Effects of Spinal Cord Injury

The spinal cord may become severed or injured due to accidents, acts of violence or physical diseases such as polio, according to Dr. Edward Benzel of the Cleveland Clinic Spine Institute. Depending upon the extent and location of the spinal cord damage, a range of motor, sensory or autonomic nervous system functions (involuntary functions such as breathing) may be affected.
Loss of Motor Function
Spinal cord injury can cause partial or complete paralysis, or loss of motor function. Loss of movement may occur as a result of bruising, compression, lacerations or complete severing of the spinal cord. Partial paralysis (called paresis) can occur in all four limbs (quadraparesis), or slight paralysis may develop only in the lower extremities (paraparesis). In some cases, complete paralysis of the lower extremities and lower trunk may occur while the upper limbs remain unaffected (paraplegia). According to Dr. Edward Benzel, chairman of the Cleveland Clinic Spine Institute, loss of motor function typically occurs below the level of impact to the spinal cord, and paralysis may be temporary or permanent depending upon the severity of the injury. For example, if the cervical spine in the neck region is affected, loss of motor function is often seen in the hands, arms and neck. If the spinal cord in the lower back region is injured, loss of function may occur in the hips and legs.
Loss of Sensation
Spinal cord injuries may be associated with damage to the sensory nerve fibers. Nerve damage can cause temporary or permanent loss of sensation in one or more areas of the body, leading to loss of sensations such as touch, pressure and temperature.
Respiratory Problems
According to a review published in a 2007 issue of the Journal of Spinal Cord Medicine, spinal cord injuries--particularly those in the cervical or neck region--may lead to paralysis or paresis of the muscles that are responsible for involuntary respiration. Those who aren't able to breathe sufficiently on their own may require long-term mechanical ventilator support to survive; however, mechanical ventilation increases the risk of complications such as pneumonia, infection and death. The review’s authors note that respiratory insufficiency is the top cause of morbidity and mortality after a spinal cord injury.
Autonomic Dysreflexia

Autonomic Dysreflexia, or hyperreflexia, is a life-threatening over-activity of the autonomic nervous system (responsible for controlling involuntary actions of muscles and organs in the body) that occurs uniquely in patients with spinal cord injury. According to the University of Washington Department of Rehabilitation Medicine, people with a severed spinal cord at or above the T-6 vertebrae are at greater risk of developing the condition. When pain or pressure (or a full bladder or bowel) below the level of spinal cord injury occur, blood vessels constrict and blood pressure rises. Nerves in the sympathetic nervous system relay a message to the brain that blood pressure is getting too high, and the brain in turn sends a signal down the spinal cord to relax blood vessels and lower blood pressure. However, spinal cord injuries may prevent this message from reaching the part of the body below the severed cord. Consequently, blood pressure acutely rises and stroke, seizures or death may occur.

What Are the Symptoms of a C2 Spinal Injury?

The spinal cord is divided into four segments: cervical, thoracic, lumbar and sacral. Together, they make up a vital part of the body's central processing nervous system; injury to the spinal cord can be grave and sometimes fatal. The cervical part of the spinal cord lies in the neck. Injuries occurring at the second cervical vertebrae, known as C2, manifest through a particular constellation of symptoms and signs.

Respiratory Dysfunction

As stated by the University of Alabama at Birmingham Spinal Cord Injury Information Network, an injury in the upper cervical region of the spinal cord—vertebrae C1 through C3—will cause complete paralysis of breathing muscles. This occurs because all the nerve signals sent by the brain originate at a higher level. An injury at C2 will interrupt the nervous system's signals to the muscles responsible for breathing. The muscles paralyzed by such an injury include the diaphragm, the chest and abdominal muscles, and the neck muscles. If the injury is complete and the spinal cord is completely transected at this level, the patient will lose the ability to breathe spontaneously and will need a ventilator.

Muscle Paralysis

The Merck Manuals Online Medical Library notes that injury of the spinal cord at C2 will result in complete or partial paralysis of all four limbs and trunk muscles. The muscles comprising the anal and bladder sphincters are also paralyzed causing the patient to lose voluntary control over urination and defecation. If the spinal cord is severely injured, the patient could remain paralyzed for life. If the injury is partial, however, the patient may regain some movement, particularly of the trunk muscles.

Sensory Loss

The nerves responsible for delivering sensation also pass through the spinal cord. Each spinal cord segment gives sensory supply to an area of the skin called a dermatome. All sensations are relayed to the brain via the spinal cord in order to provide feeling.

According to the American Spinal Injury Association, C2 provides sensory supply to the area over the back of the head and the top part of the neck. Injury at the C2 level will cause the patient to be totally deprived of sensations below that level because of the interruption of the pain pathway and the nerve signals going to the brain.

What Are the Treatments for Lumbar Tethered Spinal Cord?

Tethered spinal cord syndrome can be alleviated by surgery to the lumbar spine. This is generally performed in children because the maturing spinal column grows and stretches the spinal cord, and sometimes the spinal roots become irritated, resulting in painful sensations. Sometimes adults also require detethering when they exhibit similar signs and symptoms.
Surgical Detethering
According to the New York Presbyterian Hospital, early surgery is usually recommended for children showing signs of a tethered spinal cord, and this is the primary method used to repair this condition. Treatment will prevent deterioration of nerve function as the child's spine grows. The procedure necessitates exposing the lumbar vertebrae in the lower back where the spinal cord is tethered, or pinned. The surgeon will detether the spinal cord by excising any protrusions or removing adhesion points. This is very delicate surgery and the dangers of spinal cord or spinal nerve root injury are omnipresent. The nervous system is therefore monitored during surgery to minimize the chances of damage. However, even with these advanced techniques, the risk of complication of an atonic bladder has not proven to be diminished. Also, the complications of sexual and bowel dysfunctions may result. These conditions may be permanent or transient. If a child matures and reaches adult height without showing signs of tethered spinal cord syndrome, then treatment may not be necessary. However, there is no guarantee the patient will remain unaffected. With movement of the spine, the tethered spinal cord gradually begins to wear down and the patient may experience symptoms in adulthood; surgery may be indicated at that point.
Sometimes making a large incision on the back for open surgery to untether the spinal cord is not an option. Under these circumstances, the surgeon may opt to cut specific spinal nerve roots. This can ease the painful symptoms of tethered spinal cord syndrome. This procedure can be performed endoscopically. According to a 2009 paper in the journal "Child's Nervous System," such endoscopic untethering can be safe and effective. It has the advantages of reduced surgical trauma, postoperative pain and blood loss, as well as a smaller surgical incision and a shorter hospital stay. It is not known, however, if using endoscopic untethering techniques yields superior efficacy results.

Sometimes the spinal cord can retether after surgery, and this can happen months or years later. According to a 2006 article in the "Journal of Neurosurgery," in such circumstances another surgery may be required to untether the spinal cord once again. The incidence of retethering in children is significantly higher than in adults.

Spinal Cord Injury In Paraplegia

Spinal cord injuries are becoming more and more common. In fact, the Christopher and Dana Reeve Foundation estimates that there are more than one million people living with some type of spinal cord injury in 2010. A spinal cord injury that causes a loss of function in the legs is called paraplegia.
What Causes Paraplegia
Most spinal cord injuries are either the result of a motor vehicle accident or a work-related injury; however, other common causes include sports accidents, falls and violent crimes. The physical trauma of such accidents can compress or even sever the spinal cord, causing temporary or permanent damage. When the spinal cord damage affects the function of the lower limbs, it is termed paraplegia.
Effects of Paraplegia
In people with paraplegia, movement and sensation below the level of spinal cord injury is impaired to some degree. According to the Mayo Clinic, someone who is paraplegic will not only have symptoms in both of his legs, but also in his trunk and some of the organs in the pelvis. For some people, paraplegia disrupts bowel and bladder function. It may also impair sexual function. According to the National Spinal Cord Injury Association (NSCIA), paraplegia can affect the breathing muscles, and the ability to regulate temperature and blood pressure, depending on what part of the spinal cord is damaged.

