Spinal Cord Injury
CHAPTER
23
175
Spinal cord injury usually results from an accident that breaks or severely damages
the central nerve cord in the neck or back: falls from trees or mules, automobile
accidents, diving accidents, bullet wounds, and other injuries. Spinal cord injury is more
common in adults and older children—and in many cultures it is twice as common in
men as in women.
The spinal cord is the line of nerves that comes out of the brain and runs down the
backbone (see p. 35). From the cord, nerves go out to the whole body. Feeling and
movement are controlled by messages that travel back and forth to the brain through
the spinal cord. When the cord is damaged, feeling and movement in the body below
the level of the injury are lost or reduced.
Level of the injury
How much of the body is affected depends on the level of the injury along the
backbone. The higher the injury is, the greater the area of the body that is affected.
The backbone
consists of:
7 neck bones
(cervical
vertebrae)
12 upper back
bones (thoracic
vertebrae)
5 lower back
bones (lumber
vertebrae)
5 joined hip
or sacral
vertebrae
tailbones
brain
Spinal cord
injury of
the neck
causes
QUADRIPLEGIA.
Spinal cord
injury of
the back
causes
PARAPLEGIA.
Quadriplegia:
• loss of controlled movement and feeling from
the neck or chest down—and to some extent
the arms and hands
• affects urine and
bowel control
• Paralysis of chest
muscles affects
breathing.
• reduced sweating and
temperature control
Paraplegia:
• loss of controlled movement
and feeling in the legs
• Hips and part
of trunk may be
affected (the higher
the injury the more
is affected).
• may have partial
or complete loss
of urine and bowel
control
• may have spasticity (muscle spasms) or be
floppy in legs
Complete and incomplete injuries
When the spinal cord is damaged so completely that no nerve messages get through,
the injury is said to be ‘complete’. Feeling and controlled movement below the level of
the injury are completely and permanently lost. If the injury is ‘incomplete’, some feeling
and movement may remain. Or feeling and controlled movement may return (partly or
entirely) little by little during several months. In incomplete injuries, one side may have
less feeling and movement than the other.
X-rays often do not show how complete a spinal cord injury is. Sometimes the backbone
may be badly broken, yet the spinal cord damage may be minor. And sometimes (especially
in children) the X-ray may show no damage to the backbone, yet the spinal cord injury may
be severe or complete. Often, only time will tell how complete the injury is.