Spinal cord injury
There is estimated to be over 40,000 people living with a spinal cord injury in the UK, and each year an estimated 1,000 people will sustain a spinal cord injury.
The majority of spinal cord injuries result in paralysis, and the impact of such an injury can understandably turn lives upside down. Individuals living with the impairment, and their families, are faced not only with the challenge of coming to terms with the injury, but also rebuilding their lives with the disability.
Not all serious injuries to the spine result in spinal cord injury. A person may experience severe fractures to the bones of the spine (the vertebrae) without damaging the spinal cord itself.
A spinal cord injury is damage or trauma to the spinal cord, which is about 45cm long and runs from the base of the brain, through the centre of the vertebrae, to about waist level. Damage to the spinal cord, whether caused by trauma or disease, can result in a complete loss or impaired level of function, and reduced mobility or feeling.
If the spinal cord is damaged, either wholly or partly, the spinal nerves joining the cord below the level of injury will be harmed, thus crucially preventing the brain sending messages to the body below the level of injury.
Trauma is a common cause of spinal cord injury. The most common incidents giving rise to spinal cord injury are: falls (approximately 42%), road traffic accidents (37%), sports injury (12%) and assault (3%).
Types of Injury
A spinal cord injury can be either complete or incomplete. A complete spinal cord injury means there is total paralysis below the level of the injury, i.e. no sensation and no voluntary movement. An incomplete spinal cord injury results in a reduced level of functioning below the level of the injury.
Level of Injury and extent of paralysis
[Illustration of skull/spine/spinal cord]
Injuries at the cervical (neck) level, above the C4 level, may result in a person suffering breathing difficulties as well as partial or complete paralysis of the arms and legs.
Lesions of the spinal cord at C4 level can result in tetraplegia (complete paralysis below the neck).
Injuries at C6 level can result in partial paralysis of the hands and arms as well as the lower body.
Injuries at T4 level can result in paraplegia (paralysis below the chest).
Lesions of the spinal cord at L1 level often result in paraplegia (with paralysis below the waist).
The full extent of the paralysis will depend upon the exact level of the spinal cord injury and whether there has been a complete or incomplete lesion of the spinal cord.
Rehabilitation
Assistive Technology -
People with spinal cord injury can become quite independent and may benefit from assistive technology. In order to achieve maximum functionality an assessment can be made to determine an individual’s technological needs. Of course, not all technology will assist all injured people. However, technology can assist with:
- Mobility (specially adapted wheelchairs)
- Communication (for example, voice operated communication aids for people with speech impairments, free access to mobile and telephone land lines)
- Environmental control (e.g. motorised doors, motorised windows and curtains, remote control lights and mains sockets, intercoms and door entry systems, telephones, motorised gates)
- Computer access (e.g. alternatives to a keyboard and mouse, voice recognition, eye tracking)
Everyone's needs are different and the complexity of the technology will depend upon the individual’s wishes and capability in each case.
Accommodation/adaptation of suitable property -
A person who has suffered a spinal cord injury will often need to either purchase suitable alternative accommodation, or have their existing property adapted, converted or extended to make the property suitable to live in. The following factors will need to be considered:
- Would a single storey property be appropriate?
- What level of access will be required?
- Would undercover parking be appropriate to facilitate easier transfer from vehicle into the home?
- Is there adequate circulation space for a wheelchair?
- What extra storage space is required?
- Is carer accommodation needed?