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Complete vs Incomplete Spinal Cord Injury: Differences in Recovery Outlook

Patient leaving the hospital on a wheelchair after understanding complete vs incomplete spinal cord injury

What are the differences between a complete vs incomplete spinal cord injury?

Completeness of injury refers to the severity of spinal cord injury and it plays a significant role in determining recovery outlook.

This article will explain the primary distinctions between complete and incomplete spinal cord injuries.

Complete vs. Incomplete Spinal Cord Injury Lesions

doctor explaining complete vs incomplete spinal cord injury differences to patient

The main difference between a complete and incomplete spinal cord injury is the lesion. Lesions refer to the tissue damage caused by the spinal cord injury.

Complete spinal cord injury lesions transect across the spinal cord. They can occur due to a large, single lesion or multiple smaller lesions.

In contrast, an incomplete spinal cord injury results in partial damage, meaning some neural pathways between the brain and body are spared.

In the following section, we’ll discuss how lesion size affects recovery outlook.

Complete vs. Incomplete Spinal Cord Injury Recovery Outlook

The amount of neural pathways spared after a spinal cord injury has a significant impact on recovery outlook.

A unique characteristic of the central nervous system is that damaged neurons cannot regenerate and heal themselves. As a result, recovery after a spinal cord injury is very dependent upon spared neural pathways.

Neuroplasticity is the spinal cord’s ability to rewire itself and potentially recover functions affected by injury. The more the spinal cord is stimulated through repetitive movement, the more it understands that there is a demand for that function and rewires itself.

However, only spared neural pathways are capable of neuroplasticity. Therefore, the less severe a spinal cord lesion is, the better the patient’s potential for recovery.

Unfortunately, a complete spinal cord lesion will not result in any spared neural pathways. However, there are treatments in progress like epidural stimulation and stem cell therapy that provide hope for complete SCI patients.

Incomplete spinal cord injury patients have spared neural pathways, which means that it is possible to improve mobility and sensation through massed practice.

Can a Complete Spinal Cord Injury Become Incomplete?

There’s a difference between an anatomically complete spinal cord injury and a functionally complete one.

An anatomically complete spinal cord injury refers to the spinal cord lesion; however, a functionally complete spinal cord injury refers to the amount of mobility a patient has.

For example, if someone cannot move any functions innervated below their level of injury, they’ll be considered functionally complete, even if they have an incomplete spinal cord injury.

While anatomically complete spinal cord injuries cannot turn into incomplete SCIs, it is possible for someone who is considered functionally complete to recover mobility over time.  

This often occurs when individuals recover from spinal shock.

Mistaking an Incomplete Spinal Cord Injury for a Complete One

Immediately after a spinal cord injury, a process called spinal shock can occur. Spinal shock describes the complete loss of reflexes and movement below the level of spinal cord injury.

It’s caused by biochemical processes that occur after an SCI and result in oxidation, reduced blood flow, swelling, inflammation, and cell deaths.

When swelling exacerbates, blood flow in the spinal cord gets restricted, resulting in loss of reflexes.

Fortunately, spinal shock is a temporary condition that lasts anywhere between a few days to a few months. Reflexes can gradually start to return as swelling dies down and blood flow is restored.

However, during spinal shock, many SCI patients mistake the temporary loss of motor control with complete spinal cord injuries,

It’s only after spinal shock is over that patients discover their spinal cord injury isn’t as bad as it initially appeared.

Seeking immediate medical treatment after spinal cord injury will help minimize swelling and reduce the chances of experiencing spinal shock.

Now that you understand the differences between complete and incomplete spinal cord injuries, let’s go over treatment.

Complete vs. Incomplete Spinal Cord Injury Treatment

treatment for complete and incomplete spinal cord injury explained by doctor

Currently, there is no cure to reverse the damage caused by spinal cord injury. However, there are ways to prevent damage from progressing and minimize the occurrence of secondary complications.

Treatment for both complete and incomplete spinal cord injury consists of stabilization and rehabilitation.

Stabilization focuses on minimizing spinal cord swelling, cell deaths, and inflammation. This is essential for minimizing spinal cord damage and preserving as much motor control as possible.

After stabilization, treatment will focus on rehabilitation. Specialists will determine how much motor function is preserved and create a personalized rehabilitation plan to help SCI patients adjust to their new bodies and optimize mobility.

Rehabilitative treatments for complete and incomplete spinal cord injury include:

Each spinal cord injury is unique, and treatment will vary for every patient depending on many factors like severity of injury, level of injury, co-occurring health conditions, and mental health status.

Understanding the Differences Between Complete and Incomplete SCIs

understanding the differences between complete and incomplete SCI

Complete and incomplete spinal cord injuries have different functional outcomes and recovery prognoses; however, there are ways to manage the setbacks of either type of SCI and continue to live a very fulfilling life.

Current research is proving very promising and suggests a very hopeful future for all spinal cord injury patients.

Hopefully, this article helped you understand the differences between complete and incomplete spinal cord injuries. Good luck!

Photos from top to bottom: iStock/antonio_diaz/trumzz/Motortion

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