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Spinal Cord Injury : Quadriplegic & Paraplegic
Spinal Cord Injury (SCI) Terms : Paraplegic and Quadriplegic (Tetraplegic) are terms used to describe someone who has been paralyzed due to a spinal cord injury. This classification depends on the level and severity of a persons paralysis and how it affects their limbs.
This website provides Patient Information about acute spinal cord injuries, as well as treatment, symptoms, information on long term rehabilitation issues and Peer Support, to help improve the quality of life of those affected by spinal cord injuries.
A Spinal Cord Injury (SCI) is defined as damage or trauma to the spinal cord that in turn results in a loss or impaired function resulting in reduced mobility or feeling.
Common causes of damage to the spinal cord, are trauma (car/motorcycle accident, gunshot, falls, sports injuries, etc), or disease (Transverse Myelitis, Polio, Spina Bifida, Friedreich's Ataxia, etc.). The resulting damage to the spinal cord is known as a lesion, and the paralysis is known as Quadriplegia or Quadraplegia / Tetraplegia if the injury is in the Cervical (neck) region, or as Paraplegia if the injury is in the Thoracic, Lumbar or Sacral region.
It is possible for someone to suffer a Broken Neck,or a Broken Back without becoming paralysed. This occurs when there is a fracture or dislocation of the vertebrae, but the spinal cord has not been damaged.
The nerves that are situated within the spinal cord are called upper motor neurons, (UMNs) and their primary function is to carry the messages back and forth from the brain along spinal nerves within the spinal tract (spinal cord). The spinal nerves that branch out from the spinal cord to the other parts of the body, are called lower motor neurons (LMNs). These spinal nerves exit and enter at each vertebral level and communicate with specific areas of the body.
The sensory portions of the cord, contained within the ascending tracts of the UMNs, carry messages about sensation from the skin such as pain, temperature, touch and joint position to the brain. The motor portions of the spinal cord are contained within the descending tracts of the UMNs, and send messages from the brain to the various body parts to initiate actions such as muscle movement.
It is important to note, that the spinal cord does not have to be completely severed for there to be a loss of function. In fact, the spinal cord remains intact in most cases of spinal cord injury. One of the most common causes of damage to the spinal cord occurs through swelling of the cord, which is then damaged due to the confines of the narrow space within the vertebrae This in turn causes cellular damage resulting in scar tissue to form, which in turn inhibits the formation of new nerve pathways making the resultant paralysis permanent.
There are two types of lesions associated with a spinal cord injury, these are known as complete and incomplete injuries. A complete injury means the person is completely paralysed below their lesion. Whereas an incomplete injury, means only part of the spinal cord is damaged. A person with an incomplete injury may have sensation below their lesion but no movement, or visa versa. There are many types in incomplete spinal cord injuries, and no two are the same.
A person with an incomplete spinal cord injury has been shown to have a better chance of recovery than that of a complete injury. The degree of recovery ranges from significant motor function, to the return of sensation. It is uncommon however, for someone to recover function and sensation to that of their pre injury ability.
Such injuries are known as Brown Sequard Syndrome, Central Cord Syndrome, Anterior Cord Syndrome and Posterior Cord Syndrome.
The most common used grading system for evaluation of functional recovery of a spinal cord injury is the Frankel scale. This scale contains five grades (A-E), based on motor and sensory deficits;
A complete paralysis
B sensory function only below the injury level
C incomplete motor function below injury level
D fair to good motor function below injury level
E normal function