Spinal Cord Injuries

Brief Description

The spinal cord is the main information pathway between the brain and the peripheral nervous system. A spinal cord lesion is a disruption of this communication caused by a traumatic injury or an illness and it involves the partial or total loss of voluntary movement and sensation below the injury.

The severity of the injury is given by:

  • The level of the lesion (sacral, lumbar, thoracic or cervical): the higher the injury, the greater the effect on sensitivity and mobility
  • Completeness or incompleteness of insensitivity and immobility below the lesion

Tetraplegia, also known as Quadriplegia, is caused by damage above the seventh cervical vertebra (C7) and causes paralysis of the limbs and torso, while Paraplegia only affects parts of the torso and lower limbs.


Causes

  • traumatic: road accidents, falls, acts of violence, sports injuries
  • non traumatic: spinal cord compression, spinal cord ischemia, myelitis, disc deterioration

Symptoms

Main symptoms:

  • Paralisis: loss of voluntary mobility.
  • Anesthesia: loss of sensitivity

There may also be:

  • Breathing and coughing difficulties, with stagnation of secretions in the lungs
  • Impaired bladder and bowel control
  • Spasms
  • Changes in sexual function and sensitivity
  • Chronic pain, unusual sensations in the chest
  • Pressure sores

Cures and Therapy

Although the consequences of the lesions are not reversible at the present moment, much can be done in terms of rehabilitation, intended as the achievement of the greatest degree of autonomy possible:

  • Rehabilitation of the respiratory function: weaning from controlled ventilation. In the case of a cervical lesion above C4 patients need mechanical ventilation, support, while intermittent pressure devices are used for cases of lower injury that still require some ventilation assistance. Secretions can be managed by respiratory therapy and the use of a cough assistant.
  • Rehabilitation of the moto-neuron function: recovery of a new coordination above the lesion and strengthening of the remaining muscles.