Archive

Category Archives for "About SCI"

Thoracic Spinal Cord Injury Information

A spinal cord injury can happen anywhere along the spine.

The location of the spinal cord injury will have a great impact on what parts of the body are affected and how much of the body it affects. Spinal cord injuries that occur lower on the cord affect a lesser part of the body and spinal cord injuries farther up on the cord will affect a greater part of the body.

A person’s health at the time of injury will also have an impact on how severely their body is impacted by a spinal cord injury (SCI).

Below is an explanation of what it means when someone has a thoracic spinal cord injury.

The Thoracic Spine

Human vertebral column

Located above the lumbar vertebrae are 12 thoracic vertebrae (T1-T12). The thoracic vertebrae are indicated in orange on the picture to the right.

These vertebrae go from below the neck (approximately the top of the shoulders) down to the waist.  T1 is located closest to the neck while T12 is at the bottom, closest to the lumbar vertebrae.

Thoracic Spinal Cord Injury

The spinal cord in this area is protected by vertebrae and ribs so thoracic injuries are often extremely traumatic. These injuries often result in a complete loss of motor and sensory function below the injury.

Dr. Wise Young, world-renowned neuroscientist, distinguished professor, and founding director of the W. M. Keck Center for Collaborative Neuroscience states

The thoracic segments are the best protected of all the vertebral segments because of the ribs. It takes enormous forces to fracture the thoracic spinal vertebral bodies. Traumatic injuries of the upper thoracic spinal cord are relatively rare, accounting for only 10-15% of spinal cord injuries (compared to 40% due to cervical, 35% due to thoracolumbar injuries, and 5% due to lumbosacral injuries). Thoracic spinal cord injuries occur as a result of high-speed motor vehicular accidents, tumors that have compressed the spinal cord, and ischemic injuries of the spinal cord. When traumatic injuries of the thoracic spinal cord occur, they generally are severe and often result in complete loss of neurological function below the injury site.

Injury to the thoracic spinal cord causes paralysis or weakness of the legs (paraplegia), decreased/abnormal muscle control in the abdomen and back, sexual dysfunction, loss or decreased skin sensation, and loss of voluntary bladder and bowel control.

Hand and arm function are not usually affected.

Higher Level Thoracic Injuries

Abdominal muscles can be affected by an injury in this area which will limit torso control.

Injuries to the higher thoracic nerves can affect muscles in the upper chest and make it difficult to produce effective coughs. This increases the risk of pneumonia resulting from respiratory infections.

In some cases, a high-level thoracic nerve injury results in low blood pressure, difficulty maintaining normal body temperature, and abnormal sweating due to a dysfunctional autonomic nervous system (the nervous system that should work automatically without having to think about it). Although, this is more common in cervical spinal cord injuries.

Thoracic Nerves

The Shepherd Center subdivides the thoracic nerves into 2 sections.

T1 – T5 nerves affect muscles in the abdomen, upper chest, and mid-back. These muscles and nerves help with torso control, controlling the rib cage, and can affect your diaphragm possibly making it more difficult to breathe.

T6 – T12 nerves affect back and abdominal muscles. These muscles and nerves also are important for torso and trunk control and can affect your posture and your ability to balance.

www.physio-pedia.com

Thoracic Injury Outcomes

An injury to the thoracic spinal cord results in paraplegia. These injuries most often result in needing to use a manual wheelchair or perhaps a power wheelchair.

Your ability to sit and balance may be affected and it can be more difficult to control your torso. Posture can be affected and you may not be owed to sit up as straight as used to.

Your thoracic injury may affect your ability to effectively breath, take deep breaths, and/or produce effective coughs.

Injuries at this level result in loss of bladder and bowel control but most people are able to manage these bodily functions on their own without assistance.

Thoracic injuries do not affect the arms and hands.

Prognosis

All spinal cord injuries are different and your recovery will be different from everyone else’s.

People with thoracic injuries can drive a specially adapted vehicle; stand in specialized wheelchairs or therapy equipment such as a standing frame; may be able to walk with leg specialized braces.

A thoracic spinal cord injury certainly means life will be different but in no way does it mean that a purposeful, happy, fulfilling life is not possible.

Determination, the support of family and friends, and the willingness to think creatively out-of-the-box can go a long way in figuring out how to navigate life with a thoracic spinal cord injury.

Research has progressed so much in the last several years that innovations are now in clinical trials that enable people with thoracic injuries to regain lost function. A great place to check current clinical trials and to determine if you qualify to participate is: clinicaltrials.gov.

The Spinal Cord and Injuries

To learn more about the spinal cord and what it does click HERE.

Learn more about different types and levels of spinal cord injury as well as classifications click HERE.

Share Your Story

Do you have a thoracic spinal cord injury?

Share your story as well as any tips, suggestions, and encouragement for others in our community.

Sacral & Lumbar Spinal Cord Injury Information

A spinal cord injury can happen anywhere along the spinal cord.

The location of an injury has a great impact on what parts and how much of the body is affected by the injury. If an injury is lower on the spinal cord it will affect less of the body. Alternately, if a spinal cord injury is higher up on the cord it will affect a greater part of the body.

