If we compare the human body to a block of offices working together in an organized yet complex manner, the brain would be the ‘control centre’ on the top floor, and the spinal cord would be the lift connecting the offices on each floor to the control centre.
In the body, the spinal cord transmits sensory and motor information between the brain and the body’s muscles and joints. It also helps regulate the function of numerous internal organs.
The brain receives, organizes, and sends data continually via the spinal cord, allowing effective interaction between people and their surroundings. The information is transmitted by nerve pathways or bundles via ‘cables’ that are grouped and organized in the spinal cord.
If the spinal cord is injured, the transfer of information is interrupted. There is a loss or impairment in sensitivity, mobility, and the regulatory function of the autonomic nervous system (involved in respiration, urinary function, sexual capacity, etc.).
The causes of spinal cord injury can be split into two groups:
Traumatic causes, which are the most common causes
This group of causes includes road traffic accidents (the main cause of spinal cord injury), work accidents, and suicides (involving falls from height).
Medical or surgical causes
which include medullary tumours, infectious or vascular myelitis, and degenerative diseases.
The severity and the prognosis depend fundamentally on the level and degree of the injury:
The degree of the injury refers to whether the spinal cord injury is complete or incomplete. A complete injury means that all the information is interrupted and there is no sensitivity or mobility below the level of the injury. In incomplete injuries, some nerve pathways are unharmed or only partially damaged, so they can continue to transmit information. The more pathways that are unharmed or recover, the greater the control of the body below the injury, and the better the functional prognosis. If there is no mobility, we refer to this as tetraplegia or paraplegia, and if there is some mobility, we refer to this as tetraparesis or paraparesis.
The injury level refers to the height at which the nerve pathways are damaged. In general terms, we divide the spinal cord into the cervical, thoracic, lumbar, and sacral segments. Medical disorders manifest themselves below the injury, which means that injuries that occur higher up affect more parts of the body. Harm to the spine at the cervical level leads to tetraparesis or tetraplegia. If the thoracic segment is affected, the arms and part of the trunk will be unharmed, and the injury is defined as a paraparesis or paraplegia.
Spinal cord injuries affect many aspects of human bodily functions:
- Sensitivity to touch or temperature
- Sensation of where members are
- Bladder function
- Bowel evacuation
- Sexual and reproductive function
- Respiratory function
In addition, spinal cord injuries can predispose those affected to certain complications that may affect:
- Skin integrity
- Bone metabolism
- Venous circulation
- Arterial pressure
- Heart rate
In short, patients with spinal cord injury require ongoing care and monitoring. Specialized rehabilitation programmes are necessary to ensure that patients achieve the best possible recovery, avoid complications, achieve social and work reinsertion, and obtain maximum autonomy.