September 16, 2024 Author: Inês Campos The spinal cord is part of the central nervous system. It conducts nerve signals, between the brain and other organs and tissues of the body, in both directions. It is located in the spinal canal and is divided into segments with the same names as the spine: Cervical Thoracic Lumbar Sacral Coccygeal The 31 pairs of spinal nerves have their origin in the spinal cord (8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1 coccygeal), leave it through holes formed between the vertebrae and are responsible for the functioning of various organs and regions of the body. In adults, the spinal cord ends at the level of the first lumbar vertebrae. The spinal nerves which continue beyond this level until they exit the spinal canal form the cauda equina . Spinal cord injuries and their causes Spinal cord injury is the expression used to refer to injuries that affect the spinal cord and the nerves forming the cauda equina. The causes of spinal cord injuries can be divided into two groups: Traumatic, such as those that are consequent of falls, car accidents or diving ; Non-traumatic, which are related, for example, to some degenerative diseases, tumors, infections, congenital diseases. Spinal cord injuries: They are more common in older ages; Men are more affected than women; The most common have a traumatic cause, resulting from falls or accidents, but non-traumatic injuries have increased in recent years. Consequences of spinal cord injuries The consequences of spinal cord injuries can range from mild to very serious, which depends on: Location or level of the injury; Extent of the injury. The location or level of the spinal cord injury determines the area of the body that is affected. The higher a spinal cord injury, the more regions of the body are affected. For example, an injury that affects both the upper limbs and lower limbs is higher in the spinal cord than an injury that affects only the lower limbs. When it comes to its extent, a spinal cord injury can be: Complete, when all sensitivity and movement control below the area of injury has been lost, which means a paralysis; Incomplete, when some sensitivity and/or movement control remains below the injured area. More serious injuries can compromise autonomy and quality of life and lead to dependence on a caregiver. Paraplegia and quadriplegia and other consequences Paraplegia is the loss of sensitivity and/or movement control of the lower limbs. Tetraplegia is the loss of sensitivity and/or movement control of all upper and lower limbs. Although limb paralysis may be the most visible consequence of a spinal cord injury, injuries with this severity also have implications for the functioning of several organs, including: Loss of bladder and bowel control. Many people with spinal cord injuries need to use catheters intermittently to ensure bladder emptying as they are unable to urinate spontaneously. Loss of bowel control requires the use of oral and local medications (such as suppositories, enemas, enemas) to promote periodic emptying. Still, it is possible for some people to experience episodes of urine and/or fecal incontinence throughout the day. Changes in blood pressure, heart rate and body temperature regulation; Changes in sexual function or fertility, although women with spinal cord injury can become pregnant naturally. Involuntary muscle spasms or contractions, which can be painful and interfere with voluntary movement patterns, damaging them or even preventing them from being carried out. Complications of spinal cord injuries Complications arising from a spinal cord injury are diverse and depend on the severity and consequences of the injury. For example, the is an increased risk of: Skin ulcers that are difficult to heal (bedsores); Recurrent infections (urinary and respiratory); Venous thrombosis; Severe osteoporosis and fragility fractures; Severe chronic pain; Death. Many people who suffer severe spinal cord injuries need to use different aids for their daily activities, such as bath chairs for bathing, walking aids for walking, manual or electric wheelchairs depending on the severity of the deficits, adapted cutlery, articulated beds, anti-bedsore mattresses and pillows. In case spinal cord injury suspicion Following an accident, fall or other trauma, the signs bellow may be related to spinal cord injury and require urgent medical care: Loss of sensitivity / numbness / paralysis of limbs; Obvious injuries to the back, neck or head Difficulty controlling movements or balance; Loss of bladder and/or bowel control. Do not move the affected person, as the situation may worsen if it is a spinal cord injury. In Portugal, call 112. Meet the Physical Medicine and Rehabilitation clinical team at the Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
