Spinal Cord Injury : Quadriplegic and Paraplegic

Paraplegic or Quadriplegic ?

Spinal Cord Injury (SCI) Terms : Paraplegic and Quadriplegic (Tetraplegic) are terms used to describe someone who has been paralyzed due to a spinal cord injury. This classification depends on the level and severity of a persons paralysis and how it affects their limbs.

This website provides Patient Information about acute spinal cord injuries, as well as treatment, symptoms, information on long term rehabilitation issues and Peer Support, to help improve the quality of life of those affected by spinal cord injuries.

What is a Spinal Cord Injury ?

A Spinal Cord Injury (SCI) is 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.

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, etc.). The resulting damage to the spinal cord is known as a lesion, and the paralysis is known as Quadriplegia or Quadraplegia / Tetraplegia if the injury is in the Cervical (neck) region, or as Paraplegia if the injury is in the Thoracic, Lumbar or Sacral region.

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.

The nerves that are situated within the spinal cord are called upper motor neurons, (UMNs) and their primary function is to carry the messages back and forth from the brain along spinal nerves within the spinal tract (spinal cord). The spinal nerves that branch out from the spinal cord to the other parts of the body, are called lower motor neurons (LMNs). These spinal nerves exit and enter at each vertebral level and communicate with specific areas of the body.

The sensory portions of the cord, contained within the ascending tracts of the UMNs, carry messages about sensation from the skin such as pain, temperature, touch and joint position to the brain. The motor portions of the spinal cord are contained within the descending tracts of the UMNs, and send messages from the brain to the various body parts to initiate actions such as muscle movement.

It is important to note, that the spinal cord does not have to be completely severed for there to be a loss of function. In fact, the spinal cord remains intact in most cases of spinal cord injury. One of the most common causes of damage to the spinal cord occurs through swelling of the cord, which is then damaged due to the confines of the narrow space within the vertebrae This in turn causes cellular damage resulting in scar tissue to form, which in turn inhibits the formation of new nerve pathways making the resultant paralysis permanent.

Complete and Incomplete Spinal Cord Injury Types

There are two types of lesions associated with a spinal cord injury, these are known as complete and incomplete injuries. A complete 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 visa versa. There are many types in incomplete spinal cord injuries, and no two are the same.

A person with an incomplete spinal cord injury has been shown to have a better chance of recovery than that of a complete injury. The degree of recovery ranges from significant motor function, to the return of sensation. It is uncommon however, for someone to recover function and sensation to that of their pre injury ability.

Such injuries are known as Brown Sequard Syndrome, Central Cord Syndrome, Anterior Cord Syndrome and Posterior Cord Syndrome.

The most common used grading system for evaluation of functional recovery of a spinal cord injury is the Frankel scale. This scale contains five grades (A-E), based on motor and sensory deficits;

A complete paralysis
B sensory function only below the injury level
C incomplete motor function below injury level
D fair to good motor function below injury level
E normal function

Spinal Cord Injury Rehabilitation

Someone with a spinal cord injury will have a long road of rehabilitation ahead of them, usually at a Spinal Cord Injury Treatment Unit and Rehabilitation Centre or Spinal Injury Unit, and it is important that they keep their sense of humor on their bad days to help them maintain a positive attitude.

Generally, Paraplegics will be in hospital for around 5 months, where as Quadriplegics can be in hospital for around 6 - 8 months, whilst they undergo rehabilitation. Both Paraplegics and Quadriplegics should have some kind of rehabilitation and physiotherapy before they are discharged from hospital, to help maximise their potential, or help them get used to life in a wheelchair, and to help teach techniques which make everyday life easier.

Disabled sports, and wheelchair based sports can be an excellent way to build stamina, and help in rehabilitation by giving confidence and better social skills. The ultimate reward for many disabled sportsmen and women, is to win at the Paralympic Games, which will be coming to London in 2012.

Spinal Cord Injury Cure and Treatment

Recently, research has made progress in limiting the cellular damage in the early stages of acute spinal injuries. This treatment usually has to be applied within the first few weeks post injury, and comprises of combination therapy to restrict the formation of scar tissue, and to promote the regeneration of new axions within the spinal cord.

A cure for long term paralysis is still some years in the future, but clinical trials are taking place with Olfactory Ensheathing Glial (OEG) cells and stem cell combination therapies.

The spinal cord also contains internal nerve feedback circuits that regulate the walking process and joint reflexes. For example, these reflexes lift our foot automatically when we stub a toe, and it has been shown that there is a reflex which intiates the lifting of one foot, when the opposite foot is placed on the ground.  With intensive physiotherapy techniques, these reflexes can be used to gain additional function.

Paraplegic and Quadriplegic Discussion Forum

If you have any spinal cord injury related questions, please visit our Discussion Forums and join in on the many topics there. We will do our best to help you, or at the very least, put you in contact with someone who can if we can't. The discussion forum is intended to be a free flow of information between spinally injured people, carers, and their friends, and everyone is welcome.

Even if you don't have any questions, take a look at the forum anyway, as you may be able offer help and advice to others who have questions. More >>>

Quadriplegic, Tetraplegic, Paraplegic and What it Means

Quadraplegic is derived from two separate words from two different languages, Latin and Greek. The word “Quadra”, meaning “four” which is derived from latin, relates to the number of limbs. “Plegic”, is derived from the Greek word “Plegia”, meaning paralysis.

Put the two together, and you have “Quadraplegia”.

“Tetra” is derived from the Greek word for “Four”. “Para” is derived from the Greek word for "two" Hence: Tetraplegic and Paraplegic.

In Europe, the term for 4 limb paralysis has always been tetraplegia. The Europeans would never dream of combining a Latin and Greek root in one word.

In 1991, when the American Spinal Cord Injury Classification system was being revised, the difference in names was discussed. The British are more aware of Greek versus Latin names. Since Plegia is a greek word and quadri is Latin, the term quadriplegia mixes language sources. Upon review of the literature, it was recommended that the term tetraplegia be used by the American Spinal Cord Association so that there are not two different words in English referring to the same thing.