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Spinal Cord Injury

What is the spinal cord?

The spinal cord is a soft bundle of nerves surrounded and protected by the backbone (spine). It runs down the middle of the back from the brain to about the waist through the spinal canal.

The brain and the spinal cord make up the central nervous system. Messages between the brain and the rest of the body travel back and forth through the spinal cord. These messages give us the ability to move and to feel sensation, among other things.

What is a spinal cord injury?

A spinal cord injury (SCI) is damage to your spinal cord that results in complete or partial loss of movement (paralysis) and feeling. The amount of paralysis depends on where and how severe the damage is. The "higher" the damage is on the spinal cord, the more extensive the paralysis is. For example, damage in the neck area of the spinal cord can result in paralysis of the chest, arms, and legs (tetraplegia, also known as quadriplegia), while damage farther down the spinal cord (toward the waist) can result in paralysis of the legs and lower body (paraplegia).

Damage to the spinal cord can be complete or incomplete. In a complete SCI, you do not have feeling or movement in the areas of your body controlled by lowest part of your spinal cord. In an incomplete SCI, you have some feeling but no movement, or varying amounts of movement.

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 is damage to the spinal cord as a result of a direct trauma to the spinal cord itself or as a result of indirect damage to the bones and soft tissues and 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.

What Causes 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.

What Happens in a Spinal Cord Injury?

There are two kinds of spinal cord injury -- complete and incomplete. In a complete injury, a person loses all ability to feel and voluntarily move below the level of the injury. In an incomplete injury, there is some functioning below the level of the injury.

What will life be like after an SCI?

Adapting to living with a spinal cord injury and learning to live with new limitations can be difficult and frustrating. An SCI is a life-changing event for you and your loved ones, and getting used to a limited ability to move or feel sensation is difficult and can take a long time. However, it is important to remember that you do not lose the ability to think, feel emotions, learn, love, work, play, or to live life to its fullest.

A common saying among those who have been paralyzed is, "Before your injury, you could do 10,000 things. Now you can do 9,000. So are you going to worry about the 1,000 things you can't do or focus on 9,000 things you can do?"

People with SCIs have jobs, drive, participate in athletics and recreational activities, and have relationships and children. Many people with an SCI return to their home, although they may need some help to function. Almost 90% of those discharged from a rehabilitation program are sent to a noninstitutional residence, generally their homes.

You may make strong initial improvement but then seem to get worse. You may feel depressed, or grieve for your previous lifestyle. It is important to show these feelings; discussing your frustrations with your family, friends, and health professionals is an important part of your recovery. Your caregivers can also feel frustrated and depressed; it is also important that they form a support network.

While at one time the results of an SCI were considered permanent, new research is changing this perception-there may be a cure for paralysis some day. For information on research on SCIs, see the Search for a Cure section of this topic.


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