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Frequently Asked Questions & Answers

Spinal Cord Injuries & Traumatic Brain Injuries
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What are Spinal Cord Injuries?

Spinal cord injuries are those that result in damage to the spinal cord, a bundle of nerves that are located in the spinal column. There are two broad main categories: incomplete and complete.

Incomplete spinal injuries entail that the spinal cord has been partially severed or damaged. These injuries are increasingly common, accounting for more than 60% of spinal cord injuries due to increased medical knowledge and enhanced treatment. Some of the most common incomplete spinal injuries include:

  • Anterior cord syndrome: Impacting the front of the spinal cord, this injury impacts the cord’s motor and sensory pathways, making movement increasingly difficult and lessening sensitivity.
  • Central cord syndrome: Impacting the center of the spinal cord, this injury damages nerves that relay signals to the spinal cord from the brain. Resulting effects can include loss of fine motor functions, partial impairment and arm paralysis, and loss of bladder and bowel control and sexual functions.
  • Brown-sequard syndrome: This injury, which results in loss of movement capabilities impacting one side of the body more than the other, results from damage to one side of the spinal cord.

Complete spinal injuries entail that the spine has been completely severed at the injury site, effectively eliminating function of the nerves located below. These injuries result in loss of function due to a complete severance of the spinal cord. However, it may be possible to regain some abilities with the help of therapy and other medical treatment.

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What are the Locations That Spinal Cord Injuries Can Occur?

While spinal cord injuries can result from damage to any portion of the spinal cord or nerves at its base, these injuries typically are divided into three main areas:

  1. cervical spinal cord
  2. thoracic spinal cord
  3. lumbar spinal cord

The cervical spinal cord consists of a total of eight vertebrae, ranging from the top to bottom as C1-C8. Cervical spine damage, such as a C6 spinal cord injury, may potentially impact everything below the top of the ribcage, therefore resulting in quadriplegia.

The thoracic spinal cord is situated in the middle of the spinal cord and contains 12 vertebrae, numbered T1-T12. This range of the spinal cord, in conjunction with spinal nerves, control the main trunk of the body and aids in coordinating movement in the lower body. Learn more about T1-T8 and T9-T12 spinal cord injuries.

The lumbar spinal cord is the lower region of the spinal cord, where it naturally begins to curve. This area of the spine consists of five vertebrae, numbered L1-L5. This region of the spinal column coordinates sensations in the lower body, including bladder and sexual functions.

The sacral spine, an area of vertebrae and nerves that exists between the bottom of the lumbar spine and the coccyx (tailbone), can undermine sensation in lower regions of the body. This region of the spine does not contain any spinal cord tissue. So while it is possible to injure the vertebrae or nerves, damage cannot be directly inflicted to your spinal cord at this location.

The coccygeal region consists of bones that may be fused together and a single vertebral nerve that is located at the base of the spinal cord.

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What is the Spinal Cord?

The spinal cord, essentially, is the signal communication superhighway between the brain and the rest of the body. It is a bundle of nerve cells and fibers that is protected by the spinal column, or a series of vertebrae (bones) that run vertically along the center of the back from the hips to your skull. The spinal cord and spinal column are two separate structures.

From a high-level overview, human spinal cord anatomy consists of the cervical spinal cord, the thoracic spinal cord, the lumbar spinal cord, sacral spinal nerves, and single the coccygeal spinal nerve. It is important to understand that the spinal cord and spinal column have separate naming segmentations that do not always correspond.

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What are the Consequences of Blood and Oxygen Not Reaching the Brain?

There are two types of oxygen deprivation: Cerebral hypoxia, which occurs when oxygen supply to the brain is reduced but not completely eliminated, and cerebral anoxia, which is a complete lack of oxygen to the brain. Read more about the basics of brain oxygen deprivation.

