Backbone or vertebral column is made up of thirty-three bones called vertebrae. Seven vertebrae are in the neck region called Cervical Vertebrae denoted as C1, C2- -C7, twelve in the thorax also called dorsal vertebrae and denoted as T1--T12 or D1--D12 and five in the lumbar region , L1--L5.
There are five vertebrae in the sacral region ( S1--S5) and remaining four are fused together as a vestigial organ, to remind us that our ancestors had tails. These vertebrae are fused together in a manner creating a hollow canal through out the backbone.
Spinal cord is an elongation of the brain running right through this canal starting from the neck up to first lumbar vertebra (L1 ) One pair of spinal nerve comes out from each vertebra of the backbone and then further branch out into peripheral nerves.
The whole network is connected to the brain and performs various motor, sensory and autonomous functions in the whole body Different messages through sensory nerves reach the brain via spinal cord and a proper order comes from the brain for motor action.
Any damage to the backbone would result in " Spinal cord injury " which results into impending Physical Disability compelling the victim to lead a wheel Chair bound life. It is high time that people were made aware of the facts of the causes and consequences of SCl. As it can happen to anyone and at any point of time due to the increasing vehicular traffic apart from other reasons like fall from height such as from a tree, roof of a house, an electric pole etc. One can get a SCI while participating in various sports & games, more commonly adventurous sports like gliding, balloon flying and surfing etc. Yet vehicular accident remains the single largest factor for SCI all over the world especially in metropolitan and bigger cities. Although damage to the spine could also happen because of certain diseases like TB of the spine. But there are chances of revival in such cases with timely diagnosis and treatment. Otherwise there is permanent irreversible damage due to an SCI. There is no cure available all over the world. But yes there are tremendous efforts being made to research out a cure for SCI. Experts in the field are hoping that sooner or later they would come out with a cure. sip's ( Spinal Injured Persons ) me are keeping their fingers crossed waiting, for the day.
| The Dark area shows the part affected by a trunk injury. The person has paraplegia | The Dark area shows the part affected by a neck injury. The person has tetraplegia |
What so ever may be the cause of a spinal cord injury in individual case the consequences would depend on the site and severity of the injury. But in a lay man's term the body would be paralyzed below the level of injury i.e. suppose there is an injury in the neck at the level ofC5 that person would be paralyzed below that level and termed a Tetraplegic as all four limbs that is both hands and legs would be effected. But if the injury is in the thoracic or lumbar only lower limbs that is legs are effected and the case would be called a Paraplegic. Paralysis includes both the losses of sensation and movement that is motor power. The extent of paralysis depends on the level of injury say for example two persons have injury at C3 and C7 level respectively.Both will have paralysis in the upper limbs but the strength in the hands on person with injury at C7 level would be far more than that of C3 injury. So higher the level of injury more the damage
Second important thing is severity of injury, it could be a incomplete or a complete injury depending on the severity. Complete injuries result in total loss of sensation and function below the injury level. in-complete injuries result in partial loss. You may come across a person with injury at C4 level walking if the injury is not that severe at the same time another person with injury at a lower level ofC6 might be leading a wheel chair life. Same way depending on whether the injury is from posterior, anterior or lateral side, SIP may have loss of sensation to touch, hot and cold and still have movements in the limbs. It could be that SIP have sensation but no movements but if the injury on the lateral side it would effect the sensation to pain. So there could be so many entirely different types of cases with the same level of injury.
There is a period of Spinal shock during acute phase lasting usually maximum up to six weeks from the day of injury. It is very difficult to gauge the extent of injury during this phase as more or less all the motor and sensory functions get totally suspended at this point of time. It could be because of the swelling on the spinal cord because of the injury. It could be that once the patient comes out of the spinal shock there may be revival of some sensation and movements, but patients and their families start getting the impression that now everything will be all right. But actually it is not so, revival is only in the parts of the body which are actually not effected by the SCI.
One more point that creates doubt in the minds of patients is spasm, the involuntary movements specifically in the lower limbs. This is an unexplainable symptom normally seen in the case of incomplete spinal cord injury. Most of the times patients start getting falls hopes that movements have started coming back. Doctors, nurses and therapists must keep on telling the facts about spasm and also the positive and negative benefits of it.
What are the other organs and systems of the body that are effected due to SCI
More or less all the systems below the level of injury get slowed down be it digestive,circulatory or respiratory. But again the extent of damage depends on the level that is site and severity of the injury. In the initial phase loss of control over bladder, bowel and pressure ulcers are the main cause of worry, anger and depressions. Because of these certain reasons people with SCI feel reluctant to come out of their homes. Later they may also come to realize about loss of sensation,erection and thus inability to perform sex. It too becomes a major worry in addition to bladder and bowel management and lowers their self esteem. The family and friends have a great responsibility here to search for places like IS1C and take their SCI member for proper training ^bout management of above mentioned problems. So the person can learn to perform the activities of daily living as independently as possible and get fully rehabilitated.
People with Spinal cord injury need a very specific kind of management and care, that can be provided only at specialized centers through their trained staff. Such a center have to have trained nurses, paramedic staff, physiotherapist, occupational therapist, social worker, clinical psychologist, prosthotist & orthotist and specialists like physiatrist, spinal surgeons, neuro-surgeons, orthopedic-surgeons, reconstructive-surgeons, urologists and others. With correct training, management and rehabilitation people with SCI could become an integral part of the society and lead a meaningful life.
