For those affected by paralysis, it can mean a permanent limitation that has a significant effect on daily life. This is especially the case when there is no full cure possible. So, for example, individuals with paraplegia, must make sure that their personal environment is suited to their needs. This includes having accessibility features put in at home, the adaptation of their car, as well as moulding their free-time, for example by joining a sports team for people with disabilities. In order make use of all the available help, those affected should not be afraid to accept support from professionals or other affected people.
Paraplegia means more than a failure of the motor system. The spinal cord plays a vital role in the functional ability of the human body. Together with the brain it forms the central nervous system CNS).
The spinal cord runs through the so-called 'spinal canal' within the spine and reaches from above the first vertebrae in the neck down to the lumbar vertebrae at the base of the back. The spinal cord functions like a ladder which transfers the signals from the brain to the muscles and relays information such as the position of the limbs, temperature perception or pain from the muscles back to the brain. Paraplegia refers to a combination of symptoms that occur when this nerve ladder is damaged. Among these are paralysis, vegetative diseases, and alteration in muscle tension and reflexes.
Although many people with paraplegia are in a wheelchair, the impairments that occur through damage to the spinal cord are not limited to the ability to move. In the spinal cord there are also nerves that are responsible for the control of organs. Therefore, the spinal cord also influences, for example, digestion and cardiac rhythm.
The cause of paraplegia is damage to the spinal cord. Around 70 percent of those affected were injured through an accident. Because the spinal cord is protected by a skeletal canal, it is usually not completely torn. More commonly, it is shattered vertebrae which causes the injury to the cord. That is why patients are stabilized immediately after an accident, either by a neck brace or a special rescue mattress. This prevents the vertebrae from slipping and splinters from damaging the spinal cord.
Besides accidents, paraplegia can also occur through an infection of the spinal cord, like for example in polio or multiple sclerosis. It can also occur from a slipped disc or a tumour. Generally, however, these do not result in paralysis of the entire skeletal system.
The decisive factors for the extent of paraplegia are the areas of the spinal cord on which pressure is put and how long this pressure lasts. A lack of blood supply to the spinal cord (spinal infarction) can also lead to paraplegia. The cause of the insufficient supply can be, for example, a constricted blood vessel. In addition, a lack of oxygen (spinal ischaemia), a spinal haemorrhage, an infection, or psychogenic issues can be causes of paraplegia.
In addition to the causes of the symptoms, there may be other factors that influence the course of a paraplegia or its recovery. These include "cell death" in the damaged region (apoptosis), scarring, and circumstances that prevent or complicate the regeneration of neurons.
Once the spinal cord is torn it never grows back together. This damage can also not be repaired surgically. Patients can then only move body parts above the position of the spinal cord's tear. If, on the other hand, the paraplegia has developed slowly due to another disease, early treatment can lead to an improvement and, in some cases, complete restoration of the ability to move and physically function. However, the condition for this is that at least parts of the nerves are still intact.
Doctors use a variety of diagnostic methods to find out the cause of the paraplegia and to thereby determine the treatment options. For example, X-rays, images from a computer tomography (CT) scan or magnetic resonance imaging (MRI) scan can provide information about the location and extent of the damage to the spinal cord. In addition, blood tests may be useful to identify inflammatory signs. A neurological examination is advised if damage to nerves in the brain is a possible cause of the paralysis.