What is Spinal Cord Injury?
Spinal Cord Injury (SCI) is damage to the spinal cord that results in a loss of function such as mobility and/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's the damage to it that results in the loss of functioning. SCI is very different from back injuries such as ruptured disks, spinal stenosis or pinched nerves.
Also, 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, not the actual spinal cord. In these cases, the bones usually heal and the person does not experience paralysis.
The majority of people who have a spinal cord injury are young males (they have a greater tendency to indulge in risky behaviour). However, there are people from both sexes and of all ages with spinal cord damage.
There are people from both sexes and of all ages with spinal cord damage
There are currently around 12,000 people living with a spinal cord injury in Australia
Frequent causes of Spinal Cord Injury
The most common causes of damage to the spinal cord are traumas such as car accidents, motor bike accidents, falls, diving mishaps (particularly diving into shallow water), sports injuries and work accidents.
There are currently around 10,000 people living with a spinal cord injury in Australia, with a further 300 – 400 new cases reported every year. Around half of all new cases are people aged between 15 and 34 years old.
What are the effects of SCI?
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, may have more functioning on one side of the body than the other or may even be able to walk. 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.
SCI can be divided into two types of injury: complete and incomplete
The level of injury is very helpful in predicting what parts of the body might be affected
Levels of Injury
- Cervical (neck) injuries usually result in quadriplegia;
- C1 to C4 injuries may require a ventilator for the person to breathe;
- C5 injuries often result in shoulder and bicep control, but no control at the wrists or hands;
- C6 injuries generally yield wrist control, but no hand function;
- C7 and T1 injuries can straighten their arms but still may have dexterity problems with the hand and fingers;
- Thoracic level injuries and below result in paraplegia, with the hands not affected;
- T2 to T8 injuries have control of their hands, but poor trunk control as the result of lack of abdominal muscle control;
- T9 to T12 injuries allow good trunk control and good abdominal muscle control. Sitting balance is very good;
- Lumbar and Sacral injuries yield decreasing control of the hip flexors and legs.
Other effects of SCI besides motor control and sensation
Individuals with SCI also experience other changes in the way their body functions besides loss of motor control and sensation. For example:
- Incontinence of the bowel and bladder;
- Erectile dysfunction;
- Fertility may be affected in SCI men;
- Wide and rapid fluctuations in body temperature;
- Inability to sweat below the level of injury;
- Low blood pressure;
- Chronic pain.
Very high injuries (C1, C2, C3) can result in a loss of many involuntary functions. For example;
- The ability to breathe (may require breathing aids such as mechanical ventilators or diaphragmatic pacemakers);
- Inability to regulate blood pressure effectively.
Individuals with SCI also experience many other changes in bodily functions besides loss of muscle control and sensation
The symptoms of autonomic dysreflexia include raised body temperatures, profuse sweating, high blood pressure, slow pulse rate and blackouts
Some common health problems
Other problems which can arise for people with spinal cord injuries are:
- Frequent urinary tract infections;
- Kidney stones;
- Muscle spasm;
- Pressure sores from sitting in one position for too long without a correct pressure cushion;
- Higher level injuries may develop a condition called autonomic hyperreflexia, also known as automomic dysreflexia. This condition can be triggered by a variety of factors, including distended bladder, distended bowel and skin or pressure sores. The symptoms of this condition include raised body temperatures, profuse sweating, high blood pressure, slow pulse rate and blackouts.