Because the brain relies on oxygen, even just a minute of deprivation can cause temporary or permanent damage. Lack of oxygen symptoms can include changes in mood or personality, memory difficulties or dementia-like symptoms, chronic pain or the inability to feel pain, difficulties with impulse control, and changes in motor skills.

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What is Hypoxia?

Cerebral hypoxia occurs when oxygen supply to the brain is reduced, often as the result of decreased blood flow, but is not completely eliminated. This differs from cerebral anoxia, which is a complete lack of oxygen to the brain.

Because the brain relies on oxygen, even just a minute of deprivation can cause lasting or permanent damage. Hypoxia of the brain, which can result in short-term and long-term brain damage, can be identified in four distinct categories that range in severity: Diffuse cerebral hypoxia, focal cerebral ischemia, global cerebral ischemia, and cerebral infarction.

Learn more about hypoxia of the brain, its symptoms, short- and long-term effects, and available treatment options.

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What is Paralysis?

The paralysis definition we will use includes the partial or full loss of movement, often in response to an injury or illness that most commonly affects the spine. Strokes can be caused by a number of factors, most commonly a stroke (29%), followed by spinal cord injury (23%), multiple sclerosis (17%), cerebral palsy (7%), and other injuries and ailments.

There are four main categories of paralysis:

  • Monoplegia: This level of paralysis affects one area of the body, most commonly a single limb, and most commonly is the result of cerebral palsy (although other ailments and injuries also can be the cause).
  • Hemiplegia: This paralysis affects one arm and leg on the same side of the body. Often with the early stages being, patients report experiencing the sensation of pins and needles before progressing to muscle weakness and full paralysis.
  • Paraplegia: This paralysis affects the body below the waist, including both legs. While it interferes with walking, it also impacts the sexual and excretory abilities of the patient.
  • Tetraplegia, or what also is known as quadriplegia: This paralysis is the most debilitating type of paralysis. Typically the result of an injury high in the spinal cord, it entails the complete loss of movement in the torso, hands, legs and feet, and also means the patient. Patients may require artificial respiration assistance and need help with various other functions, including using a toilet, walking or standing.

In the case of spinal cord injuries, tetraplegia and paraplegia are the two most common forms of paralysis.

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What are the Chances of Recovery from a Cervical Spinal Cord Injury?

Cervical spinal cord injuries are among the most devastating, affecting the largest areas of the body and resulting in limited or lack of movement or feeling below the injury sites. These injuries can impact the high cervical nerves (C1-C4) or low cervical nerves (C5-C8).

Unfortunately, there is no way to fully reverse the damages to the cervical spine. However, there are options for treatment to help patients. Early recovery focuses on stabilizing the cervical spine, regulating respiratory functions and blood clot prevention efforts. Long-term rehabilitation includes spinal surgery, steroid injections, physical therapy, and experimental stem cell injections. Lastly, mental health is an important component of physical health. Speaking with a mental health professional who specializes in patients with paralysis often is highly beneficial to a patient’s recovery.

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What Results from an Injury to the Lumbar Spine?

Injuries to the lumbar spine, which encompasses a lower area of the spinal column below the cervical and thoracic regions and above the sacral spine (L1-L5), are severe but not necessarily life-threatening. It is important to note that not all spinal injuries result in paralysis. Damage to this section of the spine may result in weakness or numbness in the hips and groin and can affect the lower abdominal muscles and thigh flexion.

Whether an injury is incomplete or complete helps to determine the severity of the injury and its resulting symptoms. Something that sets the lumbar section of the spine apart from the thoracic or cervical spine is that the spinal cord does not extend its entire length; after L2, nerve roots exist each of the remaining lumbar levels.

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Can an Injury of the Spine at C6 Level Make a Person Paraplegic?

Injuries that occur between C1-C8 of the cervical spine can result in tetraplegia (commonly referred to as quadriplegia), or an injury that affects all of a person’s limbs to a certain extent. For example, a C3 or C6 spinal cord injury can result in a loss of function of both legs and arms, depending on the severity of the spinal cord damage.

