinal Cord Injury Diagnosis

To diagnose your spinal injury, doctors will use a number of different diagnostic tools. These will include spinal X-rays, MRIs, CT scans, and evoked potential testing, a process that measures how quickly nerve signals make it to the brain.

With these tools, doctors help you pinpoint precisely what is wrong and what is going on with your spinal cord injury. From there, once they know the diagnosis, they can help you gain regain as much control of mobility and sensation as possible.

It is common to have such tests conducted immediately after an injury, and then again after several days have passed. This is because it takes some time for swelling to subside. With this, your doctor will be able to conduct a more comprehensive exam. This helps them to determine the completeness and level of your injury, including by testing your ability to sense pinprick sensation and light touch, as well as your muscle strength.

Spinal Cord Injury Levels

How capable you are of controlling your limbs in the aftermath of a spinal cord injury will be dependent on two factors. The first is the location of your injury along the spinal cord. The second is the severity of the spinal cord injury.

The lowest normal part of the spinal cord is called the neurological level of the injury. Your injury’s severity is often referred to as its “completeness.” It can be classified as either complete or incomplete.

A complete injury is one in which all sensory feeling and the ability to control motor function and movement are completely lost under the location where the injury takes place.

An incomplete injury is one in which some sensory or motor function remains below the affected area. There are varying degrees of incomplete injury.  

In addition, paralysis that occurs from a spinal cord injury can be referred to as one of two things. The first is Tetraplegia, also known as Quadriplegia. This is what happens when your hands, arms, legs, trunk, and pelvic organs are all affected as a result of the injury to your spinal cord.

Paraplegia, on the other hand, refers to paralysis affecting all or just a part of your legs, trunk, and pelvic organs. In order to determine the type of injury you have, a team at a hospital will perform a number of tests intended to determine your injury’s neurological level and completeness.

The level of a spinal cord injury refers to where on the spine the injury occurred. Remember, your spine is surrounded by vertebrae. These vertebrae can be grouped into various sections. How high your injury takes place on your spinal cord determines how much damage and dysfunction can result from the injury. The following are the different groups of vertebrae that may be affected from a spinal cord injury:

High-Cervical Nerves (C1 – C4)

A high-cervical nerve injury is the most severe of injury levels. It can result in paralysis in the hands, arms, legs, and trunk. Patients may experience difficulty breathing on their own, as well as trouble coughing and controlling their bladder or bowel movements. Their ability to speak may be reduced or impaired. In situations that affect all four limbs, this is referred to as quadriplegia.

A person with a high-cervical nerve injury will require assistance with daily activities, including getting into and out of bed, dressing, bathing, and eating. Depending on the situation, a person may be able to use a powered wheelchair with special controls that allow them to move on their own. They will not be able to drive a car and require personal care 24 hours a day.

Low-Cervical Nerves

These nerves (C5 – C8) correspond with the hands and arms. A person with an injury of this level may be able to speak normally and breathe without assistance. In this group of vertebrae, the types of injury can be broken down even further depending on the affected part of the spinal cord.

  • C5 Spinal Cord Injury: With a C5 injury, a person can raise their arms and bend their elbows. However, they are likely to suffer partial or total paralysis of hands, wrists, trunk, and legs. They can use their diaphragm and speak, but their breathing is typically weakened, and they will need assistance with many facets of daily life. Once in a power wheelchair, however, they will be able to move around independently.
  • C6 Spinal Cord Injury: These nerves affect wrist extension, and cause paralysis in legs, trunk, and hands. The individual should be able to bend their wrists back, speak, and use diaphragm. Their breathing will be weaker. They should be able to move into and out of their bed and wheelchair using assistive equipment and may be able to operate an adapted vehicle. They will possess little to no voluntary control of their bladder and bowel movements, but could possibly manage on their own using special equipment.
  • C7 Spinal Cord Injury: These nerves control some finger extension and elbow extension. Most people with a C7 injury are able to straighten their arms and use normal movements in their shoulders. They can complete most daily activities on their own, but may need assistance in more challenging areas. They can typically operate an adapted vehicle. While they will have little to no bowel or bladder control, they should be able to get by using special equipment without assistance from others.  
  • C8 Spinal Cord Injury: These nerves are in control of some of your hand’s movements. A person with a C8 injury should be able to release and grasp objects and complete most daily activities on their own, but may need assistance completing more challenging tasks. They should be able to operate an adapted vehicle, but will have little to no voluntary control of their bladder and bowel movements. Like with a C7 injury, they may be able to manage by themselves using special equipment.

