Spinal Cord Society of Australia

When a person suffers a spinal cord injury, generally the spinal nerves joining the cord below the level of injury will be either completely or partially cut off from the brain resulting in Quadriplegia or Paraplegia. The body will still be trying to send messages from below the level of injury to the brain, however these messages will be blocked by the damaged spinal cord at the level of injury. Nerves joining the spinal cord above the level of injury will be unaffected and continue to work as normal.

Quadriplegia / Tetraplegia: is when a person has a spinal cord injury above the first thoracic vertebra, paralysis usually affects the cervical spinal nerves resulting in paralysis of all four limbs. In addition to the arms and legs being paralyzed, the abdominal and chest muscles will also be affected resulting in weakened breathing and the inability to properly cough and clear the chest. People with this type of paralysis are referred to as Quadriplegic or Tetraplegic.

Paraplegia: is when the level of injury occurs below the first thoracic spinal nerve. The degree at which the person is paralyzed can vary from the impairment of leg movement, to complete paralysis of the legs and abdomen up to the nipple line. Paraplegics have full use of their arms and hands.

Level of injury (Lesion)

The level of injury, otherwise known as a lesion, is the exact point in the spinal cord at which damage has occurred. The levels are determined by counting the nerves from the top of the spine downwards, and these nerves are grouped into four different area’s. These are the Cervical, Thoracic, Lumbar and Sacral parts of the spinal cord.

These area’s are important in defining quadriplegia and paraplegia, as damage to the spinal cord at these points directly determines how groups of muscles, organs and sensations will be affected.

How the spinal cord has been damage is also a consideration when evaluating a spinal cord injury. There are two types of lesion, these are a complete injury and an incomplete injury. Someone with a complete injury will have complete loss of muscle control and sensation below their level of lesion. An incomplete injury is where maybe only the muscles have been paralyzed, or where there is impaired sensation.

Functionality after a Spinal Cord Injury

The degree to which a persons body will work following a spinal cord injury resulting in quadriplegia or paraplegia will depend on the level of injury, and whether the injury was complete of incomplete. In order to show what functionality will be possible following a complete spinal cord injury, the site http://www.apparelyzed.com has put together the most common abilities for varying degree's of paralysis.

	Anterior Cord Syndrome: is when the damage is towards the front of the spinal cord, this can leave a person with the loss or impaired ability to sense pain, temperature and touch sensations below their level of injury. Pressure and joint sensation may be preserved. It is possible for some people with this injury to later recover some movement.
	Central Cord Syndrome: is when the damage is in the centre of the spinal cord. This typically results in the loss of function in the arms, but some leg movement may be preserved. There may also be some control over the bowel and bladder preserved. It is possible for some recovery from this type of injury, usually starting in the legs, gradually progressing upwards.
	Posterior Cord Syndrome: is when the damage is towards the back of the spinal cord. This type of injury may leave the person with good muscle power, pain and temperature sensation, however they may experience difficulty in coordinating movement of their limbs.
	Brown-Séquard syndrome: is when damage is towards one side of the spinal cord. This results in impaired or loss of movement to the injured side, but pain and temperature sensation may be preserved. The opposite side of injury will have normal movement, but pain and temperature sensation will be impaired or lost.

Cauda equina lesion: The Cauda Equina is the mass of nerves which fan out of the spinal cord at between the first and second Lumbar region of the spine. The spinal cord ends at L1 and L2 at which point a bundle of nerves travel downwards through the Lumbar and Sacral vertebrae. Injury to these nerves will cause partial or complete loss of movement and sensation. It is possible, if the nerves are not too badly damaged, for them to grow again and for the recovery of function.