Paraplegia, however, is the result of an injury in the spinals section below, or what are referred to as the thoracic or lumbar regions of the spine (T1-L5). With this injury, the legs and sometimes part of the torso are affected, meaning that the patient is still able to use full function of his or her hands.  

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Can a Quadriplegic Walk Again?

The circumstances surrounding spinal cord injuries (SCI) vary from person to person. Additionally, depending on whether the SCI is incomplete or complete also will play a crucial role in a person’s prognosis and whether they may again walk. Unfortunately, there is no cure for a completely severed spinal cord and therefore is no guarantees about an outcome.

The greatest chance for recovery involves undergoing immediate treatment and rehabilitation, as well as time, commitment and having a positive attitude. This may require surgery to remove any obstructive elements or to realign the spinal column, using supportive braces or other equipment, and occupational or physical therapy. Some people have responded well to acupuncture and chiropractic methods, although there is no scientific proof that these methods will affect paralysis symptoms.

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Is There Any Foundation That Helps People with Spinal Cord Injury Pay for Medical Bills?
Yes, there are a number of government, non-profit and private organizations that provide grants and other financial assistance to those who have survived spinal cord injuries. Some of the organizations include the Travis Roy Foundation, The Christopher and Dana Reeve Foundation, Spinal Cord Opportunities for Rehabilitation Endowment (SCORE).

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What is Hemiplegia?

Hemiplegia is a form of paralysis that affects one side of the body, often one arm and leg, although the paralysis sometimes can be experienced in the torso as well. Most commonly associated with cerebral palsy, this weakness or lack of sensation that leads to paralysis indicates an issue with one side of the brain, which is unable to produce, send or interpret signals as the result of disease or a traumatic injury, such as a traumatic brain injury (TBI).

In the early stages, patients often report experiencing the sensation of pins and needles before the situation progresses to muscle weakness and full paralysis.

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What is Spinal Shock?
Spinal shock is the temporary reduction or loss of reflexes resulting from a spinal cord injury (SCI). The more severe the injury and shock to the autonomic nervous system, the more severe the resulting dysfunction will be. As a result, the spine experiences either hyporeflexia or areflexia, a reduction or loss of reflexes. Learn more about the stages of spinal shock, as well as treatment options and prognosis.

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What is Monoplegia?
Monoplegia is the paralysis of one area of the body, such as an arm, and most often is associated with cerebral palsy. Most people who monoplegia experience a slow deterioration in functioning, beginning with limpness or weakness in the affected area and ultimately leading to a partial or full paralysis of the limb.

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Which Types of Injuries Have a Good Spinal Cord Injury Prognosis?

The types of spinal cord injuries (SCI) with the best spinal cord injury prognoses are those that have not resulted in paralysis. However, this most critical factors to a patient’s recovery include the patient receiving immediate and effective medical treatment, and the location and severity of the injury. The sooner that treatment begins, the faster the muscles below the injury site can begin to regain strength, and therefore improve the prognosis.

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Is There Any Cure for Spinal Cord Injuries?

While there currently is no all-inclusive “cure” for paralysis that results from spinal cord injuries (SCI), there is research taking place around the world to try to find ways to reverse spinal cord damage enough to essentially “cure” it.

Treatments to facilitate spinal cord injury recovery vary depending on the type, location and severity of injury. Some types of treatment are encompassed in four main categories: neuroprotection, regeneration, cell replacement, and CNS circuit retraining. One experimental treatment that shows promise is epidural electric stimulation, which applies electrical stimulation to the lumbosacral spinal cord (lower spinal cord) to restore autonomic and motor functions below the injury site. Early clinical trials have shown promising results, with one resulting in a previously paralyzed patient being able to voluntarily move his or her legs for the first time in years. Learn more about ongoing epidural electrical stimulation research.

Activity based therapy centers have also been extremely beneficial in providing paralysis recovery. 