The NSCIA reports that while there is no known cure for spinal cord injury, many people with paraplegia recover function gradually, and may continue to gain function for a year or more following their injury. Treatment following a spinal cord injury with paraplegia involves stabilizing the spine, often through surgery, as well as physical and occupational therapy.

What Is a Spinal Cord Injury?

Although the hard bones of the spinal column protect the soft tissues of the spinal cord, vertebrae can still be broken or dislocated in a variety of ways and cause traumatic injury to the spinal cord. Injuries can occur at any level of the spinal cord. The segment of the cord that is injured, and the severity of the injury, will determine which body functions are compromised or lost. Because the spinal cord acts as the main information pathway between the brain and the rest of the body, a spinal cord injury can have significant physiological consequences.

Catastrophic falls, being thrown from a horse or through a windshield, or any kind of physical trauma that crushes and compresses the vertebrae in the neck can cause irreversible damage at the cervical level of the spinal cord and below. Paralysis of most of the body including the arms and legs, called quadriplegia, is the likely result. Automobile accidents are often responsible for spinal cord damage in the middle back (the thoracic or lumbar area), which can cause paralysis of the lower trunk and lower extremities, called paraplegia.
Other kinds of injuries that directly penetrate the spinal cord, such as gunshot or knife wounds, can either completely or partially sever the spinal cord and create life-long disabilities.
Most injuries to the spinal cord don't completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy the axons, extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.
Until World War II, a serious spinal cord injury usually meant certain death, or at best a lifetime confined to a wheelchair and an ongoing struggle to survive secondary complications such as breathing problems or blood clots. But today, improved emergency care for people with spinal cord injuries and aggressive treatment and rehabilitation can minimize damage to the nervous system and even restore limited abilities.
Advances in research are giving doctors and patients hope that all spinal cord injuries will eventually be repairable. With new surgical techniques and exciting developments in spinal nerve regeneration, the future for spinal cord injury survivors looks brighter every day.
This information has been written to explain what happens to the spinal cord when it is injured, the current treatments for spinal cord injury patients, and the most promising avenues of research currently under investigation.
Facts and Figures About Spinal Cord Injury
There are an estimated 10,000 to 12,000 spinal cord injuries every year in the United States.
About 200,000 Americans are currently living with spinal cord injuries.
The average cost of managing the care of spinal a cord injury patient is between $15,000 and $30,000 per year.
Forty-six percent of all spinal cord injuries happen during car accidents. Sixteen percent, are the result of injuries relating to violent encounters. The rest are due to sporting accidents, falls, and work-related accidents.
Fifty to seventy percent of spinal cord injury victims are between 15 and 35 years old.

Eighty percent of spinal cord injury patients are men

Treatment for C-6 Spinal Cord Injuries

Treatment for C-6 Injuries
C-6 Spinal Cord injuries can be classified as either complete or incomplete injuries. Complete injuries result in the total loss of movement and sensation below the point of injury, while incomplete injuries indicate that some function below the level of injury is retained.
The correct intervention and support following the injury will increase the likelihood of the best possible long-term prognosis. In most cases, the acute stage of injury is followed by extensive rehabilitation, which is designed to help the survivor adapt both physically and mentally to his or her new condition. While their lives will certainly be different than they were before the injury, with the correct intervention and support, survivors with C-6 injuries can go on to lead very fulfilling lives. In the meantime, scientists continue to study treatments for spinal cord injury, designed to both reduce the effect of the injury and promote the growth of functional nerve fibers.

How should spinal cord injury be treated ?

Spinal cord treatment is divided into two phases—the acute phase and the rehabilitation phase. The acute phase starts immediately following the accident, and comprises the care that is received at the scene of the accident, the care that is administered upon admission to the hospital, and all subsequent care prior to the survivor entering the rehabilitation phase.
During the time immediately following the injury, the goal of the medical team is to stabilize the patient to ensure that no further damage to the spinal cord is sustained. Doctors are particularly concerned with reducing or minimizing swelling, as this can cause even more extensive damage to the spinal cord. Other treatment during this phase includes a combination of medication, surgery, bed rest, traction, and immobilization.
Immediately upon arriving at the hospital, the medical team will usually give the survivor a strong course of a steroid called methylprednisone (MP), which is designed to reduce swelling. The key is for this drug to be administered within eight hours of the injury. This will minimize the chances of further damage being done to the spinal cord as a result of swelling. In cases where bone fragments or foreign objects are pressing on the spine and causing additional swelling, surgery to remove these objects will be done.
Bed rest is a very important part of the acute care phase, because it allows the bones of the spine, which bear the majority of the body’s weight, to heal. Spinal traction may also be used to immobilize the spine and prevent dislocation. Sometimes the skull is immobilized with special equipment, allowing the spine to realign during the healing phase.

During the acute phase, the medical team may also indicate that the patient is experiencing something called “spinal shock.” Spinal shock is a condition that causes the survivor’s reflexes not to work, as a result of the trauma the spine has sustained. During the time the survivor is experiencing spinal shock, doctors may be hesitant to discuss long-term prognosis. That’s because it’s very difficult to accurately separate the loss of function that has resulted from the injury from the loss of function that’s occurring as a result of spinal shock. In most cases some function beyond what is seen during the spinal shock stage will return to the survivor.

How to Recoved Spinal Cord Injury

Spinal cord injuries affect between four and five million Americans per year, and about 400,000 people are living with the effects of spinal cord injury right now. While spinal cord injuries are more prevalent among males between the ages of 16 and 30, when all is said and done spinal cord injuries affect people from all walks of life, of all ages. Women, children, and the elderly—in addition to young men—are affected by spinal cord injury.
There are two types of spinal cord injuries. Complete spinal cord injuries refer to the types of injuries that result in complete loss of function below the level of the injury, while incomplete spinal cord injuries are those that result in some sensation and feeling below the point of injury. The level and degree of function in incomplete injuries is highly individual, and is dependent upon the way in which the spinal cord has been damaged.
Complete Spinal Cord Injuries
Complete spinal cord injuries result in complete paraplegia or complete tetraplegia.
Complete paraplegia is described as permanent loss of motor and nerve function at T1 level or below, resulting in loss of sensation and movement in the legs, bowel, bladder, and sexual region. Arms and hands retain normal function.
Some people with complete paraplegia have partial trunk movement, allowing them to stand or walk short distances with assistive equipment. In the majority of cases, complete paraplegics choose to get around via a self-propelled wheelchair.

Complete tetraplegia is characterized by the loss of hand and arm movement as well. Some tetraplegics require ventilator systems in order to breathe. Depending upon the location of the injury, some tetraplegics may have some arm and hand movement present.

C-6 Spinal Cord Injury :Effects and Treatment

C-6 Spinal Cord Injury
These injures to the cervical region of the spinal cord can result in either complete or incomplete quadriplegia/tetraplegia, in which the voluntary movement and sensation in all four limbs are compromised. While the patient is completely paralyzed, some function may be retained depending upon the exact location of the injury.

Complete and Incomplete Injuries
C-6 injuries can be classified as either complete or incomplete injuries. Complete injuries result in the total loss of movement and sensation below the point of injury, while incomplete injuries indicate that some function below the level of injury is retained.
Effects of C-6 Injuries
Patients with C-6 injuries typically have some wrist control but no hand function. Other effects may include:
Bowel and bladder dysfunction
Sexual dysfunction
Difficulty regulating heart rate, blood pressure, sweating, and body temperature
Spasticity
Neuropathic pain
Muscle atrophy
Osteoporosis
Gallbladder and renal stones
Treatment for C-6 Spinal Cord Injuries

The correct intervention and support following the injury will increase the likelihood of the best possible long-term prognosis. In most cases, the acute stage of injury is followed by extensive rehabilitation, which is designed to help the survivor adapt both physically and mentally to his or her new condition. While their lives will certainly be different than they were before the injury, with the correct intervention and support, survivors with C-6 injuries can go on to lead very fulfilling lives. In the meantime, scientists continue to study treatments for spinal cord injury, designed to both reduce the effect of the injury and promote the growth of functional nerve fibers.

Is Spinal Cord Regeneration Possible?

