Spinal Cord Injury Overview

A spinal cord injury is described as any damage to the spinal cord and damage to the nerves formed at the end of the spinal cord canal that ends up causing permanent damage. The damage caused can lead to lasting changes in strength, affecting the ability to move, and perform routine tasks, and numbness or loss of feeling and control below the injury area.

Since the spinal cord performs the function of carrying messages from the brain to the other parts of the body, any damage to the spinal cord affects different body areas and functions. An injured person may feel the effect of the injury at a physical, mental, emotional, and social level. 

Since there are multiple types of spinal cord injuries, it’s best to approach each in detail and see what symptoms or after-effects they bring along.

Types of Spinal Cord Injury (With Basics of Spinal Cord Anatomy)

Most people commonly perceive the spinal cord as a single-piece organ. While, anatomically, it is a column of nerves protected by a thin cover of myelin. This is further protected by 31 butterfly-shaped vertebrae.

A spinal cord is broadly classified into 4 regions that further determine the type, extent, diagnosis, and treatment of the spinal cord injury. Here’s a brief run-through of the 4 spinal cord regions:

• Cervical Spinal Cord Injury

The cervical spinal cord forms its place at the topmost portion of the spinal cord. It forms at a point where the brain connects with the spinal cord and the neck also forms a connection with the back. This region is called C1 – C8 and consists of eight vertebrae. Since all spinal cord numbers are formed to have a descending order, this means C1 is the highest vertebrae and C8 comes at the lowest.

Since the cervical spine comes closest to the brain, any injury to the cervical spine tends to be most severe. An injury to the cervical spine leads to tetraplegia, also called quadriplegia. This means partial or complete paralysis of all four limbs, including the torso.

• Thoracic Spinal Cord Injury

The thoracic spine forms the upper and middle part of the back consisting of 12 vertebrae, from T1-T12. A thoracic spine injury ends up affecting the muscles in the lower back, abdomen, and legs. Those diagnosed with a thoracic spine injury are diagnosed with paraplegia having paralysis in part of the legs and trunk. Paraplegia doesn’t affect the muscles and movement of arms and hands.

• Lumbar Spinal Cord Injury

The lumbar spine is easily remembered and comprehended as the lowest major portion forming in the spine consisting of 5 lumbar vertebrae, from L1 – L5. This is a lower area of the spinal cord where it starts bending and aids in forward-bending movements. You can even feel the inward curve in the lumbar region if you place your hand there. 

The vertebrae in the lumbar region are relatively large as they end up supporting higher weight than other areas in the spine. Anyone inflicted with a lumbar spine injury may end up losing some function control in the legs and hips. However, the upper body control remains unaffected. A patient with a lumbar spine injury can manage their routine functions while using braces or sitting in a wheelchair.

• Sacral Spine Injury

The spinal area forming just above the tailbone is known as the sacral spine. Sacral spinal nerves arising from this part control the movement in the areas of the hips, back of the thighs, and groin. Inadvertently, any injury to the sacral spine may result in loss of movement, function, and feeling in the hips and legs. A sacral spine injury can also affect bladder and bowel movements in some cases, however, the patients with such an injury can still walk.

Irrespective of the location where a spinal cord injury is inflicted, they can be broadly classified into two categories:

Complete Spinal Cord Injuries

Complete SCIs or complete spinal cord injuries are the most extreme ones as they occur when the spinal cord is badly injured and eliminates the brain’s power to send response signals below the injury site. For instance, a complete lumbar spinal injury may result in complete paralysis below the waist while keeping the upper body and arm movement and motor functions unaffected. This condition is called paraplegia. However, a complete spinal cord injury in the cervical spine ends up affecting the motor function in the lower and upper body (which is also called tetraplegia or quadriplegia).

Incomplete Spinal Cord Injuries

Incomplete SCIs or incomplete spinal cord injuries are a result of compression or damage inflicted on the spinal cord while reducing the brain’s prowess to send response signals below the site of injury. This leaves the spinal cord in an uncompromised state and causes incomplete SCI symptoms to vary from one person to another. 

Sensory and motor functions in such injuries can get affected based on multiple factors. While in some cases it can only get partially affected, it may lead to complete elimination in others. Additionally, this may also trigger a condition called triplegia which also means the loss of sensation in either arms or legs or both.

Such injuries form nearly 60% of the total spinal cord injuries which also means a great deal of recovery with rehabilitation and physical or occupational therapy.

Diagnosis of Spinal Cord Injury 

A treating doctor usually assesses spinal cord injury patients based on two critical factors – the location of the injury or injury site and current symptoms. A spinal cord injury is often a result of a blow, fall, or trauma accident among others.

If you experience loss of consciousness, difficulty breathing, excruciating pain, loss of movement, tingling, immobility or difficulty moving, or other spinal cord injury symptoms, your doctor would assess you based on certain investigations.

While there is no single investigation that can assess or diagnose spinal cord injuries, doctors often use a mix of investigation and assessment protocols to reach a certain diagnosis. Here are those:

• Clinical Assessment – Clinical evaluation for a spinal cord injury includes your doctor making a detailed list of your symptoms, some blood work, limb movement for evaluation, followed by eye movement, and other tests to reach a conclusion on the diagnosis.
• Imaging Tests – Additionally, the doctor may also ask to get some imaging tests done like CT scan, MRI, and others to get a complete picture of your spinal cord, spine, and brain.

Spinal cord injuries can cast life-altering effects on a person’s life leaving him with permanent partial or complete immobility and other challenges. It’s critical to gather support from family and loved ones and seek immaculate medical care in such scenarios to improve your health and quality of life.