A very large number of people across the world are living with spinal cord injury. In the USA alone, an estimated 290,000 are living with it. Before recent discoveries, it was previously the assumption that only those who are young and healthy can restore bodily functions from spinal cord injury. However, research now demonstrates that stimulation of the spinal cord can promptly restore voluntary and automatic roles across the body, in areas such as: cardiovascular, bowel, and the bladder. This is excellent to learn, as it is far better than other rehabilitation options.

Dr. David Darrow, a neurosurgery resident at the University of Minnesota Medical School shared his excitement to research treatments for spinal cord injury with stimulation. He mentions “This presents a great opportunity to apply epidural stimulation with both my mathematical background and with a wide variety of skilled professionals”. Epidural stimulation or epidural spinal cord stimulation (eSCS) is the application of a flowing current of electricity to the base of the spinal cord. The flow operates through a small chip placed over the dura of the spinal cord (thick membrane surrounding the spine). When activated, controlled stimulations, alongside rigorous training, enables those who are otherwise paralysed, to regain voluntary movement of their legs.

Effectiveness of epidural stimulation

To better understand the effectiveness of epidural stimulation, the team implanted two female patients with an eSCS system to their T12 level vertebrae. The patients were 5 and 10 years since injury, they were aged 48 and 52 respectively. After the implant took effect, the team were able to validate that the eSCS restored voluntary movement. Both patients showed a significant improvement in electrical activity of muscles, surface EMG (SEMG). In one patient, cardiovascular function was fully recovered. Both patients had improved their bowel-bladder synergy, with one having fully restored voluntary control of urination. One patient was once again able to have an orgasm. It’s worth noting the patients’ injuries were severe. They had both sustained radiographic injuries, and had not benefited from much prescription or rehabilitation treatment. While this study leaves areas for further research, it helps to assure others of the benefits epidural stimulation has to patients’ who are recovering from spinal cord injury. In this specific study, patients regained functions of muscle tissue, cardiovascular, bowel-bladder, urination, and of sexual functions. This gives hope to intensify efforts to research and develop new approaches for recovery in patients across the globe who are living with spinal cord injury.

Classifications of spinal cord injuries

Spinal cord injuries are easily understood by two different classifications: those which are incomplete and those which are complete. Incomplete spinal cord injuries refer to cases where the spinal cord only has partial damage. This still allows the individual to utilise some function of the spinal cord. When referring to incomplete spinal cord injuries, there is not one way to understand all, as each case depends on the nature of the injury sustained. Complete spinal cord injuries refer to the spinal cord having full function eliminated. It is widely accepted that rehabilitation and treatment over a long-period of time can help to treat complete spinal cord injuries. The study led by Dr Darrow and his team have, for this reason, shed new prospects and light in helping those recover from chronic spinal cord injury with epidural stimulation.

Incomplete spinal cord injury accounts for more than 60% of all cases (a 2015 USA study revealed). Incomplete spinal cord injuries can be understood as either: Anterior Cord syndrome (injury to the front of the spinal cord damaging motor/sensory pathways), Central Cord syndrome (injury to the center of the spinal cord damaging nerve signals from the brain), or Brown Sequard syndrome (injury to one side of the spinal cord possibly restricting movement on one side of the body).

The remaining 40% of complete spinal cord injuries are: Tetraplegia (injury to the cervical spinal cord resulting in paralysis of limbs), Paraplegia (senses and movements are removed from the lower half of the body, such as legs), and Triplegia (loss of sensation and movement in one arm and both legs). Injuries which are sustained beneath the lumbar spinal cord do not often cause paralysis or sensory loss. Instead, they supply the individual with nerve pains, and reduction in functions across the body. This type of injury may require surgeries to regain function. It’s important to know where the injury is in your spine, and weather it is incomplete or complete. This can help you to discover your options, and research your prognosis.

Cite this article as:
Editorial Staff, "Types and Levels of Spinal Cord Injury," in Medicalopedia, February 12, 2019, [Permalink: https://www.medicalopedia.org/7267/types-and-levels-of-spinal-cord-injury/].