For many years it was assumed that spinal cord regeneration was not possible. Paralysis, often resulting from damaged spinal cords, was likely to be permanent, and many peoples’ lives were forever altered by a spinal cord injury. This is still the case today, but what has changed is the degree of optimism many people hold about someday being able to use medical techniques to fix spinal cord injuries and restart the damaged nerves that have lost function after an injury has occurred.
It’s doubtful that a single researched element will provide the cure to spinal cord regeneration, and that what really will happen is that shared evidence from lots of research trials may ultimately point the way toward what needs to done. This may yet take a while, though all are joined in the hope of doctors figuring this out sooner rather than later. It’s important to note that even though optimism exists, unless miraculous events occur, chances are that people may need to wait, and potentially a cure may not exist for people whose injuries have occurred some time ago.
The studies, which everybody points to as potentially encouraging in spinal cord regeneration medicine, include those that have brought forth the importance of the axon. This is a small section of each neuron that has to communicate with other neurons in order for full function of the nerve cells to remain. Scientists now know that at least part of the problem with the damaged spinal cord is that axons have been damaged.
Another promising study occurred at USCF in recent years, and suggested that the area of damage was not the only area of concern. By stimulating nerve cells in the peripheral nervous system, researchers were able to stimulate new growth of neurons in the central nervous system and the spinal cord. This study was on mice, and has not been duplicated in humans, but it has been most important because it now proves spinal cord regeneration is possible.
As much as it’s important to understand how to repair something, it may also be necessary to understand why it won’t work. In the late 2000s, one study that may be used medically in future evaluated the blood clotting protein fibrinogen. It was found in people with damaged spinalcords that this protein was present in highly excessive amounts, and that it may be inhibiting the repair of neurons. There are ways to block the protein’s action and these might be indicated in future treatment.

These studies are just the tip of the iceberg and there are many that are still being conducted. Medical science continues to work hard on the issue of spinal cord regeneration, exploring the problem from a variety of angles. It can only be hoped that their discoveries bear fruit soon, and that the human race may soon benefit from recovery of injuries that were once thought incurable.

Can a T5 Spinal Cord injury be repaired?

Spinal cord injury is very complex and the ability to "fix" the problem depends on many things including how badly the nerves have been injured, the age of the patient, the mechanism of injury, etc.

A spinal cord injury — damage to any part of the spinal cord or nerves at the end of the spinal canal — often causes permanent changes in strength, sensation and other body functions below the site of the injury.

If you've recently experienced a spinal cord injury, it might seem like every aspect of your life will be affected.


Many scientists are optimistic that advances in research will someday make the repair of spinal cord injuries possible. Research studies are ongoing around the world. In the meantime, treatments and rehabilitation allow many people with a spinal cord injury to lead productive, independent lives.

People with a severed spinal cord face a number of complications linked to their inability to move. Deep vein thrombosis can occur from the lack of normal blood flow to parts of the body. Blood pools in the veins and can cause clots, pressure sores, joint problems, and urinary trouble. Men who are paralyzed below the waist are usually unable to perform sexually, but a woman may still be able to become pregnant and deliver a healthy child under close medical supervision.

Cells in the spinal cord do not regenerate like the cells in the skin, blood, muscle, and some other organs do. When a spinal cord is totally severed, the damage is usually permanent. Patients require long-term rehabilitation to learn how to deal with the condition and gain as much function as possible. Clinical trials began in 2010 using embryonic stem cells to treat patients with a severed spinal cord after years of studies on animals.

Stem Cell Therapy For Spinal Cord Injury

Spinal cord injuries can result in partial or full paralysis, depending on how extensive the damage is and the injury's location. When the nerves in the spinal cord are damaged, conventional medicine does not have a way of repairing them. Stem cell therapy for spinal cord injury is a controversial option that has the potential to heal nerve damage.

The spinal cord contains the nerves by which the brain communicates with the rest of the body. Just as an appliance cannot work if someone cuts its power cord, the brain will not be able to communicate through damaged nerves in the spine. The part of the spine that contains the damaged nerves will be the point below which the individual could become paralyzed, as nerve impulses will no longer be able to pass through those nerves.

Stem cell therapy for spinal cord injury works by reestablishing the severed nerve connections in the spine with new nerve cells. Doctors do this by injecting stem cells into the damaged area of the spine. These are cells that are what scientists call pluripotent, meaning they are undifferentiated cells that can become any kind of cell in the human body. When these undifferentiated stem cells are placed with cells of a particular type, they transform themselves into that kind of cell. Therefore, when stem cells are injected into an area containing nerve cells, they will turn into new nerve cells. These new nerves can recreate the connection between the part of the spine above the injured area and the part of the spine below the injured area.

This therapy has the possible benefit of helping cure paralysis due to a damaged spine, but the use of stem cells makes it a controversial topic. One source of these stem cells is fertilized human blastocysts, the stem of cells that grows into an embryo, that laboratories create from donated eggs and sperm. These embryonic stem cells are removed from the blastocyst, and scientists allow the individual stem cells to continue dividing into new stem cells. This process eventually creates large stem cell lines for use in research or medicine. Many individuals say that using these stem cells is immoral because they believe that harvesting stem cells from a human blastocyst is the moral equivalent aborting a human fetus.


Research is uncovering new sources of adult stem cells that doctors could use in stem cell therapy for spinal cord injury. These are stem cells that are present inside the adult body, such as in bone marrow, and not harvested from blastocysts. Since these stem cells come from an individual's own body, their use does not attract the kind of controversy that surrounds the use of embryonic stem cells.

What is a severed Spinal Cord Injury?

A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Most injuries to the spinal cord don't completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy axons -- extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.
The spinal cord is divided into segments which control different parts of the body. The upper segments regulate movement and sensation in the upper body, while the lower part sends signals the lower body. A cord that is completely cut in one area causes total paralysis in the part of the body linked to that segment. If the spinal cord is partially severed, some feeling and movement may be possible. Injury to the specific section of the spinal cord that controls breathing can cause death.
Car accidents account for about half of all severed spinal cords. Sporting mishaps, falls, and some diseases can also cause permanent damage to the spinal cord. More than 75% of all victims who suffer from a severed spinal cord are young, male adults. The accidents are often linked to risky behavior, such as diving into shallow water, accidents while not wearing a seat belt, and drinking while driving. Emergency workers who respond to these accidents routinely strap patients to a backboard to prevent further damage whenever a spinal cord injury is suspected.
People with a severed spinal cord face a number of complications linked to their inability to move. Deep vein thrombosis can occur from the lack of normal blood flow to parts of the body. Blood pools in the veins and can cause clots, pressure sores, joint problems, and urinary trouble. Men who are paralyzed below the waist are usually unable to perform sexually, but a woman may still be able to become pregnant and deliver a healthy child under close medical supervision.

Cells in the spinal cord do not regenerate like the cells in the skin, blood, muscle, and some other organs do. When a spinal cord is totally severed, the damage is usually permanent. Patients require long-term rehabilitation to learn how to deal with the condition and gain as much function as possible. Clinical trials began in 2010 using embryonic stem cells to treat patients with a severed spinal cord after years of studies on animals.

Rehabilitation For C5 Spinal Cord Injury

The spinal cord -- the part of the body that relays nerve signals from the brain -- is made of boney disks known as vertebrae that stack on top of each other to form a column. A sudden blow to the vertebrae -- for example, from a sports injury or a large fall -- can dislocate or fracture a part of the spinal cord. However, most injuries are less severe, usually resulting in pieces of vertebrae tearing into cord tissue or pressing down on the nerve tissue that sends signals. After the injury has been treated, a lengthy rehabilitation is needed to restore all possible functions.

