For more information please refer to the section "
Science".
Currently there is no cure, however, current research proves that spinal
cord repair and regeneration is possible in animal models. More and more
researchers around the world are confident that a putative cure for
paralysis in human could be as close as ten to twenty years away. New
breakthroughs and discoveries leading to a cure are imminent.
While recent advances in emergency care and rehabilitation allow many SCI
patients to survive, interventions to reduce the extent of injury in order
to restore functions have not yet reached a clinical process. To date,
immediate treatment of acute SCI includes techniques to relieve cord
compression, early application of high dose corticosteroids
(methylprednisolone, as early as eight hours after injury, controversial
efficacy), and stabilisation of the vertebral column to prevent further
injury.
Paraplegia is the loss of sensation and movement in the legs and in parts
or in all of the trunk usually resulting from an injury to the spinal cord
below the neck. Quadriplegia (also called tetraplegia) is the paralysis of
all four limbs (from the neck down) resulting from an injury to the neck.
Fractures or compression of the vertebrae, which cause permanent damage to
the spinal cord, may lead to a loss of sensation and/or movement, pain
management, a loss of bladder and bowel control, as well as they may affect
sexual function.
The “rings” of bone that make up the spinal column are known as
vertebrae. The vertebrae are named according to their anatomic location and
are referred to as cervical, thoracic, lumbar and sacral
vertebrae:
The seven vertebrae in the neck are the cervical
vertebrae. Spinal cord injury to these vertebrae usually causes a loss of
function of the arms and legs, thereby resulting in
quadriplegia.
The twelve vertebrae in the chest are called the
thoracic vertebrae. Injuries in the thoracic region usually affect the
chest and the legs and result in paraplegia.
The vertebrae in the
lower back are known as the lumbar vertebrae. Damage to one of these five
vertebrae will result in a loss of control of the legs, bladder, bowel and
sexual functions.
The sacral vertebrae are the five vertebrae that
run from the pelvis down to the end of the spinal column. An injury of this
region generally results in some loss of functioning in the legs and
difficulty with bowel, bladder and sexual control.
The nerve cell body remains intact and “only” the "sending" or
"receiving" nerve fibre tips (“cable endings”) have to re-grow as
extensions from the nerve cell body (“bridging the gap”). In contrast
to the nerves of the CNS, peripheral nerves (outside the brain and spinal
cord) do experience re-growth more easily. This happens mostly within a
less inhibitory environment in the peripheral nervous system (PNS).
Complete injuries result in a total loss of sensation and function below
the injury level (classified as ASIA “A”) whereas incomplete injuries
result in partial loss (classified as ASIA “B-D”). Here, functional
"complete" does not necessarily mean the cord has been completely detached
(which would be “complete” anatomically). Each of the above categories
may occur in paraplegia and quadriplegia.
It refers to a “complete” or “partial” (see below) loss of
neurological function below the lesion site.
Spinal Cord Injury (SCI) is a consequence of a traumatic or ischemic
event which results in damage to cells within the spinal cord or severs the
nerve tracts that relay signals up and down the spinal cord. The most
common type of SCI is caused by contusion injury (induced by bruising of
the spinal cord). Other types of injuries include lacerations (severing or
tearing of nerve fibres such as damage caused by a gunshot wound), and
central cord syndrome (specific damage to the corticospinal tracts of the
cervical region of the spinal cord).
Severe SCI often causes paralysis (loss of control of voluntary
movements and muscles of the body) and loss of sensation and reflex
function below the point of injury, including autonomic activity and other
activities such as bowel and bladder control. Other symptoms such as pain
or sensitivity to stimuli, muscle spasms, and sexual dysfunction may
develop over time. SCI patients are also prone to develop medical
complications, such as bladder infections, lung infections, and sores.
The types of disability associated with SCI vary greatly depending on
the severity of the injury, the segment of the spinal cord at which the
injury occurs, and which nerve fibres are damaged. Most people with SCI
regain some functions between a week and six months after the injury but
the likelihood of spontaneous recovery diminishes after six months.
Rehabilitation strategies can minimize long-term disability.
During the first year after SCI (without a particular interventional
treatment) 15.4 % change from complete (ASIA A) to incomplete (ASIA B-E)
injury.
Among them are 7.6% who regain motor function (ASIA C, D) - (Marino et
al., 1999, Arch Phys Med. Rehabil 80: 1391-6). In the following four years,
from one year until five years after the injury, an additional 5.9% change
from complete (ASIA A) to incomplete (ASIA B-E) injury. Among them are 2.2%
who regain motor function (ASIA C, D) - (Kirshblum et al. 2004, Arch Phys
Med. Rehabil 85: 1811-7). In total, during the first five years 21.3% of
patients change from complete (ASIA A) to incomplete (ASIA B-E)
injury.
Extracted from Marino et al., 1999, Arch Phys Med. Rehabil
80: 1391-6 and Kirshblum et al. 2004, Arch Phys Med. Rehabil 85:
1811-7.
The spinal cord enables the brain to “communicate” with the body by
transmitting nerve impulses (nerve conduction). Up and down the spinal
cord, every second of your life messages are sent to keep you on the move.
Following spinal cord injury nerve conduction (“communication”) may be
severed resulting in a loss of function (sensory and motor, see below).
An overall of 85% of SCI patients who survive the first 24 hours following
an injury are still alive ten years later.
Research on trauma-related central nervous system (CNS) disorders such as
SCI focuses on deeper scientific understanding of how changes in molecules,
cells, and their complex interactions determine the outcome of SCI. These
are pointing (I would rather say: promising) ways to prevent and treat such
injuries. There is also increasing interest in neural stem and progenitor
cells and their putative application as cellular approaches to treat
complex neurological disorders such as SCI.
