The spinal cord enables your brain to communicate with your body. Up and down the spinal cord, every second of your life, messages are sent to keep you on the move. When a spinal cord injury occurs, communication may be severed, resulting in a loss of function.
People with high injuries usually need a power wheelchair for independent mobility. People with low cervical SCIs and below may be able to use manual wheelchairs.
Manual chairs are more convenient as they cost and weigh less and are easy to fold for transport. However the independence provided by a power chair to the person who needs it outweighs any limitations.
Some people walk using crutches and leg braces. This does not mean they will never use a wheelchair, perhaps preferring them only for longer distances.
Each person with a disability is different. Each will have different needs in levels of care and equipment. Care comes in various forms: personal, domestic, household, respite, nursing, community access.
Personal care: showering, toileting, transferring, feeding.
Domestic services: meal preparation, shopping, cleaning, ironing.
Household support: gardening, home cleaning, home maintenance.
Community access: transport, companion.
Respite: for time spent away from home.
Other: childcare and workplace or education support.
People with paraplegia will need little or no personal care, but will need assistance with domestic duties. People with high cervical injury can require 24 hour care.
Equipment needs include manual or power wheelchair with battery charger, portable ramps, hoist, pressure relief cushion, shower chair, catheter, adjustable bed, air conditioning, ventilator, physiotherapy, home automation (possible voice controlled), computer, modified vehicle.
Paralysis refers to the inability to control movement or to detect sensations such as touch and temperature.
Paraplegia can be generalised as losing control of movement and sensation from the waist down, the term tetraplegia includes loss of function in the upper body, arms and hands.
The amount of movement and sensation you have will depend on which parts of the spinal cord have been damaged. Those parts of your friend’s spinal cord responsible for transmitting sensory information have been saved while those responsible for controlling movement may have been damaged.
Complete’ describes injuries where there is effectively no transmission of signals across a spinal cord lesion, with no voluntary control of movement or perception of sensations below the lesion. ‘Incomplete’ injuries are those where some of the pathways across the spinal cord lesion are undamaged. The outcome can be extremely variable and depends on which parts of the spinal cord are damaged.
At the time of injury, the spinal cord swells. When the swelling goes down, some functioning may return. Especially in incomplete injuries, functioning may return as late as 18 months after the injury. However, only a very small fraction of people with SCI recover all functioning. There are major advances happening in the research field today.
Most body parts and organs can repair themselves after they are injured. However the central nervous system cannot. Attempting to repair the damage caused by a brain or spinal cord injury is a puzzle that has not yet been solved. Nevertheless the damage caused by an SCI can be reduced by limiting immediate cell death and reducing the inflammation of the injured cord. Attempts to regenerate function in the damaged area are focusing on regrowing nerves, blocking the mechanism that stops neurons from re-growing themselves, inserting new cells and bypassing the damaged area. For further information see Research / Cure section.
Before World War II, most people who sustained SCI died within weeks of their injury due to urinary dysfunction, respiratory infection or bedsores. However modern antibiotics and materials such as plastics and latex, and better procedures for dealing with the everyday issues of living with SCI, mean many people approach the lifespan of the general population. Most who survive the first 24 hours are still alive 10 years later.