C5 Spinal Nerve
The spinal cord includes several main parts. The topmost division, known as the cervical spine nerve, controls many of the muscles in the neck and arms. The C5 spinal nerve occurs on the fifth vertebra down and controls parts of the shoulders and biceps. However, every nerve below an injury site is affected, so a complete spinal cord injury will cause paralysis of the body and legs, in addition to the fingers and wrists. It is likely that you will retain full head and neck movement and good control of your shoulders, but if elbow movement is compromised, then you will be unable to bend or straighten the joint.
Injuries
Rehabilitation will be mostly geared toward coping with and adapting to a change in lifestyle. Yet, depending upon the classification of the injury, muscle strength and mobility in many parts of the body may be regained to a certain degree. Those that are classified as an A injury are complete: nerve signals cannot be conveyed below the injured vertebra. The classification of B denotes that sensory but not motor function is preserved. Some physical therapy may help for injuries ranging from C, in which more than half of the key muscles are not strong enough to move the joint against gravity, to D, in which more than half of the key muscles allow the joint to move against gravity. A classification of E means that motor and sensory functions are normal, and physical therapy can restore much of the lost function.
Rehabilitation

An injury to the C5 vertebra, which supplies nerves to the diaphragm, may cause a momentary stop to breathing, requiring immediate ventilation support. Once the vertebra is treated and breathing functions improve, most patients can be weaned from the machine in the weeks following the injury. However, patients may still have low stamina. The goal of rehabilitation from that point forward is to help the patient learn to use a device such as a walker, leg braces or a wheelchair to move and also use certain communication technologies. Occupational therapy will allow the patient to redevelop motor skills, if possible, and relearn basic functions such as toileting routines and self-grooming. If the injury is complete, then the patient will need help getting in and out of a wheelchair and with domestic care and personal assistance around the house.

Causes of Spinal Cord Injuries

Spinal cord injuries occur in a variety of ways. In adults, damage to the spinal columnis usually also involved and the cord is stretched, bruised, impacted or compacted because of an external force or movement.
Age-related wear and tear on the spinal column, can cause narrowing of the intervertebral canal called stenosis. This results in pressure on the spinal cord and thespinal nerves, causing loss of function.

In children, a spinal cord injury often occurs by an over-stretching of the spinal cord.

What are the common causes of traumatic SCI?

Most traumatic SCI in Australia is caused by:

Motor vehicle accident involving either occupants or pedestrians

Falls

Sporting related accidents

Diving into shallow water

In Australia, traumatic SCI occurs in about 15 adults for each million in the population, every year. This has not changed for many years. It is expected to increase gradually in the years ahead due to our aging population, as many older people fall, which can cause a traumatic SCI.

The following types of injuries can cause spinal cord damage.

Flexion injuries:

Occur when there is a sudden forcible forward movement of the head, similar to a whiplash injury. This results in damage to the vertebrae in the neck (cervical) region of the spinal column. The damaged vertebrae then impact on the spinal cord, causing damage around C5-C6. Spinal ligaments are often also torn. These types of injuries commonly occur in motor vehicle accidents.

Rotation injuries:

Often occur alongside a flexion injury, where there is rotation of the spinal column, often in the cervical, lower thoracic and lumbar regions. This results in an associated injury of the spinal cord. Spinal ligaments are also often torn. Rotation injuries often happen in motor vehicle accidents where the vehicle is hit from the side. They also occur with people wearing lap seat belts, and in motorbike accidents.

Compression injuries:

Occur in diving accidents, where the force is transmitted through the head; or falls from a height, where the force is transmitted through the base of the spine or lower limbs. Impact causes the vertebrae, mostly commonly in the cervical or lower thoracic and lumbar region, to fracture into pieces and protrude into the spinal canal, damaging the spinal cord. The intervertebral discs may also be displaced and protrude into the spinal canal.

Hyperextension injuries:

Happen if you fall and the neck is forcibly extended in a backward direction, stretching the spinal cord. Even if there is minimal damage to the spinal column, the opening up of the discs and stretching of the ligaments damages the spinal cord. This injury is often seen in older people, and those injured in domestic accidents and assaults. Hyperextension of the neck is the most common way children damage their spinal cords. There is often little or no damage to the spinal column, but the force of the trauma causes excessive stretching of the spinal cord.

Penetrating injuries:


Occur when an object such as a knife or bullet penetrates the spinal cord. This type of injury can occur at any level of the spinal column and is often not associated withspinal column damage.

Spinal Cord Injury Causese ans Basic

Spinal cord injury occurs when there is any damage to the spinal cord that blocks communication between the brain and the body. After a spinal cord injury, a person’s sensory, motor and reflex messages are affected and may not be able to get past the damage in the spinal cord. In general, the higher on the spinal cord the injury occurs, the more dysfunction the person will experience. Injuries are referred to as complete or incomplete, based on whether any movement and sensation occurs at or below the level of injury.
The most important – and sometimes frustrating – thing to know is that each person’s recovery from spinal cord injury is different.

Causes of Spinal Cord Injury
Traumatic injuries
Motor vehicle accidents
Football
Falls
Gymnastics
Violence
Diving into shallow water
Spinal cord injuries affect more men than women. The majority of people who sustain a spinal cord injury are young adults between the ages of 16 and 30 because of riskier behaviors.
Non-traumatic injuries/illnesses
Cancer Osteoporosis
Multiple sclerosis
Inflammation of the spinal cord

Arthritis

Levels of Spinal Cord Injury

People with spinal cord injury are often told that they have an injury at a given spinal cord level, that they are “complete” or “incomplete”, that they have a bony fracture at one or more spinal vertebral levels, and that they are classified as A, B, C, D, or E according to the American Spinal Injury Association (ASIA) Classification. What is the meaning of the different spinal cord injury levels, the definition of complete and incomplete injury, and the different classification of spinal cord injury? In this article, I will try to explain the currently accepted definitions of spinal cord injury levels and classification.

Vertebral vs. Cord Segmental Levels
The spinal cord is situated within the spine. The spine consists of a series of vertebral segments. The spinal cord itself has “neurological” segmental levels that are defined by spinal roots that enter and exit the spinal column between vertebral segments. As shown figure 1, the spinal cord segmental levels do not necessarily correspond to the bony segments. The vertebral levels are indicated on the left side while the cord segmental levels are listed for the cervical (red), thoracic (blue), lumbar (green), and sacral (gray) cord.
The spine has 7 cervical (neck), 12 thoracic (chest), 5 lumbar (back), and 5 sacral (tail) vertebra. The spinal cord is shorter than the spinal canal, usually ending just below the L1 vertebral body. The C1 spinal roots exit the spinal column above the C1 vertebral body. There is no C8 vertebral body and so the C8 roots exit between C7 and T1. The T1 roots exit between T1 and T2 and the L5 roots exit between L1 and S1 vertebrae.
The first and second cervical vertebra hold and pivot the head. The C1 vertebrae, upon which the head is perched, is called Atlas after the Greek god who holds the earth. The back of the head is the occiput. The junction between the occiput and atlas is thus the atlanto-occiput junction. The C2 vertebra, upon which Atlas pivots, is called Axis, The junction between C1 and C2 vertebra is the atlanto-axis junction. The cervical cord innervates the diaphragm (C3), the deltoids (C4), biceps (C4-5), wrist extensors (C6), triceps (C7), wrist extensors (C8), and hand muscles (C8-T1).
The twelve thoracic vertebrae have associated ribs. The spinal roots form the intercostal (between the ribs) nerves that run on the bottom side of the ribs and connect to the intercostal muscles and associated dermatomes. About 5% of people have a vestigial 13th rib. The spinal cord ends just below L1. The conus is the tip of the spinal cord. Below the conus, the spinal roots of L2 to S5 form the cauda equina. Injuries to the lower thoracic spinal cords generally damage the lumbar enlargement. Injuries to the lumbosacral spine invariably reults in damage to the lumbosacral enlargement.

In summary, spinal vertebral and spinal cord segmental levels are not necessarily the same. In the upper spinal cord, the first two cervical cord segments roughly match the first two cervical vertebral levels. However, the C3 through C8 segments of the spinal cords are situated between C3 through C7 bony vertebral levels. Likewise, in the thoracic spinal cord, the first two thoracic cord segments roughly match first two thoracic vertebral levels. However, T3 through T12 cord segments are situated between T3 to T8. The lumbar cord segments are situated at the T9 through T11 levels while the sacral segments are situated from T12 to L1. The tip of the spinal cord or conus is situated at L2 vertebral level. Below L2, there is only spinal roots, called the cauda equina.

