Spinal cord injuries (SCI) can happen in a variety of ways, whether that’s through a traumatic injury (i.e. motor vehicle accident, shallow diving, acts of violence, or sports injuries) or a disease acquired at birth or later in life (i.e. tumors, electric shock, loss of oxygen related to surgical or underwater accidents). These types of injuries result in damage to the spinal cord by a way of dislocation, compression, fracture, burst, hyperextension, or hyperflexion. The spinal cord doesn’t have to be cut in order to have a loss of function.
Understanding the levels of Spinal Cord Injury
Cervical Spinal Cord injury- C1-C8: Cervical spinal cord injuries results in paralysis or weakness in the arms and legs which results in quadriplegia. This region of the spinal cord controls our head, neck, arms, legs, and diaphragm. Our neck is so fragile do to its flexibility that it makes it difficult to stabilize after an injury so it may result in the person wearing a neck brace or a stabilizing device. Cervical injuries are accompanied by loss of sensation, bowel and bladder function, regulating body temperature, and sexual dysfunction.
Thoracic Spinal Cord Injury-T1-T12: Thoracic spinal cord injuries are not as common due to the protection it receives from the rib cage. These types of injuries cause paralysis or weakness in the legs along with loss of physical sensation, bowel, bladder, and sexual dysfunction. Arms and legs are not usually affected in these types of injuries. To help produce stability for the trunk patients usually wear braces around the abdomen.
Lumbar Spinal Cord Injury- L1-L5: Lumbar spinal cord injuries only affect the lower extremities which also is referred to paraplegia. Physical sensation, bowel, bladder and sexual dysfunction can also be lost during these types of injuries. Lumbar injuries usually require surgery and external stabilization. The lumbar region of the spinal cord controls signals to the back, abdomen, and buttocks, along with some aspects of the external gential organs.
Sacral Spinal Cord Injury- S1-S5: Sacral Spinal Cord injuries cause loss of bowel, bladder and sexual dysfunction. They can cause weakness and/or paralysis in the hips and legs. Sacral region of the spine controls signals to the thighs, lower parts of legs, feet, and gential organs
There are two types of spinal cord injuries: Complete and incomplete injuries.
Complete Spinal Cord Injury happens when the spinal cord is compressed or severed completely which affects the ability of the brain to communicate motor and sensory functions to the body below the level of injury. Symptoms of a complete spinal cord injury could be loss of sensation below the level of injury, complete loss of function below the level of injury, unable to control bowel or bladder, and depending on how high the level of injury is a person could have difficulty breathing.
Incomplete Spinal Cord Injury happens when the spinal cord is compressed or injured but the brain still has the ability to send signals below the site of injury. The effects of this type of injury vary. Symptoms of an incomplete spinal cord injury could be retaining some sensation below the site of injury that comes and goes, being able to move some muscles below the level of injury or pain having chronic pain below the level of injury. For example, a patient recovering from a spinal cord injury from an infection may regain a large about of function back.
Spinal cord injuries are unpredictable and vary from person to person depending on the level and type. After a spinal cord injury the goal is to restore as much function as possible to a person's body in order to perform activities of daily living (i.e. cooking, getting dressed, showering, bathing, toileting, etc) and get back to living life. The best way to do this is to find a good inpatient hospital or outpatient center with intense therapy to help teach you ways to increase your daily function whether that's through exercises, compensatory techniques, or assistive technology. Throughout the process of recovering from a spinal cord injury it is vital to remember that each patient still can fulfill their dream of living life to the fullest it may just look different.
- Ashley Gatewood, OTR/LAshley is an occupational therapist and health writer based out of Richmond, VA. Ashley has seven years of experience across multiple practice settings and is currently working in adult home health.