Institut Guttmann

Neurorehabilitation hospital

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Spinal cord injury

The spinal cord is a nerve cord that is protected by the spine and extends from the brainstem to the lumbar region. The spinal nerves appear along the spine and, depending on the region of the column from which emerge, are named: cervical, thoracic, lumbar or sacral. The spinal cord is part of the central nervous system and it is the main route by which the brain receives information from the rest of the body and sends orders governing movement.

Tetraplejia y paraplejiaInterruption causes paralysis of voluntary mobility and absence of any sensation below the affected area; it also involves the lack of control over the urethral and anal sphincters, sexual and fertility disorders, autonomic nervous system disorders and risk of other complications (pressure sores, spasticity, kidney processes etc.)

The injury may result from trauma (work accident, sports, random, traffic etc.), a disease (tumoural, infectious, vascular etc.) or a congenital disease (spina bifida). Depending on whether the injury is complete or partial and on the level at which it occurs, the effects of it will be more or less severe.

At the cervical level, disruption of neural pathways leads to QUADRIPLEGIA, which is the loss or decreased sensitivity and/or voluntary mobility of upper and lower extremities and the entire trunk.

At the thoracic and lumbar level, resulting in PARAPLEGIA, manifested by a lack of sensitivity and/or total or partial paralysis of the lower limbs, and trunk below the injury.

A level of the conus medullaris and the cauda equina, the effect on sensitivity and voluntary mobility is lesser, so, in most cases, the ability to walk is preserved. However, the most significant effect is the loss of control over the sphincters.

To date, the effects of a spinal cord injury are irreversible because the spinal cord does not regenerate, and its complexity and structure make surgical repair with current techniques impossible. However, research continues worldwide for a future cure. Currently, important efforts are being carried out to prevent it, and there are new surgical and technological procedures that improve the prognosis and quality of life of those affected. The comprehensive rehabilitation of the patient in a specialised centre is, today, the only alternative for the proper care of these people.

References about Spinal cord injury

  • ISCoS Textbook on Comprehensive management of Spinal Cord Injuries.  Wolters Kluwer.  Editor. Harvinder Singh Chhabra.  2015
  • Middleton JW et al. Life expectancy after spinal cord injury: a 50-year study. Spinal Cord, 2012, 50:803-811.
  • World Health Organization. International Perspectives on Spinal Cord Injury (IPSCI). In: Jerome Bickenbach, Cathy Bodine, Douglas Brown, et al. (eds.) Geneva, 2013. P.1-231.