Prevention of Spinal Cord Injury

Following this advice may reduce your risk of a spinal cord injury:
Drive safely. Car crashes are one of the most common causes of spinal cord injuries. Wear a seat belt every time you drive or ride in a car.
Make sure that your children wear a seat belt or use an age- and weight-appropriate child safety seat. To protect them from air bag injuries, children under age 12 should always ride in the back seat.
Check water depth before diving. To make sure you don't dive into shallow water, don't dive into a pool unless it's 9 feet (about 3 meters) or deeper, don't dive into an aboveground pool and don't dive into any water of which you don't know the depth.

Prevent falls. Use a step stool with a grab bar to reach objects in high places. Add handrails along stairways. Put nonslip mats on tile floors and in the tub or shower. For young children, use safety gates to block stairs and consider installing window guards.
Take precautions when playing sports. Always wear recommended safety gear. Avoid leading with your head in sports. For example, don't slide headfirst in baseball, and don't tackle using the top of your helmet in football. Use a spotter for new moves in gymnastics.

Don't drink and drive. Don't drive while intoxicated or under the influence of drugs. Don't ride with a driver who's been drinking.

Spinal Cord Injury Recovery

When treating a person with a spinal cord injury, repairing the damage created by injury is the ultimate goal. By using a variety of treatments, greater improvements are achieved, and, therefore, treatment should not be limited to one method. Furthermore, increasing activity will increase his/her chances of recovery.

Making Connections
In order to restore movement and sensation, axons must grow from surrounding healthy tissue into the site of injury and then continue on to the brain. Even when researchers are able to stimulate the growth of injured axons, they often find they cannot get the axons to grow beyond the site of injury itself.
To promote this growth, Mark Tuszynski, a neuroscientist at the University of California, San Diego, added nerve cells and growth factors to the injury site and beyond. By leaving behind a trail of bread crumbs to guide axons at points along the spinal cord, for the first time researchers witnessed "axons regenerating into and beyond an injury site," Tuszynski explains.
Improving locomotor function
Improvement of locomotor function is one of the primary goals for people with a spinal cord injury. SCI treatments may focus on specific goals such as to restore walking or locomotion to an optimal level for the individual. The most effective way to restore locomotion is by complete repair, but techniques are not yet developed for regeneration. Treadmill training, over groundtraining, and functional electrical stimulation can all be used to improve walking or locomotor activity. These activities work if neurons of the central pattern generator (CPG) circuits, which generate rhythmic movements of the body, are still functioning. With inactivity, the neurons of CPG degenerate. Therefore, the above activities are important for keeping neurons active until regeneration activities are developed. A 2012 systematic review found insufficient evidence to conclude which locomotor training strategy improves walking function most for people with spinal cord injury. This suggests that it is not the type of training used, but the goals and the routines that have the biggest impact.
While there is a wide range of experimental approaches to treating spinal cord injury, they all share a common goal: improving the lives of people with spinal cord injuries.

"What we know about spinal cord injury has dramatically increased in the last 40 years," says Guest. "The rate of acceleration of improvements in treating spinal cord injuries will continue in the next decades, and the outlook for such patients will only get better."

Pain In Spinal Cord Injury

The spinal cord is the major bundle of nerves carrying nerve impulses to and from the brain to the rest of the body. Rings of bone, called vertebrae, surround the spinal cord. These bones constitute the spinal column or back bones.

Spinal cord injury can be direct trauma to the spinal cord itself or indirect damage to the bones, soft tissues, and blood vessels surrounding the spinal cord.

Spinal cord damage results in a loss of function, such as mobility or feeling. In most people who have spinal cord injury, the spinal cord is intact. Spinal cord injury is not the same as back injury, which may result from pinched nerves or ruptured disks. Even when a person sustains a break in a vertebra or vertebrae, there may not be any spinal cord injury if the spinal cord itself is not affected.

Causes of Spinal Cord Injury

Spinal cord injuries may result from falls, diseases like polio or spina bifida (a disorder involving incomplete development of the brain, spinal cord, and/or their protective coverings), motor vehicle accidents, sports injuries, industrial accidents, and assaults, among other causes. If the spine is weak because of another condition, such as arthritis, minor injuries can cause spinal cord trauma.

Spinal Cord Injury With Bowel Care

You or a caregiver can manage your bowel problems to prevent unplanned bowel movements,constipation, and diarrhea. Although this often seems overwhelming at first, knowing what to do and establishing a pattern makes bowel care easier and reduces your risk of accidents.

A spinal cord injury generally affects the process of eliminating waste from the intestines, causing a:Reflexive bowel. This means you cannot control when a bowel movement occurs.

Flaccid bowel. This means you can't have a bowel movement. If stool remains in the rectum, mucus and fluid will sometimes leak out around the stool and out the anus. This is called fecal incontinence.

Bowel programs

When choosing a way to deal with bowel problems, you and your rehab team will discuss such things as the type of bowel problem you have, your diet, whether you or a caregiver will do the program, and any medicines that may affect your program.

For a reflexive bowel, you may use a stool softener, a suppository to trigger the bowel movement, and/or stimulation with your finger (digital stimulation). There are many stool softeners and suppositories available. You will have to experiment to find what works best for you.

For a flaccid bowel, you may use digital stimulation and manual removal of the stool. At first, you do this program every other day. Later, you may need to do it more often to prevent accidents. You may also have to adjust how much and when you eat.


Eating more fiber can help some people who have spinal cord injuries manage their bowel habits. Good sources of fiber include whole-grain breads and cereals, fruits, and vegetables.

Living With Spinal Cord Injury

Often a spinal cord injury (SCI) is caused by a blow to the spine, resulting in broken or dislocated bones of the spine (vertebrae.) The vertebrae bruise or tear the spinal cord, damaging nerve cells.
When the nerve cells are damaged, messages cannot travel back and forth between the brain and the rest of the body. This causes a complete or partial loss of movement (paralysis) and feeling.
Sometimes the spinal cord is damaged by infection, bleeding into the space around the spinal cord,spinal stenosis, or a birth defect, such as spina bifida.
At the hospital
A person with a potential SCI is taken to an emergency department and then to an intensive care unit. The first priority is stabilizing bloodpressure and lung function, as well as the spine, to prevent further damage. When a spinal cord injury is caused by a serious accident, treatment for other injuries is often needed.
The following tests may be done right away to help find out the extent of the injury. They may also be done routinely throughout and after you leave rehabilitation (rehab).
An ultrasound of the kidneys checks your bladder function. This is done every 1 to 2 years.
A spinal X-ray monitors your spine's condition. Your doctor lets you know how often this is done—usually monthly for the first 3 to 6 months.
Computed tomography scan (CT scan) and magnetic resonance imaging (MRI), which provide detailed pictures of the spine, are done as needed.
A bone density test measures the minerals (such as calcium) in your bones using a special X-ray, a CT scan, or ultrasound.
A few days after the injury, your doctor will ask you questions. Also, he or she will test not only the strength of key muscles but also your response to light touch and pinpricks all over your body.

Recovery From Spinal Cord Injury Treatment

People often ask experts when or if there will ever be a cure for spinal cord injury. Although there are many differing opinions about this, I am confident there will be a cure in my lifetime. In the meantime, anyone with a spinal cord injury should have a long-term plan for their treatment and care.
The number of spinal cord injuries per year has remained fairly stable over the last two decades, with nearly 12,000 occurring each year mostly from sports injuries, car accidents and other forms of traumatic injury. Currently in the United States there are approximately 200,000 people are living with spinal cord injuries or spinal dysfunction. With today’s advanced medical treatments, more spinal cord injury patients survive the trauma compared to just a few decades ago. This positive shift in mortality rate underlines the great importance of initial acute treatment and follow up rehabilitation.
Treatment for spinal cord injuries can be divided into to two stages: acute and rehabilitation. The acute phase takes place immediate following the injury and is conducted at a hospital with an appropriate trauma center. During this time, the patient is immobilized to ensure that the damage to the spinal cord is minimized and any other injuries can be treated. This phase may also include surgery to reinforce the damaged area of the spine to prevent further injury. The acute phase will conclude when the patient is stabilized and ready to begin the next step towards recovery—rehabilitation therapy.
The rehabilitation phase will provide the tools necessary to begin working toward independence. This is a critical time for recovery because many of the gains the patient will make in movement happen during this time. This is why acute rehabilitation, as opposed to rehab done in sub-acute facilities, is so important after such an injury. Improvements made during this period can set the stage for the patient’s recovery afterwards.
While all spinal cord injury patients require rigorous physical and occupational therapy, the injuries and pace of recovery are unique to each person. An individualized plan should be designed to help the patient maximize their recovery. In addition, spinal cord injury patients should receive ongoing education from various disciplines as their injuries and resulting conditions are life-changing and permanent. This education should focus on coping, additional resources and the need for lifelong follow up to deal with changing needs, laying the groundwork for a lifetime of work and improvement.
Once acute rehabilitation concludes, the real work comes next as patients need to continually strive to maintain muscle mass and flexibility through exercise therapy. This can be done at outpatient rehabilitation therapy clinics or at other facilities.

