Overview
The term spinal cord injury (SCI) refers to damage to the spinal cord resulting from trauma (e.g. from falls and road traffic injuries) or non-traumatic causes like tumors, degenerative and vascular conditions, infections, toxins or birth defects.
The extent of SCI related impairment depends on injury severity and location in the spinal cord. SCI results in complete or incomplete loss of sensory and/or motor functions below injury level. In paraplegia arm functions are preserved; in tetraplegia they are affected. Autonomic nervous system dysfunction affecting diverse functions can occur at any level of injury.
Inappropriate management of SCI related impairments and secondary conditions often causes premature mortality.
SCI can diminish the capacity to perform daily activities, including walking, using one’s hands, physiological emptying of bowel/bladder or washing and dressing oneself. Limitations are compounded by misconceptions, negative attitudes and physical barriers to basic mobility, restricting independence and full societal participation. SCI is a major cause of long-term disability, accounting for over 4.5 million years of life lived with disability (YLDs) in 2021.
Importantly, many restrictions in performing activities and participating in meaningful life areas do not result from the condition itself, but from insufficient or inadequate medical care, rehabilitation and assistive technologies access, a high economic burden, and from barriers in the physical, social and policy environments. For example, globally, only 5–35% have wheelchair access.
Signs and symptoms
Depending on injury severity and location, people with SCI can experience
- partial or complete loss of sensory and/or motor functions (including respiratory muscle functions)
- bowel, bladder and sexual dysfunction
- dysregulation of blood pressure, heart rate, and/or body temperature.
SCI is often associated with a risk of developing complications, including debilitating and potentially life-threatening secondary conditions, such as
- spasticity
- (chronic) pain
- urinary tract infections
- pressure ulcers
- respiratory complications
- autonomic dysreflexia
- deep vein thrombosis
- osteoporosis.
Furthermore, people with SCI may develop clinical signs of depression, negatively impacting functional improvements and overall health.
Mortality risk is highest in the first year after injury, remaining high compared to the general population. Injury level and severity, availability of timely, quality medical care, transfer method to hospital after injury and time to hospital admission are important factors.