For example, my injury is in my neck so, my entire body except for my neck and head are affected by my spinal cord injury. Someone with an injury much lower on the spinal cord may have their body affected from the waist down but have normal torso and arm function.

Below is what I would call a ‘textbook’ description and explanation of a sacral or lumbar spinal cord injury.

Spinal cord injuries are truly different for everyone. I hope those with lumbar or sacral injuries will comment below this post and let others know about their experiences. Also, please comment if there is additional information you feel is important to mention.

Sacral Cord and Vertebrae

Human vertebral column

The lowest spinal cord injury occurs in the sacral vertebrae (indicated in red in the picture to the right). There are five sacral vertebrae (S1-S5) which are fused together to make one segment called the sacrum. Below the sacrum is a tiny little piece called the coccyx.

Injury to this part of the cord is uncommon and results most often from a traumatic injury.

Nerves in the sacral area of the spine control messages to and from the feet, lower legs, thighs, and genitals.

Injuries to the sacral nerves often cause some loss of function in the legs and hips as well as sexual dysfunction.

There is very little, if any, voluntary bladder and bowel control, but most often these folks can manage bladder and bowel functions without assistance.

Injury to the sacral vertebrae often does not result in paralysis. People with this level injury often retain the ability to walk.

Lumbar Cord and Vertebrae

Located above the sacrum are the five lumbar vertebrae (L1-L5) which are indicated in green in the image above. They are the largest of our vertebra and support the most weight.

Nerves in the lumbar area control messages to and from parts of the legs, the buttocks, lower parts of the back and abdomen, and some parts of the genitals.

Injuries in this area of the spine can result in:

  • paralysis or decreased function of the legs and hips
  • loss of sexual function
  • decrease or loss of skin sensation
  • loss of voluntary bladder and bowel control

Depending on where the injury is and on leg strength, injury to the lumbar nerves can necessitate the use of a wheelchair and/or braces to walk.

The Christopher & Dana Reeve Foundation (2014) indicates this level of injury often requires surgery and external stabilization.

What Does This Mean?

We all pretty much know what paralysis means – the inability to move, but what does the rest of it mean.

Sexual Dysfunction

Sexual dysfunction by definition means the inability to have and/or enjoy sex; a sexual response is absent or abnormal.

The loss of touch and sensation may make you unable to feel anything during intercourse.  Men may be unable to have an erection and/or achieve orgasm. Women may lack lubrication, experience discomfort or pain, and/or be unable to achieve orgasm.

Loss of Bladder Control

Inability to control the bladder means some or all bladder muscle tone is lost. This means the bladder muscles cannot contract and empty or the muscles may only contract a little bit so the bladder only partially empties.

Arms and hands are not affected by a sacral or lumbar spinal cord injury, so you can use a catheter to empty the bladder when needed. A tube (catheter) is inserted into the urethra to allow urine to drain out of the bladder.

For some, catheterization must be done on a schedule since you may not feel when your bladder is full.

Loss of bladder control also means an increased likelihood of urinary tract infections.

Loss of Bowel Control

With the loss of bowel control, a voluntary bowel movement cannot happen … but one cannot control when one will occur, either.

People with loss of bowel control schedule bowel movements on a routine schedule so the body can get used to when it needs to go and for convenience.

Bowel programs often include using a stool softener, suppository, mini-enema, and/or stimulation with a finger to trigger a bowel movement.  Sometimes stool will then come out on its own otherwise manual removal of the stool is necessary. With this level of spinal cord injury, most people do their bowel program sitting on the toilet.

My Injury Isn’t Like That

All spinal cord injuries are truly different. I know people with a spinal cord injury at the same location as mine but our abilities are dramatically different. There are so many nerves running through the spinal cord the likelihood of two injuries being exactly the same are very small.

The amount of sexual dysfunction, loss of bladder control, and loss of bowel control are dependent on where on the injury is on the spinal cord and also if the injury is “complete” or “incomplete”.

You can read more about the functions of the spinal cord in my blog post: Spinal Cord Function | What Does Your Spinal Cord do as well as about spinal cord injury classifications in my post: Types of Spinal Cord Injury | Levels and Classifications.

Share Your Experience with Others

Do you have a sacral or lumbar spinal cord injury? We all remember what it’s like to be newly injured and searching for as much information as we can find. Share your experiences below in the comments to help others. Have questions? Share them here so others can lend a hand.

What is Autonomic Dysreflexia?

Autonomic dysreflexia is a secondary condition that results from a high-level spinal cord injury (the 6th thoracic vertebrae or higher). It is sometimes also known as autonomic hyperreflexia or dysautonomia.

Autonomic dysreflexia (AD) can be very scary and confusing for the person experiencing it. The person's body starts having unusual sometimes very sudden and severe symptoms that seem to come out of nowhere.

Most often the cause of autonomic dysreflexia will be discovered and the symptoms alleviated but if left unresolved, AD can be life-threatening. For this reason, it is very important to be well educated about autonomic dysreflexia, symptoms, signs, and common triggers.

Continue Reading
>