Thoracic Nerves

Your thoracic vertebrae are located in your mid-back. These nerves can be broken up into two separate groups and, when injured, will affect a patient differently. Each group is as follows:

  • T1 – T5 Spinal Cord Injury: Corresponding nerves affect your muscles, mid-back, upper chest, and abdominal muscles. While hand and arm function tend to remain normal, injuries typically affect the legs and trunk. This is known as paraplegia. Those with this type of injury can typically operate a manual wheelchair and modified vehicle. Some can stand in a standing frame, and others can walk using braces.
  • T6 – T12 Spinal Cord Injury: These nerves affect the muscles in your trunk, including your back and abdominal muscles. Upper body movement tends to be normal with such an injury, and patients demonstrate a fair to good ability to balance and control their trunk while seated. If abdominal muscles are intact, the injured person should be able to productively cough. They often have little to no control of their bladder or bowels, but usually can manage by themselves with the help of special equipment. Most can use a manual wheelchair and a modified vehicle. Some patients are able to stand with a standing frame, and others can walk using braces.

Lumbar Nerves

Injuries of the lumbar nerves (L1 – L5) generally result in loss of function to some degree in the legs and hips. Affected individuals often have little to no control of their bladder or bowels, but with special equipment can usually manage by themselves. Depending on their leg strength, they may need a wheelchair. Some patients are able to walk using braces.

Sacral Nerves

Injuries of the sacral nerves (S1- S5) tend to result in a loss of function in the legs or hips. Patients often have little to no control of their bladder or bowels, but are able to manage using special equipment without the help of another person. In most cases, people with these types of injuries will be able to walk again.

Spinal Cord Injury Statistics

The annual occurrence of spinal cord injuries in the United States is approximately 54 cases per million. This results in around 17,000 new cases of spinal cord injuries every single year in the U.S. In 2016, it was estimated that around 282,000 people in the U.S. were alive and living with spinal cord injuries.

The most common causes of spinal cord injuries are motor vehicle crashes. The next most common cause is accidental falls, followed by violence (typically from gunshots). The next most common cause is sports and recreation activities. Approximately 80% of these spinal cord injuries involve male patients.

The most common neurological category is currently incomplete tetraplegia, followed by incomplete paraplegia, complete paraplegia, and complete tetraplegia.

Spinal Cord Injury Treatment and Rehabilitation

A number of spinal cord injury treatment options exist to help patients maintain as much of their body’s functions as possible. Many treatment options exist, and in a lot of cases, patients may opt for a combination of several approaches to help them regain the most control of their life as possible and achieve the best standard of living.

Some of the common treatments that patients opt for are as follows:

Regenerative Treatment

The medical field has improved vastly over the past several decades. Today, advances in researching nerve cell regeneration and cellular therapy open the door to hope for greater chances for recovery in those with spinal cord injuries. Cellular therapy shows promise to generate healthy cells to replace damaged cells. As such, the hold the potential to restore some level of function to those suffering from spinal cord injuries.

Epidural Stimulation

The epidural stimulation device is a breakthrough in spinal cord injury treatment options. It involves surgically connecting a device to the body’s nerve systems. The device is not a pain management tool or a muscle stimulator. Instead, with it, a patient can learn to control the device and the limb movements it results in.

The device works by applying continuous electrical currents to the affected locations on the lumbar spinal cord. This device sits over the spinal cord’s protective coating, where it can stimulate locomotor-esque activity. This treatment option is available to patients with both complete and incomplete injuries. Controlled by a remote control, this stimulator can make commands that bypass the injury and allow for voluntary movements as well as other secondary improvements.

Physiotherapy

Physiotherapy has been shown to have promising results for certain spinal cord injuries. Physiotherapists help push their patients to their full capabilities and teach their body how to increase its ability. This type of physical therapy can help patients get maximum results out of their time and efforts with recovery. It allows patients a functional and physical platform through which to regain muscle mass, strength, control, and mobility.

Occupational Therapy

Occupational therapists are skilled in aiding individuals with spinal cord injuries to learn how to complete daily activities and regain the most independence they can.

Pain Management

Another treatment approach is to find ways to cope with the pain resulting from spinal cord injuries. Medical experts are able to help patients in finding the right strategies and medicines to help patients in easing their pain and managing their condition to the best of their ability.

The Verdict

In this spinal cord injury guide, we have given you all the information you should need to understand spinal cord injuries. In the event of an injury of you or a loved one, the most important thing to do is remain calm and seek out medical treatment from a professional immediately.

By understanding the different types of spinal cord injuries, and how essential this part of your body is in controlling many of your daily functions, you should be able to use this information to result in the best outcome in the aftermath of an injury.