The spinal cord is a relay and integration centre for the central nervous system that sends signals to and from the brain and supports vital reflexes. The spinal cord helps to carry a lot of information about the body, and when injured, it affects the general function of the whole body.
This means that any area of your body can be affected by spinal cord injury. For example, if the arm is good, but if the spinal cord that sends signals to it gets disrupted, it results in total dysfunction of the arm.
In this way, almost every area of the body can be affected by spinal cord injury. The specific impact and long-term prognosis of the injury depend on the location of the injury, the quality of care one receives, overall health, and several unpredictable factors. However, for most SCI survivors, the journey to recovery may be extended, depending on certain infections and delays. SCI treatment should be supported by quality medical care and rehabilitation services.
In this article, Dr. Surya Prakash Rao Voleti provides information about:
- What is spinal cord injury?
- How spinal cord injuries can interfere with many bodily functions?
- What Happens In Body When Spinal Cord is Injured?
- What parts of the body are affected by a spinal cord injury?
What is a Spinal Cord Injury?
SCI is the result of damage to the spine, ligaments, spinal discs, or spinal cord.
Spinal cord injury (SCI) is spinal cord damage that causes loss of function such as mobility or feeling. Common causes of spinal cord injuries include car accident injuries, which are the leading cause of SCI among younger people. For people older than 65 years falling is a major reason. Any illness neurological or otherwise, which leads to loss of balance can lead to a fall, which in turn can cause a spine or dislocation and spinal cord injury.
In most people with spinal cord injuries, the brain remains intact, but the damage causes loss of spinal cord function. Spinal injuries are very different from back injuries such as disc rupture, stenosis, or pinched nerves.
How can spinal cord injuries interfere with many bodily functions?
The spinal cord is like an excellent telephone cable communication system consisting of millions of nerves that send messages between the brain and all parts of the body. A ring called a vertebra surrounds it. The nerve and bone columns, which travel from the brain to the coccyx, form the spinal cord.
The structure of the protective bone is the spinal column. Injury to the spine can break bones around the spinal cord and pinch the spinal cord and cause nerve damage.
Damage to the spinal cord and nerves can occur without damage to the back Bone. This happens some times in young individuals and is commonly known as SCIWORA (Spinal cord injury without radiological abnormality). Many nerves flow from the brain through the spinal cord to the skin, muscles, and organs. These nerves enter and exit the spinal cord at a certain level, and each level goes to certain parts of the body.
The first seven levels are called in the cervical spine ( C1 to C8 ). They control the function of breathing, neck, and hands.
The subsequent are twelve levels. In the thoracic spine, These are responsible for the chest and torso area. Five levels of lumbar follow and control the legs. The last levels are in the sacral spine and are latter is involved in the work of the intestines, bladder, sexual, and legs. Through these nerves, the brain commands the body to move.
Nerves work along the spinal cord; The message cannot pass if the path is broken. This occurs with spinal cord injury or disease. After a spinal cord injury, the level above the damage continues to work, but all levels below the loss get affected.
What Happens In Body When Spinal Cord is Injured?
When SCI occurs, During the Acute phase, the spinal cord swells in damaged areas, disrupting the supply of vital blood to nerve tissue and leaves it starving for oxygen. This causes a cascade of destruction that affects the entire body and causes the vertebrate tissue to die and then gets damaged, and furthermore damaged by massive immune responses.
Circulation: Slow blood flow at the site of the injury begins to reduce blood flow to adjacent areas, which immediately affects all areas of the body. The body gradually loses its ability to regulate itself, which results in a dramatic decrease in blood pressure and heart rate.
Flooding of neurotransmitters: SCI causes excessive neurotransmitter or biochemical release that allows nerve cells to communicate with each other. These chemicals, especially glutamate, over excite the neurons and kill them; this process is known as excitotoxicity. This process also kills vital oligodendrocytes that surround and protect the spinal axons.
Immune cell Invasion: The army of the immune system cells accelerate into the damaged spinal cord. While they help prevent infection and remove debris from dead cells, they also promote inflammation. These immune cells stimulate the secretion of specific cytokines, which can be toxic to neurons in high concentrations, especially those needed to maintain the myelin sheath around axons.
Free Radical Invasion: Inflammation by cells in the immune system releases waves of free radicals, which are very reactive forms of oxygen molecules. These free radicals damage many types of cell molecules, severely damage healthy nerve cells.
Self-destruction of Nerve Cells: Usually, the natural process of programmed cell death, known as apoptosis, is beyond the control of the injury site. The reason is unknown. A few days or weeks after injury, oligodendrocytes die for no apparent reason, affecting the integrity of the spinal cord.
Additional damage usually occurs within a few days or weeks after the first injury due to bleeding, swelling, inflammation, and fluid retention in and around the spinal cord.
Types of Spinal Cord Injury:
Spinal cord injuries are divided into two types of injury they are:
- Complete Injury
- Incomplete Injury
The degree of loss of bodily function after a spinal cord injury or disease depends on the extent and completeness of the spinal cord injury. The complete injury is related to the number of messages that pass through the spinal cord. If there is no sensation or movement below the level of injury, this is considered a complete injury. If the feeling or movement is far below the level of injury, it is an incomplete injury.
Initially, the nervous is in shock after injury. There is swelling around your spinal cord, just like other parts of your body that expand when injured. With a decrease in swelling, there may be an increase in bodily functions below the level of injury. Thus, spinal cord injuries affect bodily functions.
