INFORMATION

Spinal Cord Injury Information & Links

• What is a spinal cord injury?

• What about recovery?

• Advances/Research into Spinal Injuries

• Informative links

• Sports for Quadriplegics

• SCI & Sexuality

• Disability World - A bimonthly web-zine of international disability news and views

• Employment Equity in South Africa: An Appeal to Employers  and an article in The Highroad

• Quadriplegic Forum

WHAT IS A SPINAL CORD INJURY?

The spinal cord consists of tens of thousands of nerve fibres. It is essentially a two-way communication cable, carrying messages between the brain and different parts of the body. A spinal cord injury can result in loss of sensation, movement, and bladder and bowel control. It may also affect breathing, sexual function and temperature control.

Damage to the spinal cord can occur if the blood supply (and the oxygen blood carries) is cut off, or if it is bruised by a bone fragment, or if is crushed or severed. The degree to which functions such as movement and sensation are affected depends on the severity of the damage. In a complete injury, all movement and sensation below the level of the spinal cord injury is lost. In an incomplete injury, some of the pathways at the site of the injury are spared, and there may be some sensation below the level of injury, or some movement of the muscles. The amount of damage in an incomplete injury can be minor or quite substantial.

• A spinal cord injury can result in paraplegia or quadriplegia. The extent of paralysis or weakness in the legs, movement in the torso, arms and hands will depend on where the spinal cord was damaged.

• Paraplegia refers to substantial or total loss of function in the lower part of the body.

• A paraplegic is generally someone who has sustained an injury to the back, between the first and twelfth thorasic vertabrae (T1 - T12) or the first and fifth lumbar vertabrae (L1 - L5), and has full use of their arms and hands.

• Quadriplegia describes substantial or total loss of function in all four limbs.

• A quadriplegic (or tetraplegic) is generally someone who has sustained an injury to the neck, between the first and seventh cervical vertabrae (C1 - C7), and has weakness or paralysis in all four limbs.

INCIDENCE OF SPINAL CORD INJURY

While there are no statistics for South Africa, it is estimated that every year between 400-500 South Africans sustain a spinal cord injury. A spinal cord injury can happen to anyone: young children, mothers and fathers of young children, teenagers, older people ... most with active lives still before them. However, most of the people who sustain a spinal cord injury are aged between 15 and 29. For every injured female, there are five injured males.
While the majority of injuries occur to young people, it is important to note that the average person with a spinal cord injury will live almost as long as a person without a spinal cord injury. This means there is an increasing number of people with spinal cord injury who are ageing with their disability.

CAUSES OF SPINAL CORD INJURY

Causes of spinal cord injury fall into two main categories: traumatic and non-traumatic. Most cases of spinal cord injury are traumatic. Statistics from the USA and elsewhere indicate the most common traumatic causes of spinal cord injury are as follows:
• Motor Vehicle, Motorbike and Pedestrian accidents 51.1%
• Falls 19.8%
• Water Sport 13.0%
• Crush Injury 5.3%
• Violence 3.1%
• Rugby 2.5%
• Other Sport 1.2%
• Horse Riding 0.6%
• Other Trauma 3.4%
Reports from hospitals and rehabilitation clinics would suggest that the causes of spinal cord injury in South Africa are similar to the above - although the level of political violence and violent crime are adding to the statistics in South Africa.
Non-traumatic causes of spinal cord injury are much less common, and include viruses, viral infections, cysts and tumours.

EFFECTS OF SPINAL CORD INJURY

Any damage to the spinal cord is potentially very serious. A person with a spinal cord injury may experience some or all of the following effects:

• Inability to move limbs
• Inability to sense pressure, heat or cold in parts of the body below the level of injury. Without regular monitoring, blood supply to these areas may be diminished, resulting in skin damage.
• Inability to feel when the bladder is full and to empty it voluntarily
• Inability to feel when the bowel is full and to empty it voluntarily
• Involuntary muscle spasms below the level of injury
• For men, inability to achieve an erection and reduced fertility. Fertility is not usually affected in women with spinal cord injury.
• Unusually low or, more rarely, high blood pressure
• For people who have quadriplegia, inability to regulate body temperature below the level of the injury
• Changes to the person’s self-esteem, body image and emotional well-being

WHAT ABOUT RECOVERY?

People with spinal cord injuries and other disabilities often comment that what limits their independence the most is not their disability, but other people’s attitudes towards their disability. Organisations like the National Council for Quadriplegics and its affiliated associations exist to facilitate maximum independence for people with a spinal cord injury, and to promote positive images of people with physical disabilities in the community.

Advances/Research into Spinal Injuries

Injecting white blood cells into the damaged spinal cords of laboratory rats led to nerve regeneration and partial recovery of muscle function, according to a report from an international team of researchers in the July issue of Nature Medicine. "The results of our experiments are promising," Dr. Michal Schwartz from the Weizmann Institute in Rehovot, Israel, said in a statement. "However, for the moment they have only been achieved in rats, and much additional research still needs to be done before the new treatment is available to humans."

Some animals, such as fish, can easily repair damaged fibers in their central nervous systems. But the spinal cords of mammals, including humans, are unable to repair themselves, so significant injury often results in paralysis.

In the study, Schwartz's team discovered that the mammalian central nervous system suppresses macrophages - immune cells that go to an injured site to remove damaged cells and release substances that help bodies heal. Macrophages respond slowly to central nervous system injuries, and some of the cells do not become fully active at the injured site.

The researchers took macrophages from the rats and incubated them in a test tube with damaged peripheral nerves. When the macrophages received a "distress signal" from the nerves, they became activated. The researchers then placed the activated macrophages in the central nervous system of paralyzed rats, and the rats were able to partially move their previously paralyzed hind legs, with some even able to stand.

This new technique "seems to supply (damaged nerves) with cells that are an integral part of the physiological repair mechanism and can therefore facilitate self-repair," the team writes. But the process needs further research before it can be applied to humans, they conclude.

This site is a non-profit, non-commercial site. It is meant to be a free and informative resource and a "best of the web" for those suffering from spinal cord and other disabling injuries or diseases of the spine.
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disABILITY Information and Resources

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Christopher Reeve Paralysis Foundation

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