Each year, 12,500 people in the U.S. survive spinal cord injuries. The spinal cord is the relay and integration center for your central nervous system, sending signals to and from the brain and aiding in vital reflexes.
This means that a spinal cord injury can affect every region of your body. Your arm might be completely healthy, but if the spinal nerves that send signals to it are compromised, it might be rendered totally non-functional.
Thus almost every area of the body can be affected by a spinal cord injury. The specific effects you experience, as well as the long-term prognosis for your injuries, depend on the location of the injury, the quality of care you receive, your overall health, and a number of unpredictable factors.
Some people spontaneously recover from their injuries for no apparent reason at all, suggesting that there is much we don't understand about spinal cord injuries. For the majority of SCI survivors, though, the journey to recovery can be long, punctuated by infections and delays, and aided by quality medical care and rehabilitation services.
The Significance of Injury Location
Injury location is the single most important predictor of a spinal cord injury's effects. The higher the injury, the more severely an injury survivor will be debilitated. In a typical spinal cord injury, functioning below the site of the injury is severely compromised. An injury high in the cervical spinal cord will typically result in tetraplegia—the inability to move the arms and legs.
As care for SCI survivors improve, so-called incomplete spinal cord injuries have increased. These injuries cause the spinal cord nerves to be only partially compressed. In an incomplete injury, some function may persist below the site of the injury. The prognosis with these injuries is highly unpredictable.
Motor Skills
When your spinal cord cannot relay signals from your brain to an area of your body, your motor skills can't properly function. High injuries on the spinal cord typically inhibit your ability to move all four limbs, while lower injuries impede movement in the legs.
Reflexes
You probably don't give them much though, but reflexive responses keep you safe. They can even save your life! Removing your hand from a hot stove as quickly as possible help you avoid a catastrophic burn. Catching yourself as you fall can spare you from a head injury.
Reflexes evolved to operate independent of the brain, which is why they happen without any thought. Your spinal cord coordinates your reflexes, quickly receiving a danger signal and then telling the affected area what to do. When your spinal cord is injured, your reflexes won't work as well, and they might not work at all.
Sensation
Your spinal cord helps send signals to your brain about the surrounding world. A spinal cord injury undermines this role. In most cases, the same areas of your body that suffer a loss of motor control will also experience a marked loss of sensation. You might also experience new or unusual sensations, including:
- Phantom pain, such as feeling burning or tingling even though nothing is touching you.
- Unexplained chronic pain, either in an an area affected by the injury or an unrelated area.
- Electrical sensations in your limbs.
Elimination
Urination and defecation are complex bodily processes that depend on both voluntary and involuntary control. If you can't feel pressure in your bladder or bowels, you won't know that you need to go to the restroom. And depending upon the nature of your injuries, the muscles controlling these functions might not work as well. Many spinal cord injury survivors need assistance with their elimination functions, particularly in the early days following an injury. This issue might be short-lived, or you might find that you need to make long-term use of a catheter or colostomy bag.
Sexuality and Fertility
Your sexuality is a key component of who you are. It offers pleasure, a relief from daily stress, and a chance to bond with your partner. There's even some evidence that a healthy sex life can improve your overall health by reducing your risk of depression and boosting your immune system. Yet many spinal cord injury survivors are reticent to discuss issues of sexuality with their care providers. Others find that their doctors dismiss their concerns.
You deserve clear answers about your sexuality, so don't shy away from asking pointed questions. Most spinal cord injury survivors retain some degree of sexual functioning, but you might find that things are different. Your libido might change, and arousal could take longer. You might also need assistance to have intercourse; women may need to use lubricants, while men may need pharmaceutical assistance to achieve an erection. Often these issues improve with practice and time.
Fertility can also be a problem, particularly if you suffer from chronic infections. Women may not be able to safely birth children after a spinal cord injury, but the specifics of your prognosis depend on your injuries. There are many ways to become a parent, and people with spinal cord injuries can be and often are compassionate and attentive parents.
Personality and Emotions
Spinal cord injuries do not typically affect brain function, though they often affect the ability of the body to correctly relay signals to the brain. Although you don't have to worry about changes in your brain affecting your personality, your experience of the world might be quite different than it was before your injuries.
It's not uncommon for spinal cord injury survivors to become depressed or anxious, particularly in the early days after the injury. A lack of sensation in your limbs, changes in your occupation, and alterations in your sexuality may subtly change your mood and personality.
Internal Functions
Depending upon the location of your injury, a number of vital internal functions may change—most notably breathing. You may be placed on a ventilator after your injuries, and may continue needing breathing assistance. It's possible that other involuntary functions may change, too.
Some SCI survivors experience a slowed immune system response or chronic constipation. Others struggle with irregular heart rhythms. There is no cure for these challenges, but a number of medical interventions can counteract their effects.
