Types Of Spinal Cord Injuries

Types Of Spinal Cord Injuries

Spinal cord injuries are commonly seen in traumatic incidents such as gunshot, motor vehicle accidents, falls, etc. These injuries can result in various symptoms ranging from sensory symptoms such as pain, numbness, tingling, etc., to motor control deficits such as paralysis.

To understand the specific types of spinal cord injuries, you should first know the structure and function of the spinal cord.

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Spinal Cord – What is it?

The spinal cord is a structure made up of neurons (cells) that connects your brain to the rest of your body. It lies within the center of your body and is present inside your spinal column (vertebral column).

It is the continuation of your brain and starts from the point where the brain ends (beneath the skull). It then runs down in your spinal column and transmits signals from the brain to the rest of your body.

So if you want to move your hand to pick up a glass, your brain will generate a motor signal that would travel down the spinal cord and ultimately reach your muscles via nerves originating from your spinal cord.

Not only this, but the spinal cord also serves the function of carrying sensory signals to your brain. You can feel pain only when this sensation is conveyed to the brain via sensory nerves to the spinal cord to your brain.

This helps to understand that signal transmission is affected if the spinal cord is damaged, resulting in several sensory and motor symptoms.

Types of Spinal Cord Injuries

There are two types of spinal cord injuries which are as follows.

  • Complete Spinal Cord Injuries   

As the name indicates, this type of spinal cord injury results in complete damage to the spinal cord at the affected level. Transmission of signals (sensory and motor) between the brain and body parts below the involved level is interrupted.

Both sensory and motor deficits are seen below the affected level. The higher the injury level, the more significant is the damage to the body. The symptoms depend upon the level at which the spinal cord is injured.

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  • Incomplete Spinal Cord Injuries

In this type of spinal cord injury, the damage to the spinal cord is not complete, and some part of the spinal cord at the affected level is spared. Transmission of signals (motor and sensory) is affected but not completely interrupted.

 

As the injury is incomplete, the symptoms vary from person to person. The symptoms that a person may experience depend upon the part of the spinal cord that is injured. If the motor area of the spinal cord is damaged, the affected individual may feel weakness or paralysis of muscles.

Spinal Cord Injury Levels

The symptoms that result from spinal cord injury depend on the type of spinal cord injury and the level at which the spinal cord is injured.

There are three levels at which the spinal cord can be injured.

  1. Cervical Level
  2. Thoracic Level
  3. Lumbar Level

Let’s have a look at each level one by one.

Cervical Level

If the spinal cord is injured at the cervical level, the communication between the brain and the rest of the body (below the neck) is interrupted. This can result in tetraplegia. Complete spinal cord injury at the cervical level affects all four limbs, and there is complete paralysis of the arms and legs.

This occurs because the brain and limb muscles’ pathway is completely damaged, and the brain cannot control these muscles, leading to muscle paralysis.

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Sensory loss is also present in the whole body except the face and neck. The persons having this type of spinal cord injury have no control over their urination and defecation. Affected individuals are wheelchair users and cannot walk on their own. They also need assistance in daily activities because they cannot move their arms.

Thoracic Level

If the spinal cord is completely injured at the thoracic level, it paralyzes lower limbs (legs). When the spinal cord is damaged at the thoracic (upper back) level, the pathway between the brain and the lower limb is interrupted, and the brain cannot send signals to the lower limbs (legs).

An individual with spinal cord injury at the thoracic level cannot move their legs because the motor signals generated in the brain cannot be conveyed to the muscles in the legs as the spinal cord is completely damaged.

Sensory disturbances are also seen in the legs. The affected individual may or may not have control over his urination and defecation.

Lumbar Level

Complete spinal cord injury at the lumbar level leads to significant weakness in lower limbs but not complete paralysis. This happens because some of the nerves that control lower limb muscles are spared. Sensory deficits are primarily present at the back of thighs and legs.

The affected individual may or may not have control over urination or defecation. The affected individual can ambulate using braces/orthotics. The symptoms of spinal cord injury at this level vary from person to person.

Hemiplegia – Can it result from Spinal Cord injury?

Hemiplegia is a term used for paralysis of half of the body that commonly involves the ipsilateral arm and leg. The term “hemiparesis” is used if there is the only weakness of one side of your body (not paralysis). This is mainly seen in incomplete spinal cord injury.

This can result when only one-half of the spinal cord is affected at the cervical level. This type of injury causes sensory and motor disturbances only at one side of the body. The other half of the body usually functions because one-half of the spinal cord is not affected in this type of spinal cord injury.

