What is spinal cord injury?

The spinal cord consists of millions of tiny nerve fibres which carry messages from the brain to and from the arms, legs, abdomen and all our internal organs. A spinal cord Injury is damage or trauma to the spinal cord that results in a loss or impaired function causing reduced or absent movement and feeling.

How many people have a spinal cord injury?

Spinal cord injury affects approximately 20,000 Australians, with approximately 300 new cases each year (2008: 137 paraplegic and 136 quadriplegic new patients). World-wide there are approximately three million people with spinal cord injury. The average age of injury is 19 years and five out of six people suffering injury are male.

Spinal Cord anatomy

The spinal cord is located inside the spinal column, which in turn consists of small individual bones called vertebrae. The spinal nerves carry information from different levels in the spinal cord and exit the spinal column through tiny holes created where one vertebrae sits on top of another. The nerves are numbered according to their position in the spinal column:

Cervical Nerves: C1-C8
Thoracic Nerves: T1-T12
Lumbar Nerves: L1-L5
Sacral: S1-S5

What are the common types of spinal cord injury?

The most common types of injury to the spinal cord are caused by motor vehicle accidents, swimming/diving accidents, football and other recreational accidents. In most cases damage to the cord occurs without the cord actually being “cut” or severed. Damage occurs to the nerve cells due to constriction, compression or stretching of the cord which causes a lack of blood/oxygen supply and death of the nerve cells.

What are the affects of injury to the spinal cord?

A spinal cord injury usually results in the area of the body below the injury site being partially or completely unable to communicate with the brain. The messages between the brain and the body are blocked by the damaged spinal cord which results in the patient experiencing either Paraplegia or Quadriplegia. Any nerves above the level of the injury site which remain undamaged will continue to function as normal.

Paraplegia: If the injury occurs below the first thoracic vertebrae in the upper back region the paralysis is likely to be confined to the legs with more severe injuries resulting in loss of movement in the abdomen and up to the nipple line. A person with paraplegia will retain full use of their arms and hands.

Quadriplegia: Also known as Tetraplegia, is when the injury site occurs above the first thoracic vertebrae in the cervical vertebrae or neck region of the body. This type of paralysis generally results in loss of movement in all limbs. In addition the abdominal and chest muscles will also be affected.

There are two types of lesions, complete and incomplete injury. A person with a complete injury will have complete loss of muscle control and sensation below the site of their injury. A person with an incomplete injury may experience paralysis only in the muscles or impaired sensation.

Retaining function after a spinal cord injury depends upon where the injury occurred and whether it was complete or incomplete. In general the following will occur:

Loss of movement (below the level of injury)
Loss of feeling (below the level of injury
Change in cardiovascular function (slowed pulse, lowered blood pressure)
Change in bladder and bowel function
Change in respiratory function (reduced breathing ability and coughing)
Difficulty in regulating body temperature
Loss of normal sexual function
Problems with skin integrity (such as pressure sores)

Why can’t spinal cord injury be fixed? What does the future hold?

Unlike if we cut our skin or break a bone, the spinal cord does not have the ability to regenerate and heal it self and as such these injuries cannot be “fixed”. Treatment to date focuses on rehabilitation to restore as much function and independence as possible, while at the same time facilitating adjustment to disability, promoting self determination and enhancing quality of life. This involves a multidisciplinary team comprising medical, nursing, physiotherapy, occupational therapy, social work and psychology health professionals.

A revolutionary approach that is currently being trialed in experiments across the world is the use of stem cell therapies.