Spinal Cord Injury Paraplegia

If you or a family member have suffered a spinal cord injury or illness (SCI) it’s natural to have questions about the conditions—and to wonder about long-term outcomes.  We’ve prepared this SCI Primer to help provide a broad overview of spinal cord injury—and answer frequently asked questions about the disorder. Remember for specific information about your condition its best to speak to your rehabilitation specialist.

Two Types of SCI: Traumatic SCI (TSCI) and Non-traumatic SCI (NTSCI)

Usually traumatic SCI (TSCI) begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Most injuries to the spinal cord don't completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy axons -- extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.

Non-traumatic SCI (NTSCI) is defined as any damage to the spinal cord that has not been caused by a major trauma. So rather than the spinal cord being injured in a traumatic impact like a car crash or a fall, it has been damaged in other ways such as infection, loss of blood supply, compression by a cancer or through slow degeneration of the spinal bones (vertebrae) as well as other diseases.

Commonly Used SCI Terms

  • Paraplegia: Impairment in motor, sensory or both affecting legs, trunk but no arms
  • Tetraplegia: Impairment in motor, sensory or both affecting arms and neck muscles
  • Neurological level of injury: the most proximal (caudal) level of motor and sensory deficits
  • ASIA calcification: international classification to determine severity of the spinal cord lesion
  • Complete: Reflects the lack of motor or sensory below the spinal cord level of injury
  • Incomplete: Reflects sparing of motor, sensory or both below the spinal cord level of injury
  • Traumatic Spinal Cord Injury: Most common type of spinal cord injury related to physical trauma.
  • Non-Traumatic Spinal Cord Injury: Injury that is secondary to multiple arrange of diseases and pathologies including arthritis and or degeneration of the spinal column, cancer, infections, circulation and bleeding problems, inflammation, Multiple sclerosis and others.
  • Anterior Cord Syndrome: Results after the primary blood supply to the anterior portion of the spinal cord is interrupted, causing ischemia or infarction of the spinal cord in the anterior two-thirds of the spinal cord
  • Central Cord Syndrome: A spinal cord injury with more pronounced deficits on the upper extremities compared with lower extremities
  • Brown-Sequard Syndrome: Hemi-section of the spinal cord with motor impairment on the same side of the injury and sensory impairment to the opposite site of the injury  
  • Conus Medularis Syndrome: A collection of signs and symptoms associated with injury affecting the terminal portion of the spinal cord, conus medullaris, accompanied by weakness of lower extremities
  • Cauda Equine Syndrome: A condition that may cause radicular pain, bowel/bladder dysfunction, saddle anesthesia and lower extremity weakness at the level of the lumbar and sacral roots

Common Medical Issues Seen Following SCI

  • Neurogenic bladder: Dysfunction (flaccid or spastic) caused by neurologic damage of the spinal cord
  • Neurogenic bowel: Dysfunction of the bowel habits secondary to neurological damage of the spinal cord
  • Autonomic dysreflexia: sudden onset of excessive high blood pressure secondary to spinal cord injury involving the thoracic nerves above T6
  • Spasticity: Increased tendon reflex activity and tone. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles.
  • Neuropathic pain: Pain caused by damage or disease affecting the somatosensory nervous system, such as burning and electrical pain
  • Nociceptive pain: Condition caused by stimulation of peripheral nerve fibers that respond only to stimuli approaching or exceeding harmful intensity (nociceptors); may be classified according to the mode of noxious stimulation, such as mechanical and visceral pain
  • Heterotopic ossification: The presence of bone in soft tissue where bone normally does not exist; the acquired form of HO most frequently is seen with musculoskeletal trauma, spinal cord injury, or central nervous system injury
  • Pressure wounds: Also known as pressure sores, bedsores and decubitus ulcers, are localized injuries to the skin and/or underlying tissue that usually occur over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction.
  • Deep Venous Thrombosis (DVT): A blood clot that forms in a vein deep in the body and occurs when blood thickens and clumps together; usually affects the lower leg or thigh, but also can occur in other parts of the body

To learn more about spinal cord injury, visit How the Spinal Cord Works on the Christopher Reeve Foundation web site.

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