Spinal cord injuries refer to damage to any region of the spinal cord or nerves at the end of the spinal canal, known as cauda equina, and result in permanent changes below the area of injury. The severity of the injury, and the region where it occurs in the spinal cord, determine one's ability to control their limbs.
The neurological level of spinal injury is defined in accordance with the lowest part of the spinal cord that remains undamaged after an injury. The completeness of the injury is defined in accordance with the severity.
Based on completeness, spinal cord injuries can be complete or incomplete.
A complete spinal cord injury is one in which all the sensory feelings and the ability to control movements or motor functions are lost below the spinal cord injury.
An incomplete spinal cord injury is one in which some motor or sensory function remains below the affected area.
Different types of paralysis that occur depending on the location of spinal cord injury
A spinal cord injury can cause a person to have paralysis, which means they cannot move their body parts. Determining the section of the spinal cord in which injury has occurred can help diagnose the type of paralysis.
Paralysis occurring due to a spinal cord injury can be of two types: tetraplegia and paraplegia.
Tetraplegia is also known as quadriplegia. It is a form of paralysis in which the arms, hands, trunk, legs and pelvic organs are affected due to the spinal cord injury.
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“Quadriplegia is considered a severe paralysis condition as the injury is usually detected in the cervical ( neck ) area of the spinal cord. Usually, patients with both legs and arms get affected resulting in no motion in all four limbs. Daily chores become the biggest task and always need someone to feed them, make them walk, and do other daily activities like bathing, dressing,” Dr Neeraj Kumar Tulara, General Medicine & Infectious Disease Specialist, Dr LH Hiranandani Hospital, Powai, told ABP Live.
When there is incomplete paralysis in all the four limbs, the condition is called quadriparesis, and when there is complete paralysis in all the four limbs, the condition is called quadriplegia, Dr Tarun Suri, Head, Department of Spine Surgery, Amrita Hospital, Faridabad, told ABP Live.
Paraplegia is a form of paralysis in which the entire trunk, legs and pelvic organs, or parts of them are affected.
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When an injury occurs in the upper- and mid-back, or the thoracic and thoraco-lumbar spines, the upper limbs are not affected, and weakness only occurs in the lower limbs. This is known as paraparesis or paraplegia, said Dr Suri.
“Both quadriplegia and paraplegia are linked with problems in the bladder and bowels. An injury further down in the lower back (lumbar spine) causes variable and incomplete weakness in both lower limbs, depending on the exact level. Patients may have weakness only below the knees,” Dr Suri explained.
Thus, paraplegia usually occurs when spinal cord injuries take place in the lower back region of the body.
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“The legs are seriously affected. Usually, the lower body loses all sensations. Movement of the legs is also lost. But these patients can easily work with their upper body parts,” said Dr Tulara.
Hemiplegia is a form of paralysis in which spinal cord damage is not directly linked. When one side of the brain is damaged, other body parts may be affected. It causes paralysis on one side of the body. For instance, if the right side of the brain is damaged, the left side of the body is paralysed.
Different complications are associated with different types of paralysis. For instance, some patients can lose sensation or motion in the affected part, while others may lose their sensations in most parts of the body, said Dr Tulara. “Physical therapy, rehabilitation, and new technical devices help people regain consciousness and some independence and can help them adjust to the old life routine with regular therapies.”
The type of paralysis, and the segment of spinal cord damage are interconnected.
“Paraplegia affects the lower body section, quadriplegia affects the leg and arms and hemiplegia is caused due to brain damage that leads to the dysfunctionality of one side of the body. Each paralysis condition needs special care, attention, and assistance to regain the person to a normal life” Dr Tulara concluded.