I would like to begin my first official blog as the Spinal Cord Injury Lifestyle Specialist for Shield HealthCare by sharing ten general facts about Spinal Cord Injury. I will briefly explain the function of the human spine and spinal cord, mechanisms of spinal cord injury, most common secondary complications to injury and my personal strategy for managing life with this condition. This short-list of facts and information is a combination of the most current, nationally recognized and standardized statistics, as well as my personal input derived from seventeen years’ experience of living life with SCI.
The human spine (more commonly called the backbone) is a complex anatomic, bony structure that is the scaffolding for the entire body. It provides several important functions, like protecting the spinal cord and nerves and serves as a structural support for the body, allowing us to stand upright against gravity. Structurally, the spine supports roughly half the weight of the body and is made up primarily of 33 vertebrae, 23 discs, and the spinal cord. The spinal column is separated into 5 specific functional areas.
- Cervical (neck) C 1-7
- Thoracic (upper/mid-back) T 1-12
- Lumbar (lower back) L 1-5
- Sacral (central hip) S-1
- Coccyx (tailbone)
2. The Spinal Cord
The spinal cord itself is an extension of the brain, a long bundle of nerve cells and fibers wrapped together (like high-speed internet, fiber-optic cable) that runs through the bony center of the vertebral column, extending down from the brain stem to the lower back. The cord acts as a communication conduit for the brain to send bio-electrical signals through, giving instructions to the arms, legs, feet, hands and all other areas of the body.
3. What is a Spinal Cord Injury?
A spinal cord injury (SCI) occurs when cells within the spinal cord become damaged, compromising the nerve tracts that relay signals up and down the spinal cord (like kinking a garden hose, impeding the flow of water). Severe spinal cord injury often causes paralysis (loss of control over voluntary movement and muscles of the body) and loss of sensation and reflex function below the point of injury, including autonomic activity such as breathing and other activities like bowel and bladder control.
4. Common types of Spinal Cord Injury
The most common types of SCI include contusion (bruising of the spinal cord) and compression (caused by pressure on the spinal cord). Other types of injuries include lacerations (severing or tearing of some nerve fibers, such as damage caused by a knife or gun shot wound), and central cord syndrome (specific damage to the corticospinal tracts of the cervical region of the spinal cord). My spinal cord suffered a combination of these, having been both compressed and bruised, with the outer protective myelin sheath of the cord (dura) being ripped, resulting in my paralysis.
What is the difference between Paraplegia and Quadriplegia? Paraplegia is the loss of sensation and movement in the legs and in part, or all of the trunk, usually resulting from an injury to the spinal cord below the neck . Quadriplegia (also Tetraplegia) is paralysis of all four limbs (from the neck down) resulting from injury to the neck. In my case, I broke my neck (cervical vertebra C- 4, 5, 6) rendering me a Quadriplegic (entire body paralysis). This mean’t I had very little sensation or movement from the chin down. Initially, I was dependent on a ventilator machine to assist breathing because all voluntary and involuntary function below my level of injury had ceased.
6. What is Meant by the Terms “Complete” and “Incomplete” Injuries?
Complete and Incomplete are general terms used to diagnose the severity of a spinal cord injury. Typically, injuries that result in total loss of sensation and function below the injury level are classified as a Complete injury. Incomplete injuries result in partial loss and have a higher rate of return of function over time. To clarify, “complete” does not necessarily mean the cord has been severed. Each of the above categories can occur in both paraplegia and quadriplegia. My initial diagnosis was a “complete quadriplegic”. Fortunately, after many years of intense therapies, a total lifestyle change and the creation of an optimal healing environment, I have been reclassified as an incomplete “recovering quadriplegic” – my terminology.
7. Secondary Complications
Living with paralysis is one thing, it’s the long list of secondary complications that accompany a spinal cord injury that make this condition so severe. SCI patients are highly prone to develop medical problems, such as bladder infections, bowl impaction, lung infections, and decubitus ulcers (bed sores). Bones begin to demineralize in the absence of weight bearing (gravity) causing osteoporosis (brittle bones), and muscles atrophy reducing blood/nutrient circulation. The joints in the body contract, limiting range of motion and can cause premature arthritis. Other symptoms such as nerve pain or sensitivity to stimuli, muscle spasms, muscle tone and sexual dysfunction may develop over time.
8. Managing my SCI
Over the years I have literally had to re-learn how to control my body and how to listen to its needs. Typically, as our body grows from infancy, the process is a subconscious, natural occurrence by which we develop the ability to move and function in life. Most of us are unaware of the incredible complexity of human movement. In my case this process is very conscious. Every thought is deliberately focused into my body and from my body, back to my brain to create function, coordination and movement. I have learned ways to manage my time, energy and risk with a heightened sense of self awareness and understanding. I pay close attention to my nutrition because digestion is difficult and my bowel and bladder function is sub-optimal. I have coined the term “Mindful Movement” because every task takes intention. I willfully make my body move and do the things I want it to. By becoming a student of my body I have gained more control over my life with this injury, rather than having the injury and it’s brutal effects control me.
9. Causes of Spinal Cord Injury
The most common causes of spinal cord injury are car and other motor vehicle collisions. Falls, violence, sports and other medical conditions/surgeries attribute for less common cause. The injury is usually a result of sudden impact, (blunt-force trauma) which crushes or contuses the spine and cord.
10. By the Numbers (United States) – sited NSCISC National Spinal Cord Injury Statistical Center
• 2016 the US population size is 314 million
• Estimated 282,000 Americans in the United States are living with a spinal cord injury
• Annual incident of SCI is approximately 54 cases per million of the population.
• Approximately 17,000 new SCI cases every year
• 41% Incomplete Quadriplegic
• 19% Incomplete Paraplegic
• 12% Complete Quadriplegic
• 18% Complete Paraplegic
• 50% of Americans suffering a spinal cord injury are between 16-30 years of age
• 80% of spinal injuries affect males
• 38% Vehicular
• 30.5% Falls
• 13.5% Violence
• 9% Sports
• 5% Medical/Surgical
• 4% Other
Estimated Lifetime Costs (in dollars 2015) by age at injury (25 years old)
• $4,729,788 – High level complete quadriplegic
• $3,455,879 – Low level complete quadriplegic
• $2,312,846 – Paraplegic
• $1,580,148 – Motor function at any level