At the core of the matter
It is estimated that 90% of what we know about spinal cord injury was discovered in the last 20 years. There is a great deal more resources and research on hand today than ever before, but there is a ways to go before accessibility, opportunities and health care for people with SCI are at optimal level. Meantime, it's helpful to look at the science behind the injury.
An SCI, or spinal cord injury, is sustained damage to the spinal cord at any part of it, or the nerves at the end of the spinal canal. This can permanently affect many physiological areas, such as sensations, strength, motor ability and any other functions. A spinal cord injury can impact a person’s life and lifestyle. An SCI can either be complete or incomplete.
What is the spinal cord?
The spinal cord is a thick bundle of nerves that runs through the vertebrae (backbones) in your spine. This nerve bundle is about 18 inches long, starting at the base of your brain and ending at your buttocks. The spinal cord acts as a superhighway between your brain and the rest of your body. Want to take a step, or wriggle a finger? The message is normally sent through the spinal cord to these body parts, in the form of nerve impulses. The highway runs in both directions: stub a toe or touch something sharp, and those pain or pressure signals speed back up along the spinal cord to your brain faster than you can say “ow.”
What happens when a spinal cord is injured?
Certain neurological diseases or an accident that causes your vertebrae to break can damage your spinal cord. And when the spinal cord is damaged, the highway is essentially closed. Nerve impulses can’t get through. This results in paralysis – loss of mobility and sensation – below the level of injury.
What’s an incomplete SCI?
Not all spinal cord injuries cause complete paralysis. In the case of an incomplete spinal cord injury, a small stream of highway traffic still gets through. Someone with an incomplete SCI may have a certain amount of feeling or movement below the level of injury. Often, in the case of an incomplete SCI, one side of the body has more function than the other. Thanks to new medical treatments at the time of injury, incomplete spinal cord injuries are more common than they used to be. These same injuries might have been complete if they’d happened a couple of decades earlier.
Why is level of injury important?
The site of your injury will determine what parts of your body are paralyzed. The higher the injury, the more body parts that are affected. For instance, a spinal cord injury in the upper, or cervical, region of your spine will affect your arms as well as your trunk, legs and pelvic area (including bowel and bladder). Someone with this level of injury is considered to be quadriplegic. But an injury lower down, in the thoracic or lumbar region, won’t affect your arms. Someone with a spinal cord injury in either of these regions is considered to be paraplegic. About half of all people with SCI are quadriplegic, and half are paraplegic.
There is a great need for more research on spinal cord injury causes, treatment and prevention in Canada. We are actively researching with a wide variety of partners from all sectors to enhance the quality and quantity of SCI research and data. The Praxis Spinal Cord Institute is a good source of national statistics and we are always looking to contribute to current knowledge by tapping into the insights of our community across Ontario.
In some cases, you may assume someone is paraplegic, rather than quadriplegic, because they are using their arms and hands, but that may not be the case. Their injury could be in the upper, cervical region, and they may have some use of their arms and hands but it could be limited to varying degrees. This is good reason to never assume the degree of movement of someone you first meet – and, if it’s important to know, ask the person with an SCI for clarification.