Which Body Parts Can be Affected By Spinal Cord Injury:
At first, the changes in how your body works can be overwhelming. However, a doctor will help to develop the tools that need to manage changes caused by spinal cord injury and recommend equipment, or resources to improve the quality of life. The areas most commonly affected include:
The bladder will continue to store urine from the kidneys. However, the brain may not be able to control the bladder because the messenger (spinal cord) is injured. Changes in bladder control increase the risk of urinary tract infections. Changes can also cause kidney infections and kidney or bladder stones.
The urinary system consists of the kidneys (which filter blood and produce urine) and the bladder (which holds urine and then removes it). After a spinal cord injury, the kidneys continue to pass urine, but the bladder may not function as before. You might not be able to know when the bladder is full, or you might not be able to drain urine if necessary. There are several types of catheters, drugs, and other techniques that promote independence by deflating your bladder. The doctors work with you to find ways to manage your urinary tract.
The digestive system breaks the food one eats. Digestion continues after spinal cord injury, but the ability to control bowel movements may be impaired. When the rectum is full, a message is sent to the brain telling you to wait until you reach the bathroom. The news may not reach the brain after a spinal cord injury. Therefore, there may be problems with stopping or initiating defecation. Depending on the extent of the injury, you should not use abdominal muscles that help push the stool out.
After a new spinal cord injury, you need to retrain your intestines. New routines with various techniques, methods, and medicines can help you restore normal bowel excretion. The doctor will work with you to develop a bowel program.
The skin protects the body from the outside world and makes penetration of bacteria and germs into the body difficult. The spinal cord serves your skin as an essential messenger to protect it from injury. For example, sitting in an extended position makes you feel uncomfortable and moves in the chair.
This helps prevent injury. After a spinal cord injury, you may not have discomfort or movement and risk of having a pressure sore. When the wound develops, the skin opens, and germs can enter the body, increasing the risk of serious infections. There are many ways to change positions and detect potential skin problems before they occur. Skin checks and skincare can discuss with a doctor.
Spinal cord damage can cause circulation problems ranging from low blood pressure when standing (orthostatic hypotension) to swell of the limbs. This change in blood flow can also increase the risk of developing blood clots, such as deep vein thrombosis or pulmonary embolism.
Another problem with blood circulation control is the increased life-threatening blood pressure (autonomic hyperreflexia). Our doctor will show you how to deal with these problems if they affect you.
The lungs are the main respiratory organ and remain unaffected by spinal cord injury. However, the ability to move air in and out of the lungs depends on the muscles. Depending on the severity of the injury, you may have a cough or deep breath. The diaphragm is the muscle used in breathing. This is a large dome-shaped muscle just below the lungs.
If a cervical spinal cord injury is higher, a ventilator may be needed to facilitate breathing. There are additional respiratory problems with spinal cord injuries at this level. Coughing and deep breathing are ways to fully expand and open the lungs to keep them moving and healthy. Thoracic levels help keep coughing strong and lungs clean.
There are several things you can do to maintain lung health. If your injury is under thoracic 6 and you are active, you may not notice any change in your breathing ability. A useful tool for those who live in hospitals is an incentive spirometer. This is a tool that allows you to breathe deeply, open your lungs, and help keep the lungs clean and healthy. Treatment and therapy can help prevent and treat this problem
Muscle and Tendon:
Some people with spinal cord injuries experience two types of muscle tone problems: Uncontrolled muscle movements (spasticity) or muscle tone (flaccidity).
Spasticity can occur after SCI when signals blocked from the brain to the muscles. This is often only observed when the spinal shock has subsided. When flexibility occurs, there is resistance to muscle stretching. This can be painful and cause contractures, shortening of muscles, and tendons.
If flexibility is a problem, then it is treated. Repositioning and drugs can help. Botox injections can also be helpful and used.
Sexuality, fertility, and sexual function can be affected by spinal cord injury. Men may notice changes in erection and ejaculation; Women can see changes in lubrication.
Some people suffer from pain, such as muscle or joint pain, when certain muscle groups experience excess pressure. Nerve pain can occur after a spinal cord injury, especially in those with incomplete injuries.
In SCI, the pain can be acute or chronic. Severe pain can cause bruising, fractures, surgery, or positioning. Chronic pain can be caused by too many joints and muscles or by changes in muscles and joints. Pain is treated according to the nature and causes of pain. The most important thing to remember is that pain is real, and there are physical causes. Talk to your doctor about pain.
Feelings and Reactions:
The body is not the only one affected by spinal cord injury, but it affects emotions too. It would be helpful to understand that most people with spinal cord injuries experience various emotional reactions, including feelings of depression, depression, and anger.
For some people, the worst thing is that they cannot do everything for themselves. This can be very frustrating if you have to rely on something else to do it for you. Most people say that talking about feelings is very helpful. Sharing your opinions with others makes it easy for you to help. Otherwise, it is difficult for people to understand what you are going through. It might be useful to talk with someone who has a spinal cord injury.
What Parts of the Body Can Be Affected by a Spinal Cord Injury will give you an idea of spinal cord injuries that cause a certain degree of damage. It is essential to know the extent of the damage and question whether the injury is complete or incomplete. Other important factors, such as general health, age, fitness, height, and motivation, determine how much you can do for yourself.