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Severe Spinal Cord Injury: Why Prognosis Varies & How to Recover

man undergoing rehabilitation for severe spinal cord injury

While a severe spinal cord injury can result in loss of motor control and sensation, individuals can learn to use what functions they do have to significantly improve their quality of life.

With the help of rehabilitation therapies, many also regain some mobility and learn effective ways to cope.

This article will explain what factors determine the severity of a spinal cord injury and various rehabilitation methods that can help promote recovery.

Factors That Affect the Severity of a Spinal Cord Injury

Severe spinal cord injuries result in extensive loss of motor control and sensation. However, there are many ways to measure the severity of a spinal cord injury.

Below, we’ll discuss 4 factors that can affect the severity of a spinal cord injury.

Completeness of Injury

completeness of injury is a major determinant of recovery outlook

One way to measure the severity of a spinal cord injury is to determine whether it is complete or incomplete.

complete spinal cord injury occurs when the injury site damages the spinal cord all the way across, leaving no spared neural pathways. Because messages between the brain and areas innervated below the level of injury cannot get past the spinal cord damage, complete loss of sensation and motor control below the level of injury occurs.

In contrast, an incomplete spinal cord injury occurs when only partial damage of the cord occurs at the site of injury (the cord is not completely transected). As a result, some neural pathways between the brain and areas innervated below the level of injury are spared and individuals may be able to feel or control movements in those areas.

Completeness of injury significantly affects recovery outlook. Only healthy, undamaged neural pathways are capable of using neuroplasticity to adapt and reorganize themselves. Therefore, the more spared neural pathways exist, the better the potential for recovery.

Level of Injury

severe spinal cord injury outcomes

The severity of a spinal cord injury can also be gauged by one’s level of injury. Each level of the spinal cord innervates a different area of the body, and after an injury to the cord, all the areas below the level of the injury have the potential to be affected. Therefore, the higher your level of injury, the more functions can be affected.

For example, someone with a severe C4 spinal cord injury may have paralysis from the shoulders down. In contrast, someone with a severe L3 injury may only have paralysis in the lower legs.

While individuals can generally live independently with paralysis in the lower body, those with upper body involvement may require more help.

Click here to learn more about your specific level of injury »

Spinal Shock

If you experience spinal shock, your spinal cord injury may initially seem more severe than it actually is.

Spinal shock describes the temporary loss of all reflexes, control, and sensation below your level of injury due to swelling of the spinal cord. Once the swelling starts to reduce, blood flow will be restored and reflexes may gradually return.

As a result, many mistake their incomplete spinal cord injuries for complete ones. It isn’t until spinal shock subsides that they understand how much motor function and sensation is actually preserved.

This is why immediate medical attention after a spinal cord injury is essential. Early stabilization of a spinal cord injury can help minimize the exacerbation of secondary processes like swelling and potentially prevent spinal shock from occurring.

Secondary Complications

Generally, the more severe a spinal cord injury is, the greater the risk of experiencing secondary complications.

Common complications amongst individuals with spinal cord injuries include:

The onset of secondary complications after spinal cord injury can cause further physical and psychological distress.

Now that you understand what factors can contribute to the severity of a spinal cord injury, let’s discuss the goals of treatment.

Severe Spinal Cord Injury Rehabilitation

severe spinal cord injury practicing passive range of motion exercises at physical therapy

Rehabilitation after a severe spinal cord injury will generally focus on maximizing your functional abilities. This means learning how to use functions you do have control over to optimize your ability to care for yourself and protect paralyzed regions of your body from further complications.

Because every spinal cord injury is unique, a personalized rehabilitation plan that targets your specific weaknesses is essential for optimal rehabilitation outcomes.

Rehabilitation for severe spinal cord injuries can consist of:

  • Physical therapy. PT will help improve your mobility through targeted exercises. Those with severe paralysis will likely practice range of motion exercises to promote circulation.
  • Occupational therapy. OT will teach you new ways to perform everyday activities. For example, you might learn how to use adaptive tools to compensate for limited motor function.
  • Speech therapy. If your injury affected respiratory functions, working with a speech therapist can help you to improve breathing, increase your cough strength, and teach you how to manage secretions.
  • Psychotherapy. Generally, the more severe a spinal cord injury is, the more challenging it is to cope and adapt. A psychotherapist can help provide the emotional support and guidance you need to get through this difficult time.
  • Orthotics. Orthotic devices like braces provide structural support to help individuals sit upright, manage spasticity, and practice better form when relearning movements.
  • Medications. Medications may help those with severe spinal cord injuries manage some of their complications. For example, muscle relaxants may help reduce spasticity, pain relievers can help manage pain, and suppositories can help promote bowel movements.
  • Catheterization. Catheterization will help individuals with bladder dysfunction avoid complications like leaking, kidney damage, and urinary retention.
  • Surgery. Severe spasticity can significantly restrict movement. Surgical management may be necessary to avoid severe pain, poor quality of sleep, and barriers to overall performance.
  • Caregiver assistance. A severe spinal cord injury can require you to become more dependent on others. Some people don’t want to burden their loved ones with tasks like using the toilet or bathing. Instead, they find it more comfortable to hire a caregiver.
  • Joining a Support Group. Joining a support group is a great way to connect with others that understand what you’re going through.

Consult with your doctor to determine which rehabilitation interventions are ideal for your specific spinal cord injury and complications.

Understanding Severe Spinal Cord Injury: Key Points

Many factors including the level and completeness of injury, spinal shock, and the onset of secondary complications can influence the recovery outlook of severe spinal cord injuries. Individuals can learn to adapt and maximize their functional abilities to improve their quality of life.

We hope this article helped you understand that with the right mindset and commitment to rehabilitation, recovery after severe spinal cord injury is possible. Good luck!

Photo credits: iStock/Halfpoint

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