Patients must work on sustaining physical integrity until there is a cure so when the time comes, they will be ready for it.

C1-C7 Level of Spinal Cord Injury

C-1 to C-3:
An injury that occurs in the C-1 to C-3 area results in limited movement of the head and neck, with paralysis below that region. In many cases, survivors of C-1 to C-3 injuries have difficulty talking, and require the use of a ventilator to breathe.

C-3 to C-4:
Survivors with C-3 to C-4 injuries have head and neck movement, as well as some limited shoulder movement. They are typically able to talk, and can eventually adjust to breathing without a ventilator.
C-5:
People with spinal cord injuries that occur at the C-5 level often have head, neck, and shoulder control, and can bend the elbows and rotate the hands. This is the level at which self-care and management becomes possible. Survivors with C-5 injuries are usually able to push their own wheelchairs, and can also be taught to drive a car with adaptive equipment.
C-6 to C-7:

Survivors with injuries at the C-6 to C-7 levels can move their heads, necks, shoulders, arms, and wrists. They can also bend the elbows, extend the wrists, and rotate their hands. Most self-care is possible for people who fall into this category, as is driving, managing a manual wheelchair, and housekeeping.

Early Treatment for Spinal Cord Injury

Spinal cord treatment is divided into two phases—the acute phase and the rehabilitation phase. The acute phase starts immediately following the accident, and comprises the care that is received at the scene of the accident, the care that is administered upon admission to the hospital, and all subsequent care prior to the survivor entering the rehabilitation phase.
During the time immediately following the injury, the goal of the medical team is to stabilize the patient to ensure that no further damage to the spinal cord is sustained. Doctors are particularly concerned with reducing or minimizing swelling, as this can cause even more extensive damage to the spinal cord. Other treatment during this phase includes a combination of medication, surgery, bed rest, traction, and immobilization.
Immediately upon arriving at the hospital, the medical team will usually give the survivor a strong course of a steroid called methylprednisone (MP), which is designed to reduce swelling. The key is for this drug to be administered within eight hours of the injury. This will minimize the chances of further damage being done to the spinal cord as a result of swelling. In cases where bone fragments or foreign objects are pressing on the spine and causing additional swelling, surgery to remove these objects will be done.
Bed rest is a very important part of the acute care phase, because it allows the bones of the spine, which bear the majority of the body’s weight, to heal. Spinal traction may also be used to immobilize the spine and prevent dislocation. Sometimes the skull is immobilized with special equipment, allowing the spine to realign during the healing phase.
During the acute phase, the medical team may also indicate that the patient is experiencing something called “spinal shock.” Spinal shock is a condition that causes the survivor’s reflexes not to work, as a result of the trauma the spine has sustained. During the time the survivor is experiencing spinal shock, doctors may be hesitant to discuss long-term prognosis. That’s because it’s very difficult to accurately separate the loss of function that has resulted from the injury from the loss of function that’s occurring as a result of spinal shock. In most cases some function beyond what is seen during the spinal shock stage will return to the survivor.
When all is said and done, the goal during the acute phase is to stabilize the patient and minimize the amount of damage done to the spinal cord. Once the patient has stabilized, he or she will enter into the rehabilitative phase of care.
How do we know the hospital is equipped and knowledgeable to deal with a spinal cord injury?
Family members won’t have time to be choosy about where their loved one is taken, but they can rest assured that they’ll be taken to a hospital that has the experience and ability to handle the acute phase of spinal cord injury.

The main goal of the emergency response team—the group that arrives upon the scene of the accident—is to get the injured person to the nearest Brain and Spinal Cord Injury Program (BSCIP) designated facility. BSCIP-designated hospitals must meet certain standards and criteria set forth by the Department of Health, and must also be approved by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Any hospital that has been designated with the BSCIP label has the experience, personnel, and equipment necessary to see that the patient receives the best care possible. BSCIP-designated facilities are located throughout the country, in a pattern that ensures that every person who sustains a spinal cord injury is able to reach one in a reasonable amount of time.

Exercises for Spinal Cord Injuries

Spinal cord injury can occur to any area of the spine, including the cervical, thoracic or lumbar areas or the neck, chest or lower back. Where the injury occurs will determine what symptoms or loss of function a person experiences. For example, a person with a cervical spinal column fracture may experience loss of function below the neck, or he may heal with complete recovery of his body. The type, severity and prognosis for spinal cord injuries determine the physical therapy or exercise approach for each individual patient.

Spinal Cord Injuries
Spinal cord injuries almost always cause some kind of loss of function below the site of the injury, according to the National Center on Physical Activity and Disability. Spinal cord injuries are considered to be complete or incomplete, meaning that partial or temporary damage to the spinal cord, or as in the case of complete injury, severe and sometimes permanent damage to the spinal cord. The cervical spinal cord is made up of 8 vertebrae, while the thoracic is made up of 12, the lumbar 5 and the sacral area 5 vertebral bone structures that allow for movement and flexibility while at the same time protecting the spinal cord from injury. A number of exercise approaches may be appropriate, depending on the location, extent and severity of damage to the spinal column or cord.
Exercises for Spinal Cord Injuries
Several types of exercises are generally incorporated into an exercise program for someone who's experienced a spinal cord injury, according to the National Center on Physical Activity and Disability. These exercises can include but are not limited to cardiovascular, weight or strength training and aerobic conditioning, all of which can be adapted by physical therapists for those in wheelchairs. Range of motion exercises as well as stretching and balancing exercises help promote muscle and joint health and flexibility.
Exercising helps prevent atrophy of muscle tissues, though some atrophy or loss of muscle mass usually occurs following inactivity caused by conditions like paralysis. Exercise and movement also encourages circulation of nutrients and blood to all areas of the body, helps prevent bed sores or decubitous ulcers and promotes movement, independence and adaptive mobility to those experiencing partial paralysis. Physical therapy and exercise begun as soon as swelling surrounding a spinal cord fracture is reduced may promote healing and some or complete restored function to areas of the body affected by the spinal cord injury.

Passive range of motion exercises can be done by a physical therapist or other care provider to gently move or rotate a person's joints in order to maintain mobility, range of motion, and prevent contractures. Range of motion exercises help promote circulation and help keep joints flexible, though this type of exercise doesn't make muscles stronger, according to Drugs.com.

C-1 to C-4 Spinal Cord Injury

These extremely high injuries can result in either complete or incomplete quadriplegia/tetraplegia, in which the voluntary movement and sensation in all four limbs are compromised. While the patient is completely paralyzed, some function may be retained depending upon the exact location of the injury.

Complete and Incomplete Spinal Cord Injuries
C-1 to C-4 injuries can be classified as either complete or incomplete injuries. Complete injuries result in the total loss of movement and sensation below the point of injury, while incomplete injuries indicate that some function below the level of injury is retained.
Effects of C-1 to C-4  Spinal Cord Injuries
Patients with C-1 to C-4 spinal cord injuries generally use diaphragm function and require a ventilator to breathe. Other complications may include:
Bowel and bladder dysfunction
Sexual dysfunction
Difficulty regulating heart rate, blood pressure, sweating, and body temperature
Spasticity
Neuropathic pain
Muscle atrophy
Osteoporosis
Gallbladder and renal stones
Treatment for C-1 to C-4  Spinal Cord Injuries

Immediate medical intervention following the injury will increase the likelihood of the best possible long-term prognosis. In most cases, the acute stage of injury is followed by extensive rehabilitation, which is designed to help the survivor adapt both physically and mentally to his or her new condition. While their lives will certainly be different than they were before the injury, with the correct intervention and support, survivors with C-1 to C-4 injuries can go on to lead very fulfilling lives. In the meantime, scientists continue to study treatments for spinal cord injury, designed to both reduce the effect of the injury and promote the growth of functional nerve fibers.

