What is a spinal cord injury?
Understanding your injury
Spinal cord injury (SCI) is damage to the spinal cord that results in a loss of functional mobility or feeling
An SCI can occur as a result of a trauma such as a fall, car accident, medical condition such as spina bifida, stroke or Friedreich’s Ataxia, or as a result of other back and spine conditions.
The spinal cord does not have to be severed in order for a loss of functioning to occur. In fact, in most people with spinal cord injury, the spinal cord is intact, but the damage due to compression or bruising to it results in loss of function. SCI is very different from back injuries such as ruptured disks, spinal stenosis or pinched nerves.
A person can “break their back or neck” yet not sustain a spinal cord injury if only the bones around the spinal cord (the vertebrae) are damaged, but the spinal cord is not affected. In these situations, the individual may not experience paralysis if bone damage is treated correctly.
What are the effects of spinal cord injury?
The effects of spinal cord injury depend on the type and level of the injury
SCI is commonly referred to as either complete or incomplete. In a complete spinal cord injury there are no signals below the point of injury between the brain and the body— no sensation and no voluntary movement. 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.
Injuries below T1 result in paraplegia. At T1 to T8 there is most often control of the hands, but lack of abdominal muscle control leaves poor trunk control. Lower T injuries leave good control of the trunk and abdominal muscles. Injuries at the lumbar and sacral vertebra reduce control of the hip flexors and legs.
A person with an SCI above C4 may require a ventilator to breathe. A C5 injury often leaves shoulder and biceps control, but no control at the wrist or hand. C6 injury leaves control of the wrist, but not the hand. C7 and T1 injuries leave the ability to straighten the arms, but have only limited hand and finger dexterity.
As well as a loss of sensation or motor function, an SCI produces other changes. There can be bowel and bladder dysfunction and sexual functioning is also frequently affected. Men may have their fertility affected, while women’s fertility is generally not affected. Very high injuries (C1, C2) 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.
After spinal cord injury how much function can be restored?
Intensive exercise programs can assist in the improvement of independent functional abilities.
At the time of injury, the spinal cord swells. As this swelling reduces, some function may return. This can take up to 18 months after the injury. However, only a very small fraction of people with a spinal cord injury recover all function.
Most body parts and organs can repair themselves after they are injured. However the central nervous system cannot. Attempting to repair the damage caused by a brain or spinal cord injury is a puzzle that has not yet been solved.
Nevertheless the damage caused by a spinal cord injury can be reduced by limiting immediate cell death and reducing the inflammation of the injured cord.
Intensive exercise programs such as NeuroMoves Locomotor Training and Activity Based Therapy can assist in the improvement of independent functional abilities.
There are currently no treatments or cures for spinal cord injury however internationally and here in Australia researchers are working towards possible treatments
Does everyone with a spinal cord injury use a wheelchair?
People with high injuries usually need a power wheelchair for independent mobility. People with low C spinal cord injuries and below may be able to use manual wheelchairs.
Manual chairs are more convenient as they cost and weigh less and are easy to fold for transport. However the independence provided by a power chair to the person who needs it outweighs any limitations.
Some people walk using crutches and leg braces. This does not mean they will never use a wheelchair, perhaps preferring them only for longer distances.
For further information
For further information about a wide range of topics, visit the SCIA Resource Library