Paralysis occurs when a part of the nervous system in the spine is impacted and damaged. The two main types of paralysis are paraplegia and quadriplegia or tetraplegia. The spine is in four segments, and each segment affects different parts of the body. The four segments are:
• Neck or cervical spine with seven cervical vertebrae
• Upper back or thoracic spine with 12 thoracic vertebrae
• Lower back or lumbar spine with five vertebrae
• Bottom of the spine or sacral region with five bony segments that are fused together
Paraplegia is usually caused by a spinal injury that occurs below the first thoracic spinal nerve. The legs and possibly the trunk may be entirely or incompletely paralyzed. The arms are not affected. The trunk will be affected according to the level of spinal cord injury.
If the injury is to the first to eighth vertebrae, the patient usually has control of his or her hands, but there will most likely be poor trunk control because there is no abdominal muscle control. If the injury is in the ninth to 12th vertebrae, there will be good control of the abdominal muscles and trunk. Sitting balance will also be good. Injuries in the sacral and lumbar areas mean less control of the legs and hips.
Some of the other changes a person with a spinal cord injury may face are:
• Loss of bowel and bladder control
• Impaired sexual functioning
• Low blood pressure because of the inability to regulate blood pressure
• Lack of control of body temperature
• Inability to sweat below the point of injury
• Chronic pain
Quadriplegia or Tetraplegia
Injuries to the neck or cervical part of the spine usually result in paralysis of all four limbs. Injuries above the fourth level of the cervical may require a ventilator or electrical implant to enable the person to breathe. Since the arms are also paralyzed, tetraplegia is more debilitating than paraplegia. However, there are cases where hand and arm movement is possible.
Treatments of SCI
When a person is injured, the emergency medical personnel must immobilize them for transport. The medical treatment received within the first eight hours after an injury is crucial for the patient’s recovery. Medical personnel has much more knowledge about SCI than they did just a few years ago. If the patient is not handled correctly at the beginning, it could seriously worsen their condition.
Steroid drugs are given immediately to combat the swelling that is the spinal cord’s first response to injury. This will prevent more damage to nerves and nerve death. Every injury is unique. Some require surgery; some may be placed in traction so that the spine can heal naturally.
Immediately after the injury the spinal cord goes into shock. Spinal shock stops the nerves from transmitting signals. It may take several hours for this to happen. When the spinal shock subsides, some nerve transmissions will be regained. This may take four to six weeks or several months. Because of this, it is not likely that an accurate prediction of the person’s recovery can be determined.
Recovery may take a long time. The patient may need help with daily activities such as dressing, eating, bathing and moving around so as not to develop bedsores. There are several different types of rehabilitation available for various levels of paralysis including physical therapy, speech and language therapy, counseling and occupational therapy. These therapies may be done in a special individual spinal injuries unit, as an outpatient or at home.