The spinal cord is an essential component of the body's central nervous system. Injury to the spinal cord, either the vertebra or the nerves, can result from a fall, trauma or an underlying illness. The immediate and long-term effects of such an injury depend on the severity and location on the spinal cord. People who suffer spinal cord injuries can experience loss of sensation in a part of the body, impaired mobility and paralysis. What do the different spinal cord injury levels mean, and how do they affect your prognosis?
The classification of a spinal cord injury can be either complete or incomplete. What is the difference?
The American Spinal Injury Association (ASIA) impairment scale helps doctors assess sensory and mobility damage following various types of spinal cord injury. The scale, which covers both complete and incomplete injuries, ranges from the letter "A" to the letter "E."
The spinal column, which houses the spinal cord, consists of 33 individual vertebrae. Doctors group the vertebrae into different sections, including cervical, thoracic, lumbar, sacral and coccyx, or tailbone. The bony spinal column protects the nerves of the spinal cord, which runs from the brain to the lower back.
Various parts of the spinal cord are responsible for different bodily functions, as follows.
A spinal injury impacts different bodily functions, depending on the affected area of the spine. In addition to the incomplete and complete groupings, medical professionals also classify different spinal cord injuries based on which section of the spine they affect.
Spinal cord injuries affect the site of the injury and below it. As such, cervical spinal nerve injuries tend to be the most severe type of spinal cord injury. Injury of the C1 to C6 nerves will likely result in quadriplegia, or paralysis that affects the arms and legs. In cases of cervical spinal cord injury, the person may be unable to move anything below the neck. Injuries on the lowest part of the cervical spinal cord, the C7 nerve, may allow someone to retain some control of their arms and hands.
Trauma is the most common cause of injury to the cervical spinal cord. Car accidents, falls or sports-related injuries can result in this kind of injury. Illness, such as cancer, may also affect the cervical spinal cord.
Severe paralysis that typically results from a cervical spinal cord injury has a series of effects. You will likely need assistance with day-to-day living. These types of injuries can result in permanent loss of bladder control, inability to breathe unassisted and impaired speech ability. Injuries that occur on the lowest part of the cervical spine may allow someone to retain more independence with specialized equipment. Recovery from this type of injury is unlikely. Most people who experience damage to the nerves of the cervical spine won't be able to live alone, and will need help for the rest of their lives.
Thoracic spinal nerves play a role in our limbs' sensation and movement, as well as our ability to breathe. Any injury to this area of the spine can hamper feeling and movement. Typically, injuries to the thoracic spine result in paraplegia, rather than quadriplegia. Paraplegia is paralysis of the lower half of the body, which means loss of movement and sensation from the waist and below. Paraplegia results in an inability to walk and loss of bladder and bowel control.
As is the case with cervical spine injuries, trauma is also the most likely cause of injury to the thoracic spinal cord. A car accident, a severe fall or a gunshot wound could injure the thoracic spinal nerves.
At a lower level of the spine than the cervical nerves, thoracic nerve injury may allow for a greater level of independence following recovery. You may have full use of your upper body and have mobility with the help of a manual wheelchair. Some people who have had a thoracic nerve injury, depending on its location, may be able to stand with the help of a frame or braces. There are also modified cars available for those who do not have use of their lower limbs.
In most cases, lumbar spinal cord injuries are not life-threatening. Injury to this area of the spinal cord may result in hampered mobility and sensation in the legs and hips. Loss of bowel and bladder control is also common with this type of spinal cord injury. Incomplete lumbar injuries will likely result in less loss of mobility and sensation, while complete lumbar injuries can result in paraplegia.
Lumbar spinal injuries are most commonly the result of trauma caused by car accidents, falls and violence. Congenital defects and degeneration due to age can also cause injury to this area of the spine.
Following a lumbar spinal cord injury, patients will undergo a recovery process. The prognosis for this type of injury depends on its location and severity. In most cases, people can retain a high degree of independence. People with complete injuries resulting in paraplegia can learn how to use a wheelchair. Others with less severe injuries may be able to move with the help of braces.
Doctors don't classify sacral nerve damage as injury to the spinal cord. Therefore, the prognosis for this type of injury is typically more favorable than for damage that occurs higher on the spine. Sacral nerve damage may affect one side of the body, or be bilateral. While there will usually be some effect on motor function and sensation in the hips or legs, most people can still walk following this kind of injury.
Injury to this portion of the spine and its nerves can result from any of the same issues that can affect other areas of the spine. Sacral spine injuries are the potential outcome of car accidents and other trauma, as well as congenital defects and age-related degeneration.
You will likely be able to live your life with a high degree of independence following a sacral nerve injury. Because the sacral nerves supply sensation to the lower regions of the body, sexual dysfunction and loss of bladder and bowel control are common following a sacral nerve injury. Sacral nerve damage in men may lead to infertility. Patients' condition can improve over time and with treatment, such as anti-inflammatory drugs, physical therapy and potentially surgery.
Whether it has happened to you or someone you love, life after a spinal cord injury can be scary and difficult to imagine. How will you cope with changes to your mobility and ability to feel? If you are a caregiver, how can you provide the right kind of support for your loved one? You are not alone. There are multiple resources available to help you recover from an injury and move forward. Post Acute Medical provides individualized treatment plans through our spinal cord injury rehabilitation program. Browse our website to learn about the resources we offer for our patients and their families. We want to help you get the care you need and develop the necessary skills to maintain as much independence as possible.