Paralyzed from the neck down after a spinal cord injury?
This is a type of paralysis called quadriplegia.
Quadriplegia is when you have paralysis in your upper and lower body. It’s also commonly called tetraplegia.
This article will go over the causes and potential outcomes of quadriplegia after spinal cord injury.
What Causes Quadriplegia?
Getting paralyzed from the neck down after a spinal cord injury means that you’ve injured one of the higher cervical nerves.
The cervical region of your spinal column consists of 8 nerves that start from the bottom of your skull and make up your neck.
Injury to the first 3 nerves are the most dangerous and will cause paralysis from the neck down.
People with C4 injuries should be able to move their heads, necks, and parts of their shoulders.
The most common causes of quadriplegia are:
- Motor vehicle accidents
The cervical spinal column has the greatest range of motion and least stability, which makes it the easiest to injure.
Is It Possible to Be Partially Paralyzed from the Neck Down?
Spinal cord injuries can be complete or incomplete.
A complete spinal cord injury will result in no control or feeling below the level of injury.
In contrast, an incomplete spinal cord injury may result in some sensations or movements.
This is because some neural circuitries between the brain and body survived the injury and can still interact.
Spinal shock is a condition in which the body‘s inflammatory response and swelling after SCI cut off blood flow in the spinal cord.
Its results in flaccid muscles and a loss of reflexes. It can last anywhere between a few days to a few months.
Many people with complete spinal cord injuries don’t actually have complete lesions.
Their complete motor and sensory deficits are typically due to spinal shock.
Once the swelling of the spinal cord starts to relieve itself, functions gradually come back and people often find out that what they thought was a complete SCI is actually incomplete.
What to Expect When Paralyzed from the Neck Down
Here are some of the most common situations people with quadriplegia find themselves in after a spinal cord injury.
Depending on the severity of your injury, you may not experience all of these outcomes.
1. Increased Dependence on Others
People with severe quadriplegia will need to rely on a caregiver to help them with activities of daily living like bathing, toileting, eating, dressing, and grooming.
Chances are, the bladder and bowel muscles won’t work so catheterization and bowel management will be necessary.
2. Pressure Sores
Because they can’t control their body movements, people with quadriplegia must be moved from time to time to avoid getting pressure sores.
Pressure sores occur when people lay or sit in the same position for too long.
Too much pressure for too long causes the bone to start breaking the skin.
Be sure to use cushions to help pad bony areas prone to pressure sores like the elbows, hip, tailbone, shoulders, knees, and ankles.
3. Inability to Regulate Body Temperature
Another thing to expect when paralyzed from the neck down is that you may not be able to regulate your own body temperature.
Our bodies cool themselves off by sweating, but with a cervical spinal cord injury, people can’t sweat and are prone to overheating.
Good ways to cool off include having a spray bottle or a damp towel.
Just as the body can’t cool off on its own, it also can’t tell when it’s too cold and may result in hypothermia.
To prevent getting too cold, make sure to wear a lot of layers and to drink warm fluids.
Due to this inability to regulate body temperature, people with quadriplegia should definitely avoid extreme temperatures.
4. Breathing Difficulties
The reason why cervical spinal cord injury is so dangerous is that it can cut off control over your diaphragm.
The diaphragm is one of the major muscles necessary to breathe and inability to control it can result in death.
Those that lose control over their diaphragms will need to use a ventilator to breathe.
Patients also may not be able to cough, which increases their risk of respiratory complications like pneumonia.
5. Limited Mobility
With quadriplegia, it becomes much more difficult to get to where you need to go.
While some people with paralysis from the neck down will be able to use a power wheelchair to get around, most will need the assistance of another person.
Those with high-level cervical injuries won’t be able to drive and will need a ramp or lift to get into cars.
6. Muscle Atrophy
Muscle atrophy is when your muscles shrink and weaken from disuse.
It’s inevitable when you’re paralyzed from the neck down because you can’t actively move as much as you’d like.
However, having your caretaker perform passive range of motion exercises can help stimulate the muscles, increase range of motion, and improve circulation throughout the body.
Spasticity occurs in people with quadriplegia because the communication channels between the brain and body are disrupted.
Because the brain can’t send signals for the muscles to relax, they become overactive and stay contracted.
When muscles contract for too long, it becomes painful and can make it difficult to move or result in spasms.
Spasticity treatment typically consists of muscle relaxants, physical therapy, or surgery.
Recovery from Quadriplegia
Depending on the severity of your injury, you may be able to recover movement.
Both the brain and spinal cord have plasticity, which is the ability to adapt.
Recovery for incomplete spinal cord injury patients will focus on strengthening intact neural circuitries and promoting axonal sprouting.
Recovery for complete spinal cord injury patients is a little more difficult because all the connections are severed.
But there still is hope! Currently, there are 2 very promising treatments that can help SCI patients move again after spinal cord injury.
Both treatments are still in development, but they have been tested on patients with complete spinal cord injuries and have resulted in improved mobility.
The first of the treatments is called electrical stimulation.
It involves using electricity to mimic brain signals and stimulate the spinal cord.
The goal of electric stimulation is to retrain the spinal cord to move by reconnecting to the brain with a new pathway.
Stem Cell Treatments
The second treatment involves stem cell therapy.
Stem cells are versatile cells that can differentiate into a variety of different cell types.
It’s suggested that when transplanted into the spinal cord, they can help promote the regeneration of damaged axons.
Another thing electrical stimulation and stem cell therapy have in common is that they both require lots of intensive training.
Your spinal cord still needs retraining to move and the only way to do that is through lots of repetition.
Your body won’t be able to recognize new movements unless you constantly perform them and strengthen the new connections.
Living with Paralysis from the Neck Down
It can be extremely overwhelming to be paralyzed from the neck down.
However, most spinal cord injuries are incomplete, meaning that the majority of SCI patients can recover some mobility.
The types of cervical spinal cord injuries that result in paralysis from the neck down are the most dangerous and are often fatal. As a survivor, you’re extremely lucky.
Recovery takes time, so stay positive and focus on what you can do rather than what you can’t. Good luck!