SPINAL CORD INJURY
The spinal cord is a long fragile network of fibres that travel between the brain and the bottom of the spine. The spinal column is made up of a column of bones called the vertebra, these bones protect the spinal cord. 31 pairs of spinal nerves travel out from the spinal cord between each vertebra. There are motor nerves that carry commands from the brain and spinal cord to other parts of the body, namely skeletal muscles which help us to move. The sensory nerves carry information to the brain from other parts of the body. Where the spinal cord ends there is a bundle of nerves called the cauda equina. The spinal cord is responsible for transmitting nervous impulses which help us to move our body, feel pressure and control vital functions like breathing, blood pressure, bladder and bowel.
Damage to the spinal cord can happen as a result of trauma like an accident or as a result of infection or disease. If it is damaged the communication between our brain and the rest of our body is disrupted resulting in a loss of movement and sensation from below the level of the injury. The degree of loss of movement and sensation will vary from person to person. The higher up the damage the more movement and sensation will be lost.
Paraplegia: affects the movement and sensation in the legs and sometimes the stomach muscles. It is caused by a spinal cord injury in the back.
Tetraplegia: affects movements and sensation in all four limbs, as well as stomach and chest muscles. It occurs as a result of a spinal cord injury in the neck.
Healthcare professionals use letters and numbers to classify the level of spinal cord injury that someone may have. Physiotherapists complete detailed motor and sensory testing to help to classify spinal cord injury levels. SCI in the neck would be classified as C1-C8 (cervical spine), SCI in the back would either be classified in the Thoracic region (T1-12) or the lumbar region (L1-5).
Incomplete spinal cord injuries are most common. Here, there is some preservation of movement or sensation below the level of injury. Complete Injuries are where both sides of the body are affected and there is no muscle function or voluntary movement or sensation from the level of injury and below.
Problems that might arise from spinal cord injury include:
· Muscle Weakness or Paralysis
· Reduced ability to breathe independently
· Loss of general Mobility and Balance
· Loss of Functional Movement
· Poor Posture
Physiotherapists use detailed assessment techniques to gain a clear picture of how a spinal cord injury may affect you. Physiotherapists are paramount in helping those who have suffered a SCI to reach there goals no matter what stage they are at in their recovery following the injury.
Treatments are tailored to an individual’s need and may include:
· Flexibility and strengthening exercises
· Breathing exercises
· Balance and posture exercises
· Functional activities
· Mobility education (gait re-education / mobility aid and orthotics use / wheelchair use)