Level of Spinal Cord Injury

Level of Spinal Cord Injury
As many as 400,000 Americans are living with spinal cord injuries. Most spinal cord injuries occur between the ages of 16 and 30, and about 82 percent of those who experience spinal cord injuries are male. Motor vehicle accidents account for approximately 44 percent of all spinal cord injuries.

Doctors and specialists use the level of injury to most accurately predict which parts of the body are most likely to be affected by loss of movement and sensation. Complete injuries will result in total loss of movement and sensation below the point of injury, while incomplete injuries will result in some degree of loss of movement and sensation below the point of injury. Levels of injury are classified as:
Neck
C-1 to C-4
C-5
C-6
C-7 and T-1
T-1 to T-8

T-9 to T-12

Medicine Treatment For Spinal Cord Injury

Each year around 12,000 people in the United States suffer a spinal cord injury. The medical costs of a spinal cord injury can be staggering. The costs depend on the severity of the injury and the length of stay in the hospital and rehab.
An average hospital stay for SCI is around 12 days and the average inpatient rehabilitation stay is around 37 days. Because of medical improvements these figures are much lower than the rates in the early 1970s, when a rehab stay for SCI was often longer than 90 days.
Expenses for an SCI include: initial hospitalization, rehabilitation, and most likely the continuing need for a caregiver and medical care. A person who suffers high tetraplegia, the most severe form of SCI, may acquire medical expenses of over $800,000 in the first year after the injury. If this person is 25 years old or younger their medical expenses may mount up to over $3 million over their lifetime. People 50 years old or older at the time of a severe SCI may expect medical expenses of over $1.8 million over the course of their lifetime. SCI survivors with less disabling injuries face lower, but still hefty medical bills.
Insurance which may cover Spinal cord injury
If you or a family member has suffered a spinal cord injury the insurance company of the party responsible for the accident which caused your injury or your insurance may pay some of your medical bills. The amount of coverage depends on the policy and on the circumstances of the accident. Often, the insurance company of the party responsible for the injury will not pay a sufficient amount of damages for the injury; this makes it vital to obtain advice from an experienced brain injury attorney. Lawyers experienced in advocating for SCI survivors know how to get just financial compensation for you.
Health and Accident Insurance

These policies vary considerably. Some only pay only for injuries from accidents and natural disasters; others offer more coverage, including, routine doctor visits and annual physicals, as well as coverage for tests, and hospital stays for illness and injuries. Insurance polices are usually written in complicated legal terms, making them difficult to understand; talk with someone from your insurance company when an accident occurs so that you know what they will cover. Homeowner’s insurance may offer some coverage when an accident which results in a spinal cord injury occurs at home; this insurance also generally offers some coverage when someone else is injured in your home. About 26 percent of spinal cord injuries are the result of falls and many falls occur at home.

Foods to Avoid for Spinal Cord Injury Patients

After a spinal cord injury, a person's metabolism often changes significantly. Because they use fewer muscles, people with a spinal cord injury require fewer calories per day. However, if their eating habits do not change after their injury, they may be at risk for obesity and other related health conditions. Avoiding certain types of food after a spinal cord injury can help a person maintain a healthy weight.

Fast Foods
Fast foods are high on the list of foods to avoid after a spinal cord injury, or SCI, as they tend to pack excessive calories into a single meal. The Spinal Cord Injury Network reports that the average fast food meal contains around 1,200 calories. For some people, this may be half of their entire daily recommendation after their spinal cord injury.
Clearinghouse, a person with a spinal cord injury usually requires around 10 percent fewer calories per day than the average person. They may need even less if they are severely impaired or inactive. Avoiding fast foods can help a person reduce his caloric intake, as well as avoid the excess fat, cholesterol and sodium that these foods tend to contain.
High-Sodium Foods
The Spinal Cord Injury Network recommends people with paraplegia or quadriplegia limit their sodium intake to between 500 and 1,000 mg daily. More than this amount may cause excess fluid retention, which can leave their bodies more vulnerable to related health conditions. Excess sodium can raise blood pressure, a risk factor for heart disease and stroke. Sodium is found not only in salt but also in many sauces, condiments and pre-made meals. Reading labels and avoiding high-sodium foods can help people living with SCI reduce their risk of heart attack and stroke.
Alcoholic Beverages

Alcohol is another empty calorie beverage, which not only adds to the daily calorie count without adding any nutrition but has other potential side effects as well. Alcohol can have an increased effect for someone with a spinal cord injury; because of this, daily consumption should be limited. Baylor recommends one drink per day for women with SCI and two for men with SCI as a maximum.

What is Spinal Cord Injury

A spinal cord injury (SCI) refers to any injury to the spinal cord that is caused by trauma instead of disease. Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence. Spinal cord injuries are described at various levels of “incomplete”, which can vary from having no effect on the patient to a “complete” injury which means a total loss of function.
Treatment of spinal cord injuries starts with restraining the spine and controlling inflammation to prevent further damage. The actual treatment can vary widely depending on the location and extent of the injury. In many cases, spinal cord injuries require substantial physical therapy and rehabilitation, especially if the patient’s injury interferes with activities of daily life.

Spinal cord injuries have many causes, but are typically associated with major trauma from motor vehicle accidents,falls, sports injuries, and violence. Research into treatments for spinal cord injuries includes controlled hypothermiaand stem cells, though many treatments have not been studied thoroughly and very little new research has been implemented in standard care.

Nursing Care Plan for a Spinal Cord Injury

A spinal cord injury can be a very serious condition that requires around-the-clock care for the patient. As a nurse, it's your job not only to make sure the patient is receiving any treatments, medications, or tests the doctor orders; it's also your job to see that the patient is comfortable, that he is taken care of mentally and emotionally as well. The complexity of a spinal cord injury requires you to pay close attention to every detail the patient tells you about or that you observe, so that you can report any problems or complications to the doctor in charge.

If you work in the emergency department of the hospital, you will, at some point, have a patient come in with a spinal cord injury. In order for the patient's prognosis to be the best that it can be, you must work very closely with the doctors and other nurses to make sure that several things don't happen. For instance, the patient's head and neck need to be stabilized to ensure that he doesn't receive even more injury; it may be necessary for you to place the patient into traction. He may need help breathing also, depending on the severity of his injury. Keep him as still as possible, administering sedatives, if ordered, to allow for less movement or irritation during tests and treatments; you must also monitor his oxygen intake as well. Other things the doctor may order are the placement of a catheter, so as to allow the patient to be rid of wastes and not have it sitting in his bladder. Vital signs will also need to be monitored very closely, as the patient could develop cardiovascular signs of distress or blood clots. The doctor may order a medication called Medrol to be given to the patient, and this needs to be done right away to possibly minimize damage done to the spinal cord. Of course, keeping the charts carefully updated is always a must, as this keeps the doctors and other nurses who come in at different shifts updated and aware of any history or potential complications.
The patient will most likely be admitted to the hospital to stay for several days or even weeks. If he is not able to move below a certain point, he may be at risk for certain complications. You will need to keep monitoring his cardiovascular and respiratory health, especially watching for blood clots, as immobilization drastically increases the risk for these. He may need exercises called range-of-motion exercises to keep his arms and legs from losing the muscle and to keep them from becoming flaccid and cramped. Make sure the patient is turned or moved to a different position every two hours so that the risk for pressure ulcers can be minimized; examine his skin every eight hours. The patient's input and output need to be charted; that way if signs of retention show up, something can be done to help the patient. You must give all medications that are ordered and chart that they were given. Again, charting is crucial at this point to show the patient's progress and history.
As the patient improves, he may be transferred to a rehabilitation facility to recover and learn how to live with his injury. As a nurse in the rehab center, you may have several jobs. Most rehab involves therapists and physical therapists, but you will be monitoring the patient's health overall, and you may assist with certain things. You will help the patient in his recovery process by encouraging him to go to every session with the physical therapist, as this will speed his recovery. While there, he will be working not only with movement and strength training, but he will be learning how to live with his injury, such as using a wheelchair. He'll be relearning even the simplest tasks because he will have to do them in a different way now. You will also need to teach the patient about certain physical aspects of his injury and things that he might expect when he gets home. He may need to be taught how to use a catheter; he may need teaching on UTI's and taking care of his skin, as well as making sure his home is ready for him when he gets there.