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Are Cervical C1 C2 Injuries Fatal?

Injuries to the cervical spine, particularly C1 and C2, often are considered the most devastating of spinal cord injuries, either killing or leaving individuals fully paralyzed. Because of the close proximity to vertebral arteries, the disruption at C1 and C2 also can inflict neurological damage by depriving the brain of vital blood and the oxygen it carries.

The chance of C2 fracture recovery is dependent on several factors, mainly the individual circumstances of the injury. Immediate treatment is critical for the recovery of patients who sustain C1 and C2 injuries. Securely stabilizing the head helps to prevent further damage from being inflicted and encourages healing. Learn more about some of the fundamentals of these injuries and the latest treatments.

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Brain Damage That May Be Reversible Occurs How Long After Being Deprived of Oxygen?

The human brain uses about 20% of the body’s oxygen supply. Hypoxic brain injuries occur when the brain receives less oxygen than it requires without completely depriving it. This differs from cerebral anoxia, which entails complete oxygen deprivation of the brain.

As a general rule of thumb, brain damage that results from loss of oxygen begins at the one-minute mark and can cause immediate or long-term brain damage. Hypoxic brain injury recovery depends on the length of time that the brain goes without oxygen. Brain cells begin dying after the first minute of oxygen loss. Neuron sustain extensive damage after three minutes of oxygen deprivation, increasing the chances of lasting brain damage. Death becomes imminent at the five minute mark after oxygen deprivation — even when an oxygen supply is restored.

An unusual but effective preventative treatment for brain damage includes therapeutic hypothermia, or what is referred to as “brain cooling.” This process involves reducing the patient’s body temperature to a subnormal level to chill the brain and slow metabolic processes. This reduces the amount of oxygen needed by the brain and aids in slowing the processes that result in brain damage.

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Can a Blood Circulation Massager Machine Heal Spinal Cord Problem?

Blood circulation dysfunctions is one of the most common challenges that people face after sustaining a spinal cord injury (SCI). “Cardiovascular disturbances are the leading causes of morbidity and mortality in both acute and chronic stages of SCI,” according to a study on vascular functions. Vascular dysfunctions also can increase the risk for deep-vein thrombosis, or blood clots in deep veins. Massage helps to improve blood circulation in the body. A study at the University of Alberta found that improved blood flow or inhaling more oxygen helped to increase cord oxygenation and improved motor functions in rat test subjects that experienced compromised spinal blood flow due to SCI.

A person’s mental and physical health also are connected — this is particularly true for people with chronic illness and those that have sustained catastrophic injuries. A study on the effects of massage on patients with spinal cord injuries shows that the patients who underwent massage treatments experienced increased development of muscle strength and improved wrist range of motion. 

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Can a Man with a Broken Spinal Cord Have Children?

Yes, it is still possible for men to have sex and to get their partners pregnant after surviving a spinal cord injury (SCI). However, engaging in sexual relations after sustaining a SCI will be different experience than what people have done before suffering their injuries. Loss of sensitivity, muscle movement and sexual reflexes often result from sustaining an SCI. However, the impact the injury has on a person’s fertility and ability to achieve arousal and orgasm will vary depending on the location and severity of his or her injury.

Sexual function after spinal cord injury are among the primary obstacles to fertility for both men and women. These issues can include a lack of desire and sexual sensations that result in decreased self-esteem. For men, SCIs can result in a loss of an ability to get or hold an erection and to ejaculate. This means that they may not be able to get their partner pregnant if they have issues sustaining an erection. However, there are therapy and alternative options, including penis pumps or electro stimulation to facilitate an erection or ejaculation.

For women, lubricants can help them to safely have sex and by help sperm travel more efficiently. There also are other alternatives to getting pregnant, including intrauterine insemination, in-vitro fertilization, hormonal treatments and medications, or even surgery to clear blocked fallopian tubes or to remove uterine scar tissue or fibroids.

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