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Sacral Sparing After Spinal Cord Injury: Determining Your Chances of Recovery

understanding sacral sparing after spinal cord injury

Did you know that the presence of sacral sparing after spinal cord injury can determine your chances of recovery?

The sacral region of the spinal cord makes up most of the lower spinal column.

The bottom-most spinal cord segments innervate the perianal area and are tested to check for any preserved motor control or sensation.

In this article, we’ll explain why checking for sacral sparing after spinal cord injury is so important and how it affects your recovery outlook.

Testing for Sacral Sparing After Spinal Cord Injury

To determine if a spinal cord injury patient has sacral sparing, an anal exam is required.

Your doctor will examine functions innervated by the bottom-most spinal cord segments (S4-S5) like:

  • light touch at the perianal area
  • pinprick sensation at the perianal area
  • deep anal pressure
  • voluntary anal contraction

To test for deep anal pressure, the doctor will insert their gloved finger into the rectum and ask the patient which direction they feel pressure being applied.

To test for voluntary anal contraction, the doctor will insert their gloved finger into the rectum and ask the patient to contract and release their anus.

Aside from being uncomfortable and awkward, an anal exam can induce autonomic dysreflexia, rectal bleeding, and stimulate bowel movements.

Unfortunately, it’s the only way to determine the presence of sacral sparing after spinal cord injury.

What Is Sacral Sparing Used For?

understanding the importance of sacral sparing after spinal cord injury

Sacral sparing is used to help diagnose whether a person’s spinal cord injury is complete or incomplete.

With spinal cord injuries, functions below your level of injury get affected because motor signals from the brain cannot travel past the spinal lesion.

Anal contraction is controlled by one of the bottom-most segments of the spinal cord. Therefore, if that reflex is present, it means that connections between the brain and areas of the body below the injury site still exist, and your SCI is incomplete.

Spinal Shock

Spinal shock occurs after a spinal cord injury and results in the temporary loss of all reflexes and motor functions below the level of injury.

This can trick a lot of SCI patients into believing that they have complete spinal cord injuries.

As reflexes and functions gradually start to return, doctors can then test for sacral sparing and make an accurate diagnosis.

Find out more about spinal shock after spinal cord injury »

Incomplete Spinal Cord Injury Recovery Outlook

sacral sparing after SCI recovery outlook


The recovery outlooks between complete and incomplete spinal cord injuries vary quite a bit and are determined by many different factors.

An incomplete spinal cord injury means that neural pathways between the brain and body below your level of injury still exist.

Damage to the spinal cord can’t be reversed. Luckily, the spinal cord has neuroplasticity, which is its ability to rewire itself and recover functions affected by SCI.

With sacral sparing, you’ll likely develop some motor control or sensation in areas below your level of injury. While these functions may be very weak, they can be relearned and strengthened through repetition.

The more you repeat a function affected by spinal cord injury, the more your central nervous system adapts to improve that function.

Complete Spinal Cord Injury Recovery Outlook

Unfortunately, after a complete spinal cord injury, the spinal lesion is transected all the way through, and all connections between the brain and area below the level of injury are lost.

Because there are no spared neural pathways, there’s no way for the brain to connect to paralyzed regions of the body.

But there’s still hope for complete spinal cord injury recovery!

Epidural Stimulation

Epidural stimulation involves implanting an electrode array onto your spinal column.

The brain and the body are in good shape; however, messages between the two can’t get past the spinal lesion.

Electrical stimulation works around the spinal lesion and sends electric currents that mimic brain signals to areas below your injury site.

Read more about epidural stimulation for spinal cord injury patients »

Stem Cell Therapy

Stem cell therapy involves transplanting stem cells into the spinal cord.

Depending on the environment they’re placed in, stem cells can differentiate into a variety of different cell types.

A spinal cord injury results in a lot of cell deaths, and because stem cells can divide infinitely, they’re ideal for healing the spinal cord.


exoskeleton for walking after complete spinal cord injury

© chudakov2

While epidural stimulation and stem cell therapy are still works in progress, there is one option that is available to the public.

What makes it even better is that it’s noninvasive.

An exoskeleton is a wearable device that helps you walk!

Although it takes some getting used to, all you really have to do is shift your weight forward. The exoskeleton’s sensor will help facilitate the movement and keep you balanced.

Read more about exoskeletons for spinal cord injury patients »

Understanding Sacral Sparing After Spinal Cord Injury

Sacral sparing is a good thing!

It means that neural pathways that connect your brain and body below your level of injury still exist, which increases your recovery outlook.

Hopefully, this article helped you better understand what sacral sparing is and why it plays such a significant role in determining your chances of recovery.

Good luck!

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