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About Spinal Cord Injury

 

1. About Spinal Cord Injury
It is estimated that approximately 273,000 individuals in the United States have spinal cord injuries. Every year, approximately 12,000 people sustain new spinal cord injuries. Most of these people are injured in auto and sports accidents, falls, and industrial mishaps. An estimated 60 percent of these individuals are 30 years old or younger, and the majority of them are men. (source: National Spinal Cord Injury Statistical Center)

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2. 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 or feeling. Frequent causes of damage are trauma (car accident, gunshot, falls, etc.) or disease (polio, spina bifida, Friedreich's Ataxia, etc.). The spinal cord does not have to be severed in order for a loss of functioning to occur. In fact, in most people with SCI, the spinal cord is intact, but the damage to it results in loss of functioning. SCI is very different from back injuries such as ruptured disks, spinal stenosis or pinched nerves.

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, but the spinal cord is not affected. In these situations, the individual may not experience paralysis after the bones are stabilized.

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3. What is the spinal cord and the vertebra?
The spinal cord is the major bundle of nerves that carry nerve impulses to and from the brain to the rest of the body. The brain and the spinal cord constitute the Central Nervous System. Motor and sensory nerves outside the central nervous system constitute the Peripheral Nervous System, and another diffuse system of nerves that control involuntary functions such as blood pressure and temperature regulation are the Sympathetic and Parasympathetic Nervous Systems.

The spinal cord is surrounded by rings of bone called vertebrae. These bones constitute the spinal column (back bones). In general, the higher in the spinal column the injury occurs, the more dysfunction a person will experience. The vertebrae are named according to their location. The seven vertebrae in the neck are called the Cervical Vertebrae. The top vertebra is called C-1, the next is C-2, etc. Cervical SCIs usually cause loss of function in the arms and legs, resulting in tetraplegia. The twelve vertebrae in the chest are called the Thoracic Vertebrae. The first thoracic vertebra, T-1, is the vertebra where the top rib attaches. Injuries in the thoracic region usually affect the chest and the legs and result in paraplegia.

The vertebrae in the lower back - between the thoracic vertebrae, where the ribs attach, and the pelvis (hip bone), are the Lumbar Vertebrae. The sacral vertebrae run from the pelvis to the end of the spinal column. Injuries to the five Lumbar vertebrae (L-1 thru L-5) and similarly to the five Sacral Vertebrae (S-1 thru S-5) generally result in some loss of functioning in the hips and legs.

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4. What are the leading causes of Spinal Cord Injury?Motor vehicle crashes rank as the leading cause of spinal cord injury at 38.6%, followed by acts of falls at 32.2%, violence at 14.0%, sports at 7.8% and all others at 7.4%. (Source: National Spinal Cord Injury Statistical Center, 2020).

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5. 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, or may have more functioning on one side of the body than the other. 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. Cervical (neck) injuries usually result in tetraplegia. Injuries above the C-4 level may require a ventilator for the person to breathe. C-5 injuries often result in shoulder and biceps control, but no control at the wrist or hand. C-6 injuries generally yield wrist control, but no hand function. Individuals with C-7 and T-1 injuries can straighten their arms but still may have dexterity problems with the hand and fingers.

Injuries at the thoracic level and below result in paraplegia, with the hands not affected. At T-1 to T-8 there is most often control of the hands, but poor trunk control as the result of lack of abdominal muscle control. Lower T-injuries (T-9 to T-12) allow good truck control and good abdominal muscle control. Sitting balance is good. Lumbar and Sacral injuries yield decreasing control of the hip flexors and legs.

Besides a loss of sensation or motor functioning, individuals with SCI also experience other changes. For example, they may experience dysfunction of the bowel and bladder. Sexual functioning is frequently affected: men with SCI may have their fertility affected, while women's fertility is generally not affected. Very high injuries (C-1, C-2) can result in a loss of many involuntary functions including the ability to breathe, necessitating breathing aids such as mechanical ventilators or diaphragmatic pacemakers. Other effects of SCI may include low blood pressure, inability to regulate blood pressure effectively, reduced control of body temperature, inability to sweat below the level of injury, and chronic pain.

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6. Where can I learn more about spinal cord injury?There are many on-line resources available that can help you learn more about spinal cord injury. The United Spinal Association is an excellent educational website. Check out the Special Tree Helpful Links page for additional resources.

United Spinal Association
120-34 Queens Blvd Suite 320
Kew Gardens, NY 11415
http://www.unitedspinal.org

Paralyzed Veterans of America
Healthcare Helpline: 1-800-232-1782
Donor Hotline: 1-800-555-9140
Benefits Helpline: 1-866-734-0857
https://www.pva.org

The Paralyzed Veterans of America (PVA) was founded in l946 as a national service organization to meet the needs of veterans who were paralyzed as a result of disease or injury to the spinal cord. PVA is supported by donations from the general public. It works to ensure quality health care, rehabilitation, and full civil rights for veterans with spinal cord injuries or diseases, and all persons with a disability. PVA supports legislation and advances in medicine and technology through various programs, activities, and such departments as: the Spinal Cord Research Foundation; Education and Training Foundation; National Research Program; National Advocacy Program; National Legislation Program; National Veterans Benefits Program; and a National Sports and Recreation Program.

Ann Arbor Center for Independent Living (AACIL)

https://www.annarborcil.org/

Ann Arbor Center for Independent Living (AACIL) assists people with disabilities and their families in living full and productive lives. Their mission is to assure the equality of opportunity, full participation, independent living and economic self-sufficiency of people with disabilities in our community. Centers for Independent Living (CILs) are very different from traditional agencies, because they are staffed and operated mainly by people with disabilities, for people with disabilities. AACIL was established in 1976, the fourth CIL created in the United States, and recently celebrated their 25th anniversary.

American Spinal Injury Association (ASIA)
https://asia-spinalinjury.org

During the decade of the 1960s, physicians and other medical professionals engaged in the treatment of spinal cord injury sought to align themselves as a group, in an effort to exchange ideas and work together toward the establishment of a model for care delivery to this patient population. The early 1970s brought support for the concept of a model of care from the Rehabilitation Services Administration (under the then Department of Health, Education and Welfare) which created the “model spinal cord injury systems” program. The program is now supported by the Department of Education, National Institute on Disability and Rehabilitation Research. It was out of this group the American Spinal Injury Association (ASIA) was created in 1973.

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