Depending on its severity, paraplegia is the result of a complete or partial severing of the spinal cord. From the damaged area downwards, the transmission of electrical impulses through the nerves no longer functions. Here you will find further information as well as selected specialists and centers for paraplegia.
Spinal cord injury is also known as paraplegia. The condition has a severe impact on the patient's everyday life. The possible causes range from vertebral fractures to tumors and multiple sclerosis.
Various functions or nerves are affected by the interruption of the spinal cord:
Doctors distinguish between two forms of paraplegia, depending on the cause:
The type of functional loss depends on
Complete paraplegia is referred to as plegia, incomplete paraplegia as paresis. In complete paraplegia, all nerve tracts are severed. Paraplegia is the term used by doctors to describe the complete inability to move both legs.
As paraplegia persists throughout life, people with this condition are considered severely disabled. They usually require a wheelchair and receive a lifelong pension depending on the severity of their physical disability.
The main causes of severing the spinal cord are accidents, such as
Paralysis also occurs as a result of certain diseases. These include, for example
Researchers assume that only a third of the nerve cells are affected by the acute injury. Inflammatory processes and the formation of scar tissue then destroy the remaining nerves.
70% of all spinal cord injuries are caused by accidents.
The most common cause of the disease is multiple sclerosis, a relapsing disease of the central nervous system, which accounts for around 43%.
The interruption of the spinal cord immediately causes spinal shock in those affected. It paralyzes all functions below the damaged vertebral segment. The impaired limbs are limp and unable to move. The patient can no longer feel them.
The autonomic nervous system is also involved in the disease process. This can lead to dilation of the blood vessels, which in the worst case can lead to acute circulatory failure. If the area above the fifth thoracic vertebra is injured, the heartbeat and breathing stop.
Patients who suffer spinal shock require immediate treatment in a hospital intensive care unit. A few weeks or months later, the acute shock condition then turns into paraplegia.
With timely emergency treatment, there is at least a partial recovery of the impaired autonomic nerves some time after the spinal cord has been severed.
Complete paraplegia manifests itself in the complete loss
The patient does not feel any pain or pressure in the affected areas of the body. He also no longer feels his legs, for example. He feels as if they are not there at all. He has also lost his sense of temperature.
Late effects of the accident or the underlying disease are sexual impotence in people of both sexes despite a normal sex drive.
In the case of complete and partial paraplegia, the first consequence is the inability to empty the bladder and the retention of stool. As the disease progresses, this leads to urinary and/or fecal incontinence (involuntary urination and/or defecation). However, some patients suffer from constipation for the rest of their lives.
If the transmission of nerve impulses is interrupted in the cervical spine region (cervical vertebrae C1 to C7), this is referred to as tetraplegia or tetraparesis. These patients with partial paraplegia can only move both arms and legs to a limited extent. If the cervical vertebrae C1 to C4 are affected, the patient also suffers from paralysis of the diaphragm and requires immediate artificial respiration.
Spinal cord injuries can be caused by vertebral body fractures © TeraVector | AdobeStock
If the signal transmission below the cervical spine is impaired, this results in paralysis of the legs (paraplegia, paraparesis). Damage to the spinal cord in the thoracic vertebrae also means that certain trunk muscles are no longer able to function.
Spinal cord damage in the lumbar region leads to partial loss of leg mobility. If the spinal cord is injured at the level of the lowest vertebrae (sacral cord, vertebrae S1 to S5), this leads to paralysis of the foot muscles, bladder and bowel problems and sexual dysfunction.
The flaccid paralysis that occurs shortly after the spinal shock turns into spastic paralysis in the following weeks. This causes the muscles to spasm, as the newly formed nerve connections in the spinal cord are not functional.
The suspected diagnosis of paraplegia is made for most people affected on the basis of their description of the accident. An X-ray examination of the spine and other imaging procedures can be used to assess the exact extent of the damage.
Neurological tests provide information about any remaining sensitivity and mobility of the limbs. Ultrasound images show whether and to what extent internal organs such as the bladder and kidneys are affected by the spinal cord damage. Blood pressure and heart rate measurements also allow conclusions to be drawn about the patient's condition.
Disease-related paraplegia requires separate clarification. In addition, the underlying disease must be treated.
Paraplegia is treated if the cause is due to illness
For example, constipation is treated with laxatives. Bladder catheters ensure unobstructed emptying of the bladder.
The specialist treating the patient uses imaging procedures to determine whether or not surgical intervention is helpful. Acute cases of spinal shock are treated immediately in the intensive care unit. There
are monitored and stabilized.
High doses of cortisone are administered to prevent any inflammation of the damaged nerves. The patient is also given pain-relieving medication.
In accident patients with an unstable vertebral fracture, the spine can only be stabilized with the help of an operation. Surgical interventions can also prevent further damage in the case of spinal cord contusions.
People with paraplegia are often able to cope well with everyday life © Drazen | AdobeStock
A complete severing of the spinal cord cannot be reversed. The severed spinal cord will not grow back together even after an operation. However, certain measures can be taken to prevent the occurrence of muscle shortening.
If the accident victims do not die from their serious injuries, their life expectancy is by no means lower than that of healthy people. However, this can be different with artificial respiration.
Paraplegia does not necessarily mean that a person is confined to a wheelchair and is permanently dependent on other people. The patient can take part in rehabilitation measures in specialized clinics. Their aim is to strengthen the patient's autonomy. With the help of a physiotherapist, the patient learns to use their still intact muscles in a more targeted way and to move partially paralyzed limbs.
The patient can also learn to empty their bladder voluntarily through intensive training of the abdominal press. If this is not successful, patients can place their bladder catheter themselves several times a day or can live with a permanent bladder catheter that is replaced every four weeks.
Massages and physical exercises in water can help to regain at least some of the lost sensitivity. In a special self-help group for paraplegics, the person affected learns to cope better with their changed life and no longer feels socially isolated.
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