Sections of the spinal cord

The spine and spinal cord are divided into sections, based on the bones that make up the spine. Injuries to a particular section will usually affect all the body parts below it. This is caused by the ways that human nerves work and are arranged in the human body. An injury prevents nerve signals from travelling past the injury toward the brain, the muscles, or the organs. The sections of the spine are:

• Cervical – The cervical spinal cord controls the head and neck above the shoulders. There are seven cervical vertebrae or spinal bones, and eight pairs of cervical nerves. Injuries to the cervical cord often result in quadriplegia or tetraplegia.
• Thoracic – The thoracic spinal nerves control the upper chest, back and abdomen. There are twelve pairs of nerves.
• Lumbar – The lumbar nerves control the hips and legs. They are placed where the spine starts to bend inward. There are five pairs of nerves.
• Sacral – The sacral nerves control the hips, back of the thighs, buttocks and pelvic organs. There are also five pairs of nerves. An injury here doesn’t usually cause paralysis or loss of sensation, but it can cause pain/weakness, or reduced functions.

Complete and incomplete injuries

A complete spinal cord injury is caused by damage that completely stops the brain and spinal cord from communicating with body parts below the injury.

An incomplete spinal cord injury is the result of partial damage to the spinal cord. The sensation and ability to move that remains depends on how severe the damage is. Recovering from these injuries depends on both your health and medical history.

There are three kinds of incomplete spinal injury that result in different outcomes from the norm:

• Anterior cord syndrome describes an incomplete spinal injury in which all functions are absent below the level of injury, except for sensation/feeling and proprioception. Proprioception is the sense of knowing where a part of your body is in space.
• Central cord syndrome results in sacral sensory sparing (sensation still being felt around the anus and pelvis) and more weakness in the arms than in the legs. It indicates that the central structures of the spinal cord have been injured. Central cord syndrome occurs almost only in the cervical spine. It is most commonly seen in older patients with cervical arthritis. It may also occur without any spinal fracture.
• Brown-Sequard syndrome is an incomplete spinal cord injury where half of the cord has been damaged. It results in losing movement on the same side of the injury, and losing sensation on the opposite side of the injury. It often preserves bowel and bladder function and does not prevent a person from being able to walk, though they may need additional support such as a cane or crutch.

Levels of Paralysis

Tetraplegia or Quadriplegia – a loss of sensation and movement across all four limbs, and below the site of the injury. It can also affect bodily control and other functions. Tetraplegia is caused by injuries to the cervical spine. The higher up the spine injury is, the more severe its effects will be.

Paraplegia – a loss of sensation and movement in the legs and the lower half of the body. This is caused by injuries to the thoracic spinal cord.

Triplegia: loss of sensation and movement in one arm and both legs. It is usually caused by an incomplete spinal injury.

Other terms

Acute Rehabilitation Program – comprehensive early rehabilitation which usually begins as soon as a person is medically stable.

Activities of Daily Living/ADL – Activities such as eating, dressing and grooming that are essential to life and quality of life. They are also sometimes called DLS or daily living skills.

Allodynia – a disorder where sensations that normally do not hurt become painful.

Ankylosis – A joint losing its movement due to bony deposits of calcium.

Anticholinergic – a drug that reduces spasms of smooth muscle, including bladder muscles. You will often be prescribed this if you use a catheter.

Aphasia – Change or loss in language function due to an injury

Apraxia – Inability to voluntarily produce speech.

ASIA score – A five-letter scale used to measure function after spinal cord injury. A stands for complete injury, while E means full recovery.

Ataxia – Poor or missing muscle coordination

Autonomic nervous system – the part of the nervous system controlling involuntary activities, including heartbeat, glands and smooth muscle contractions.

Bilateral – ‘both-sided’. Referring to both sides of the body or both arms/legs.

Central nervous system – the brain and spinal cord.

Cerebrospinal fluid/CSF – A colourless fluid that protects the brain and spinal cord from shock.

Continuous positive airway pressure/CPAP – A means of breathing assistance using a mask.

Dura mater – the tough outer membrane that protects the brain and spinal cord.

Dysphagia – difficulty eating and swallowing.

Electromyogram/EMG – a test that records muscle response to electrical stimulation.

Functional Electrical Stimulation/FES – the use of low-level, computer-controlled electrical current to stimulate muscle movement and restore useful movements, like standing or stepping. Also known as functional neuromuscular stimulation.

Glossopharyngeal Breathing / GPB – A way to force extra air into the lungs for a functional cough. Also called “frog breathing.”

Hemiparesis – weakness on one side of the body.

Hemiplegia – paralysis on one side of the body.

Intermittent Catheterization (ICP) – using a catheter to empty the bladder regularly.

Nerve Growth Factor / NGF – a protein that helps embryonic neurons survive and regulates neurotransmitters. It works like a ‘vitamin’ for nerve cells.

Postural drainage – Using gravity to clear mucus from the lungs by placing the head lower than the chest.

Range of motion/ROM – the normal range of movement of any joint, and also the exercises designed to maintain this range and prevent contractures.

References

Christopher and Dana Reeve Foundation (2019) Spinal cord glossary [Accessed: 5 Dec 2019] Available at: https://www.christopherreeve.org/living-with-paralysis/health/spinal-cord-glossary

SCI Info Pages (2019) Spinal Cord Injury Glossary [Accessed: 5 Dec 2019] Available at: 

https://www.sci-info-pages.com/spinal-cord-injury-glossary/

Shepherd Center (2019) Understanding Spinal Cord Injury [Accessed: 5 Dec 2019] Available at: http://www.spinalinjury101.org/details/glossary

Shepherd Center (2019) Types and Levels of Spinal Cord Injury [Accessed: 5 Dec 2019] Available at: https://www.shepherd.org/patient-programs/spinal-cord-injury/about/levels-and-types

Swope, Rodante P.A. (2019) Types of Spinal Cord Injuries [Accessed: 5 Dec 2019] Available at: https://www.spinalcord.com/types-of-spinal-cord-injuries