Are spinal cord injuries permanent?
While physical damage to the spinal cord is permanent, some functions affected by spinal cord injury may be recovered through neuroplasticity (the central nervous system’s ability to reorganize itself).
This article will go over the permanent effects of spinal cord injury and explain why there is hope for healing.
Are Spinal Cord Injuries Permanent?
Physical damage to the spinal cord is permanent because damaged neurons in the central nervous system cannot regenerate.
After a spinal cord injury, the spinal cord is left in a very hectic state consisting of:
- Cell deaths
- Limited/ loss of blood supply
- Excitotoxicity (damage to neurons caused by hyperactive neurotransmitters)
All these factors can contribute to tissue loss and the formation of cysts and glial scarring at the site of injury. While there are several barriers to spinal cord injury recovery, there are ways for individuals to improve their functional abilities and relearn movements. In the following section, we’ll discuss the mechanisms that make recovery after spinal cord injury possible.
The Effects of Spinal Cord Injury Aren’t Always Permanent
Physical damage to the spinal cord is permanent; however the spinal cord is also extremely adaptive and can use neuroplasticity to reorganize itself.
Spinal cord injury recovery consists of 2 parts: neuroprotection and neuroregeneration.
Neuroprotection is all about limiting damage to the spinal cord.
While the damage caused by the initial impact of the spinal cord injury cannot be controlled, seeking immediate medical attention will help stabilize the spinal cord and minimize damage caused by secondary processes like swelling, inflammation, and excitotoxicity.
Neuroprotection is time-sensitive and must be carried out within the acute phase (the first 48 hours) of injury.
Neuroregeneration focuses on promoting neuroplasticity in the spinal cord so that functions can be recovered.
Because transected or compressed neurons have very little recovery potential, SCI recovery relies heavily on the adaptive properties of neurons spared by the injury.
Spared neural pathways can utilize neuroplasticity to reorganize their circuits and sprout new axons.
Neuroplasticity is powered by your actions. The more repetitions you perform, the more rewiring occurs and the stronger neural pathways for that action become.
However, neuroplasticity is limited, so the severity of your spinal cord injury will affect chances of recovery.
The Severity of the Spinal Cord Injury Determines If It’s Permanent
The ability to heal after spinal cord injury primarily depends on the completeness of your injury.
Spinal cord injuries can be complete or incomplete. A complete spinal cord injury occurs when the spinal cord is severed all the way through, leaving no neural connections between the brain and areas below your level of injury intact.
In contrast, an incomplete spinal cord injury describes when only part of the spinal cord at that level of injury is damaged. As a result, spared neural pathways between areas below your level of injury and the brain exist.
Spared neural pathways play an essential role in the rehabilitation process because only undamaged regions of the spinal cord are capable of neuroadaptive changes. As a result, the more spared neural pathways there are, the greater the recovery potential.
Treatment for Permanent Paralysis After Spinal Cord Injury
If you have a complete spinal cord injury, or very severe incomplete spinal cord injury, there is still hope!
Researchers are developing treatments like stem cell therapy and epidural electrical stimulation to promote functional recovery even after complete SCI.
Additionally, the development of robotic exoskeletons is enabling individuals with severe paralysis after SCI get on their feet again.
We’ll discuss each of these potential treatments for severe SCI in further detail below.
Stem Cell Therapy
Stem cells are extremely versatile because they’re able to specialize into a variety of different cell types depending on the environment they’re placed in.
They can also divide infinitely, which makes them ideal for restoring cell count and neural connections after spinal cord injury.
However, there are a few obstacles to stem cell therapy for SCI recovery that need to be worked out like:
- getting through/ limiting the formation of glial scarring
- determining what type of stem cell to use
- optimizing dosages and timing
As a result, stem cell therapy is not currently an approved SCI treatment. However, researchers are hopeful that it can be a promising treatment in the future.
Epidural Electrical Stimulation
Epidural electrical stimulation involves getting an implant that sends electrical currents to areas below your level of injury.
It works around the spinal cord lesion and uses electrical currents that mimic brain signals to stimulate movement. In addition to using epidural stimulation, individuals with spinal cord injuries must relearn how to control their movements with intensive physical training.
This study found that by combining intensive physical training and epidural stimulation, individuals with motor complete injuries were able to improve their motor functions.
Like stem cell therapy, epidural stimulation is still being developed, but the research for it is yielding very promising results.
A robotic exoskeleton can help individuals with completely transected spinal cord injuries walk again. It’s a wearable device that assists you with walking, sitting, and standing.
Robotic exoskeletons are ideal for individuals with complete spinal cord injuries who may otherwise not be able to walk at all.
Models will vary, but typically individuals can facilitate movements by shifting their weight. The sensors in the exoskeleton will then help complete the movement.
While exoskeletons are costly ($40,000+), they may be worth the investment if it means you can walk again.
Understanding Recovery After Spinal Cord Injury: Key Points
If you have an incomplete spinal cord injury, there’s no way to know for sure when or if functions will return. The body works in miraculous, spontaneous ways, and its ability to adapt after traumatic events like spinal cord injury is unpredictable.
All we know for certain is that the spinal cord has neuroplasticity, which relies heavily on repetition. The more you practice, the stronger neural pathways become.
Physical damage to the spinal cord is permanent. However, depending on the severity of your SCI and how aggressively you pursue rehabilitation, functional recovery may be possible. Additionally, even those with complete injuries (where the cord is completely transected and neuroplasticity is not possible), can learn ways to increase their independence and improve their quality of life if they engage in rehabilitation.
It will require a lot of hard work, but as long as you continue to exercise weak movements, you’ll be stimulating and strengthening those neural connections.
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