Spinal Cord Injury

Spinal Cord Injury Overview

A spinal cord injury (SCI) is typically defined as damage or trauma to the spinal cord that in turn results in a loss or impaired function resulting in reduced mobility or feeling.

Typical common causes of damage to the spinal cord, are trauma (car/motorcycle accident, gunshot, falls, sports injuries, etc.), or disease (Transverse Myelitis, Polio, Spina Bifida, Friedreich's Ataxia, spinal cord tumour, spinal stenosis, etc.). The resulting damage to the spinal cord is known as a lesion, and the paralysis is known as quadriplegia or quadriplegia / tetraplegia if the injury is in the cervical (neck) region or as paraplegia if the injury is in the thoracic, lumbar or sacral region.

The spinal cord injury level is usually referred to alpha numerically, relating to the affected segment in the spinal cord, ie, C4, T5, L5 etc.

Below the conus medullaris (L1-L2), the spinal canal contains a mass of nerves referred to as the cauda equina or "horse-tail". These nerves branch off the lower end of the spinal cord and contain the nerve roots from L1-5 and S1-5. Injury to these nerve roots are referred to as cauda equina syndrome.

It is possible for someone to suffer a broken neck, or a broken back without becoming paralysed. This occurs when there is a fracture or dislocation of the vertebrae, but the spinal cord has not been damaged. There are typically two types of lesions associated with a spinal cord injury, these are known as a complete spinal cord injury and an incomplete spinal cord injury. A complete type of injury means the person is completely paralysed below their lesion. Whereas an incomplete injury, means only part of the spinal cord is damaged. A person with an incomplete injury may have sensation below their lesion but no movement, or v3isa versa. There are many types in incomplete spinal cord injuries, and no two are the same.

A recent World Bank Report revealed that 8-10% of the population in India lives with a disability. Over 40% of them have physical disabilities, many of whom are people with Spinal Cord Injuries (SCI's) . Approximately 200,000 people live with SCI in India (statistic s are hard to confirm in India) . According to Rajinder Johar, director of Family of Disabled, approximately 15,000 individuals in India become paralysed as a result of spinal cord injuries each year. Half of these die within five years due to lack of follow up and rehabilitation. For those who survive in addition to direct costs of treatment and indirect cost from others who provide care, foregone income from disability represents the highest cost to the family.

WHO predicts an increase of 120% in the number of people in India dependant on daily care from 2000-2050. Most SCI's are dependent on their families and hired help to get by. Such a lifestyle not only leads to lack of confidence and purpose it prevents society from full engagement with otherwise capable individuals. Indeed, every person with a SCI in India has the capacity to be free and independent with the promise to make real dreams as you and I. To date such concepts are within reach for those living in countries such as Scandinavia, Western Europe, Australia and Canada. Fortunately, the existing traditional view of medical and rehabilitation models current in India - prevention, cure and intervention - is giving way to a social model that now exists worldwide. This model looks at disability as a socio-economic construct in which discrimination is rife.

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