Spinal Cord Injury

The nerves around a vertebra control specific parts of the body. Paralysis occurs in the areas of the body that are controlled by the nerves associated with the damaged vertebra, as well as the nerves below the damaged vertebra.

The spinal cord is surrounded by protective rings of bone called vertebrae. The vertebrae and spinal nerves are organized into segments, starting at the top of the spinal cord. Within each segment, the vertebrae and nerves are numbered. The segments are as follows:

Cervical
The neck area contains seven cervical vertebrae (C1 through C7) and eight cervical nerves (C1 through C8). Cervical spinal cord injuries (SCIs) usually cause loss of function in the chest, arms and legs. Cervical injuries can also affect breathing and bowel and bladder control.

Thoracic
The chest contains 12 thoracic vertebrae (T1 through T12) and 12 thoracic nerves (T1 through T12). The first thoracic vertebra, T1, is where the top rib attaches to the spine. Thoracic SCIs usually affect the chest and the legs. Injuries to the upper thoracic area can affect breathing. Thoracic injuries can also affect bowel and bladder control.

Lumbar
The lumbar area (between the chest area and the pelvis) contains five lumbar vertebrae (L1 through L5) and 5 lumbar nerves (L1 through L5). Lumbar SCIs usually affect the hips and legs. Lumbar injuries can also affect bowel and bladder control.

Sacral
The sacral area (from the pelvis to the end of the spine) contains five sacral vertebrae (S1 through S5) and five sacral nerves (S1 through S5). Sacral SCIs usually affect the hips and legs. Injuries to the upper sacral area can also affect bowel and bladder control.

To determine the extent of a spinal cord injury, your physician may order a CT scan (computed tomography scan) and an MRI (magnetic resonance imaging). In addition, you will be tested to see how you respond to pinpricks and light touch to areas of your body. The doctor will ask you to move different parts of your body and test the strength of your muscles.

Together, these tests help the doctor identify the severity of the injury and how likely it is that you could get back some feeling and movement.

If treated within the hospital setting, steps will be taken to get your blood pressure stable and help you breathe. You may also get a steroid medicine to reduce swelling of the spinal cord.

As soon as you are stable, a person with spinal cord injury is typically referred for rehabilitation (rehab). The goal of rehab is to prevent more damage to the spine and spinal cord, to help prepare you for life after rehab and help you be as independent as possible. What happens in rehab depends on your level of injury.

Regaining strength and flexibility is critical to increasing your mobility and the ability to complete everyday tasks. In rehab, your therapist will help you learn to safely complete such tasks as:

• Transferring to and from a wheelchair
• Preventing pressure injuries
• Improving mobility and getting some form of physical activity such as passive stretching

Your therapist can also assist with:

• Adapting your home for your current abilities
• Managing your bladder and bowel
• Preventing lung problems with proper seated positioning

Today, with improved medical care and support, the outlook for people with a spinal cord injury is better than ever. In many cases, one year after the injury, life expectancy is close to that of a person without a spinal cord injury.

• You have frequent coughing periods.
• You feel like you are choking or have problems swallowing.
• You have trouble breathing.
• You have fallen.
• You have a fever.