Through all of the added stress that a spinal cord injury produces, your patient will need you sometimes to just be there as his nurse. He will need encouragement and all the help you can muster from the beginning. He's going to probably go through a grieving process, as he feels he's lost a part of his life that he might never regain. He may have problems coping. As his nurse, you need to make sure that you communicate effectively with him; study and research his injury, so that you fully understand what is going on with him physically. This will allow for much better communication with the patient. Be honest and upfront with him; don't sugarcoat any detail because this could lead to distrust later on. Most importantly, listen to the patient. He just needs a listening ear at this point. As he improves and starts gaining ability to do certain things on his own, encourage him and praise him, as this will improve his emotional well-being overall and could spur him to keep going and not to give up. Get to know your patient and what he likes or dislikes. If you are going to administer a treatment, tell the patient what you are doing in full detail, so that he understands what to expect. If the patient gets bored, which is very possible with immobilization, find interesting things for him to do, based on what you've learned about him, by getting to know him. Lastly, watch for and report any signs of psychological distress in the patient, so that if the need arises, he can be seen by a social worker or therapist.

Rehabilitation for T12 Spinal Cord Injuries

Spinal cord injuries below T12 affect your lower back, anal sphincter muscle and may damage your defecation reflux. Such injuries can range from mild to severe. Exercise, a good mental outlook and activity play important roles in recovering from a spinal cord injury by managing and/or reducing symptoms, lowering the risks of constipation and promoting more efficient bowel programs. Rehabilitation for spinal cord injuries below T12 should concentrate on returning you and your spine to a healthier functioning level. Always check with your doctor before beginning any exercise or therapy program.

Abdominal Massaging
Massage can play a role in rehabilitation for spinal cord injuries below T12. Performing an external massage, using circular motions, can increase bowel activity, notes the University of Washington Rehabilitation Medicine Department. Lie on your back on a comfortable surface, such as a bed or sofa. Fully extend your legs. Place your right hand on your lower abdomen. Gently apply pressure and start massaging in a clockwise circular motion. Start at your right side and keep making circles until you reach your left abdominal side. Stop the massage and relax for 30 seconds. Repeat this exercise by making counterclockwise circular motions from your left to your right side.
Rehabilitation for spinal cord injuries below the T12 sometimes can benefit from gentle aerobics. Aerobics improve cardiovascular health and provide an all-body workout. Gentle and mild aerobics place minimal stress upon joints and can be especially beneficial as a form of physical activity for spinal cord injuries, according to the University of Washington Rehabilitation Medicine.Start by walking or using a manually operated wheelchair five minutes daily at a comfortable pace. Wear well-fitted, comfortable walking shoes if you are on foot. If standing upright, maintain good posture throughout your walk to stabilize your spine and minimize stress. As your strength builds, increase your time and pace.

Water activities can fit into a rehabilitation program for individuals unable to exercise on land. Water offers a natural buoyancy that supports the majority of your body weight, taking pressure and stress off of joints and making movement more effortless, enabling and pain-free, according to Texas Woman's University. If you are able, walk in water. The deeper the water, the more intense the workout you will get. Begin by holding onto the pool's side with your right hand or hold onto your instructor's hand. Walk around the pool's perimeter, using a comfortable pace. Swing your arms as you would on land and make certain your feet touch the pool's bottom. If walking the entire pool perimeter is too difficult, walk to the opposite side or across the pool's width. Another option involves walking in circles, starting with small circles and increasing to larger ones as your strength builds. If you are new to water walking, an instructors can help you develop proper form and prevent further injury.

What is a spinal cord injury?

A spinal cord injury can happen to anyone at any time. It’s a permanent and irreversible injury and prevention is the only cure.
On average, one person sustains a spinal cord injury every four days in Queensland – about 90 people each year.
Sustaining a spinal cord injury is a traumatic and devastating experience for any individual, and their family and friends. It changes their lives forever.
This short video explains the levels of function of spinal cord injury:
When the vertebrae of the spine are displaced or injured, the spinal cord, which is housed inside the spine, may also be injured. Spinal cord injury occurs if pressure is applied to the spinal cord, and/or the blood and oxygen supply to the cord is cut off.
The spinal cord can also become damaged as a result of the late effects of polio  or inflammation that may result from viral infections, abnormal immune reactions, or insufficient blood flow through the blood vessels located in the spinal cord (this can result in transverse myelitis – a neurological disorder caused by inflammation across both sides of one level, or segment, of the spinal cord).

If the spinal cord is damaged through crushing, bruising or severing the messages to and from the brain cannot get through. The millions of nerve fibres which make up the spinal cord cannot regenerate after injury.(Spinal Cord Injury Symptoms)
The damage to the spinal cord may be complete or incomplete, depending on the degree of injury to the nerve fibres. Incomplete injury can result in movement and sensation abnormalities and a complete injury usually means total loss of movement and sensation – permanent paralysis.
Generally, the level and degree of injury to the spinal cord will determine the extent and areas of paralysis. A person who has paraplegia will usually always have full use of their hands, arms and shoulders. The damage to their spinal cord will have occurred in the upper or lower back (thoracic, lumbar or sacral regions). A person who has quadriplegia will not be able to fully use their hands, arms and shoulders. The damage to their spinal cord will have occurred in the neck (cervical region).
Spinal damage can occur at the sacral or coccygeal levels. When this occurs, the bowel, bladder and the leg area below the knee are generally affected. However, many people who injure their spinal cord at this level will be able to walk with the assistance of special aids, such as a walking stick or foot splints etc.

Spinal cord injury research into nerve reconnection continues to be carried out throughout the world, including Australia.

What Are Complications Of C5 Spinal Cord Injury

Spinal Cord Injury can cause permanent disability or paralysis or loss of movement in several areas. It can also make a person lose sensation on the areas involved. The severity of spinal cord injuries depends on the level of the spinal cord affected, as well as the completeness of the injury. A spinal cord injury in the level of the 5th cervical spine, also known as C5, is relatively high. According to Brain & Spinal Cord.org, C5 spinal injuries can cause paralysis along with several complete or incomplete complications.

According to the spinal cord injury peer support group called Apparelyzed, people with C5 spinal cord injury will still be able to have full neck and head movement. However, they will have complete paralysis of the whole body, legs and arms, a condition known as quadriplegia. There is a complete loss of function in the fingers, hands and wrists. The shoulders and the biceps can also be potentially paralyzed. Sensation will also be lost in these areas, including a person's ability to feel touch, heat and cold.
Although the urinary bladder will still be able to do its job of storing urine, it will not be able to communicate to the brain because of the C5 spinal cord injury, hence the person will no longer have any control over bladder emptying, as stated by cpchildrentreatment.com . Furthermore, this increases the risk of developing urinary tract and kidney infections. As for the bowels, fecal incontinence, or the inability to control the anal muscles, will also be apparent. When it comes to sexual function, cpchildrentreatment.com reports that men may not be able to have a normal erection and ejaculation as they did in the past, while women may also experience changes in lubrication. Sensation and movement in these areas will be decreased or will be absent altogether.

Since patients with C5 spinal cord injuries experience paralysis in the extremities, the muscles in these areas may have changes in muscle tone. According to cpchildrentreatment.com , there are two types of problems when it comes to muscle tone. One is muscle spasticity, in which the patient experiences tightening or uncontrolled spasms in the affected muscles. On the other hand, the person may also have soft and limp muscles that lack muscle tone, a condition known as muscle flaccidity. Due to lack of movement, weight loss and wasting away of the muscles may occur.