Frequently Asked Questions
What is Spinal Cord Injury?
A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Most injuries to the spinal cord don't completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy the axons, extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.
Back to Top...What are the Effects of Spinal Cord Injury?
The effects of SCI depend on the type of injury and the level of the injury. SCI can be divided into two types of injury - complete and incomplete. A complete injury means that there is no function below the level of the injury; no sensation and no voluntary movement. Both sides of the body are equally affected. An incomplete injury means that there is some functioning below the primary level of the injury. A person with an incomplete injury may be able to move one limb more than another, may be able to feel parts of the body that cannot be moved, or may have more functioning on one side of the body than the other. With the advances in acute treatment of SCI, incomplete injuries are becoming more common.
The level of injury is very helpful in predicting what parts of the body might be affected by paralysis and loss of function. Remember that in incomplete injuries there will be some variation in these prognoses.
Cervical (neck) injuries usually result in quadriplegia. Injuries above the C-4 level may require a ventilator for the person to breathe. C-5 injuries often result in shoulder and biceps control, but no control at the wrist or hand. C-6 injuries generally yield wrist control, but no hand function. Individuals with C-7 and T-1 injuries can straighten their arms but still may have dexterity problems with the hand and fingers. Injuries at the thoracic level and below result in paraplegia, with the hands not affected. At T-1 to T-8 there is most often control of the hands, but poor trunk control as the result of lack of abdominal muscle control. Lower T-injuries (T-9 to T-12) allow good truck control and good abdominal muscle control. Sitting balance is very good. Lumbar and Sacral injuries yield decreasing control of the hip flexors and legs.
Besides a loss of sensation or motor functioning, individuals with SCI also experience other changes. For example, they may experience dysfunction of the bowel and bladder,. Sexual functioning is frequently with SCI may have their fertility affected, while women's fertility is generally not affected. Very high injuries (C-1, C-2) can result in a loss of many involuntary functions including the ability to breathe, necessitating breathing aids such as mechanical ventilators or diaphragmatic pacemakers. Other effects of SCI may include low blood pressure, inability to regulate blood pressure effectively, reduced control of body temperature, inability to sweat below the level of injury, and chronic pain.
What is the Prognosis?
Spinal cord injuries are classified as either complete or incomplete. An incomplete injury means that the ability of the spinal cord to convey messages to or from the brain is not completely lost. People with incomplete injuries retain some motor or sensory function below the injury. A complete injury is indicated by a total lack of sensory and motor function below the level of injury. People who survive a spinal cord injury will most likely have medical complications such as chronic pain and bladder and bowel dysfunction, along with an increased susceptibility to respiratory and heart problems. Successful recovery depends upon how well these chronic conditions are handled day to day.
Back to Top...What Research is Being Done?
The National Institute of Neurological Disorders and Stroke (NINDS) conducts spinal cord research in its laboratories at the National Institutes of Health (NIH) and also supports additional research through grants to major medical institutions across the country. Advances in research are giving doctors and patients hope that repairing injured spinal cords is a reachable goal. Advances in basic research are also being matched by progress in clinical research, especially in understanding the kinds of physical rehabilitation that work best to restore function. Some of the more promising rehabilitation techniques are helping spinal cord injury patients become more mobile.
Back to Top...What is the Beyond Therapy Program at The Shepherd Center?
To learn more about the Beyond Therapy program at The Shepherd Center in Atlanta, Georgia, please click on the following link:
Shepherd Beyond Therapy Program
Is There a "Cure" for this Injury?
Right now there is no clear-cut medical cure for SCI. Administration of IV steroids at the time of the injury may prevent further damage to the nerves that is caused by the natural inflammation process following trauma. This can improve the long-term functional outcome. There has been, however, ongoing research at the Christopher Reeve Research Center in California and the Miami Project in Florida focusing on ways to regenerate or reconnect nerve pathways.
Back to Top...Can People with Spinal Cord Injury Still Have Sex?
Absolutely! We are all sexual humans with or without a disability. After a spinal cord injury, a person can continue to be sexually active and experience a satisfying intimate relationship. Your injury, however, may mean there is a change in how your body can respond. Females with spinal cord injuries are still able to bear and have children.
Back to Top...How Many People Have SCI? Who are They?
Approximately 315,000 people live with SCI in the US. There are about 12,000 new SCIs every year; the majority of them (82%) involve males between the ages of 16-30. These injuries result from motor vehicle accidents (42%), violence (24%), or falls (22%). Quadriplegia is slightly more common than paraplegia.
Back to Top...Is there a treatment?
Improved emergency care for people with spinal cord injuries and aggressive treatment and rehabilitation can minimize damage to the nervous system and even restore limited abilities. Respiratory complications are often an indication of the severity of spinal cord injury. About one-third of those with injury to the neck area will need help with breathing and require respiratory support. The steroid drug methylprednisolone appears to reduce the damage to nerve cells if it is given within the first 8 hours after injury. Rehabilitation programs combine physical therapies with skill-building activities and counseling to provide social and emotional support.
Back to Top...What Types of Therapeutic Recreational Activities are Available to Individuals with Spinal Cord Injuries?
There are as many therapeutic recreational activities available to those with spinal cord injuries as there are to able bodied individuals. Most reputable treatment centers have resources available to offer a complete line of sports activities and hobbies which include such areas as rugby, basketball, swimming, fencing, power soccer, scuba diving, water and snow skiing, whitewater rafting, hunting, fishing, gardening, painting, photography, etc. It is important to get involved and maintain hobbies and active recreational interests to live a full and rewarding lifestyle.
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