The ability to move the affected body side is not entirely lost because the spinal cord injury is not completed. The ability to feel sensations such as hot, cold, pain is affected on one side of the body, and this is because the sensory signals are not transmitted to the brain.

The affected individual is not completely paralyzed, and they can ambulate with some strength and balance deficits. As the spinal cord injury is incomplete, the symptoms of this type vary from person to person.

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Kim Spranger tells us her story of discovering the NewGait

Kim Spranger tells us her story of discovering the NewGait

Kim Spranger using the newgait

Kim Spranger Discovers the NewGait

Watch the video version here. Kim Spranger tells us her story as the first therapist to ever use the NewGait.

BENGA: Thank you everyone for joining. Today we had the opportunity to speak with Kim Spranger, one of our founding NewGait clinicians, and discoverer of the NewGait as a rehab device. Kim is a physical therapist in the UP of Michigan and today she is going to tell us her story as the first person to use the NewGait.

Kim Spranger was the first therapist to ever use the NewGait. Today, she is the Director of Culture at NewGait. Listen to her story about discovering the device and her experience using it for Spinal Cord Injury Rehab.

KIM: My name is Kim Spranger, and I’m a physical therapist. I’m a lymphedema specialist, so I have treated lymphedema patients for years, but otherwise, I have been working in outpatient orthopedics for about 14 years now.

KIM: It actually wasn’t a NewGait, when I saw the device, and I saw it, on Facebook, actually. My son pointed it out to me, as a unique training device for runners. Immediately I saw the potential application to physical therapy, so I obtained one and started to use it.

KIM: Well, if I think about the day I just had it in the clinic, I probably used it on 60-70% of the patients that I saw today. I use it for diagnosing, like, what really is problem with their gait? If I try it on them in a certain way does that change their gait? Which helps me know what muscles to train with them. So I use it in a diagnostic sort of way. I use it for biofeedback when I’m trying to teach them something about how they’re moving, but they’re not really hearing me, or they can’t take what I’m saying and then change what they’re doing. It’s great for manual cueing to make that happen. Sometimes people just need some postural stability or feedback, I’ve used it that way as well. Sometimes people are coming in with a neurological condition and they just have so much fatigue or heaviness to their limbs that the NewGait is just a fabulous way to kind of de-weight them. One of the fellows said today, “Wow, it’s just picking up my leg for me.” So I’m using it in all of those different ways throughout my day.

“I probably used it on 60-70% of the patients that I saw today… It’s great for manual cueing… Sometimes people just need some postural stability or feedback.”

KIM: Well, once someone said to me that, as therapists, we are like carpenters, and we have tools in our tool belt. The more tools we have, then the more effectively we can do our job. So the NewGait has become, a special tool in my tool belt. Throughout my day, it’s not like, “oh, this is a certain diagnosis, so I should use the NewGait.” That is not how it works, it’s more like, this is what I see, or don’t see, in how they’re moving, that I now have a whole new set of tools to give them the feedback, and help them reach their goals.

I feel like the staff that works here are always looking for new and different approaches to what we do. And we talk about it frequently. The thing about this device is, it’s not like, you know, “here’s the directions, and you put it on this way and you always use it the same way.” It’s not like that at all. We’ll be playing around with it, and be like, “Hey, you know, look at this new thing I just did. Oh my gosh, that is so cool.” I heard Megan saying that today about someone, and I will think, “Wow, I should try that on patient X tomorrow, because I see the same thing with him that you’re seeing with this patient.” So it gives us reasons to collaborate and try new things together. Patients will pick up on that energy too. They want to be looked at as individuals and not just doing the same exercises everyday, but instead really modifying things to make their therapy the most effective, and the NewGait has done that for us.

“It gives us reasons to collaborate and try new things. Patients pick up on that energy too. They want to be looked at as individuals and not just doing the same exercises everyday, but instead modifying things to make their therapy the most effective, the NewGait has done that for us.”

KIM: Well, I believe that this group of people has been, literally hand picked for this moment and for this product. We did not go searching for them. They just came into our lives. And yet, we are all very much equally have the same kind of passion for life. We are the kind of people who just really want to make a difference. We’re a team who cares in a way that is unique for this day that we live in. As we’ve all worked together over the last three years or so, it’s been truly an experience for all of us. We don’t do this because we have to, we do this because we want to. There is something within me that is really fulfilled by working on this project and watching what it can do.

“We’re a team who cares in a way that is unique for this day that we live in.”

KIM: Well, that’s easy for me because when I first got it, I had never seen it before so it was like, you know, trying a new bike for the first time. No one had ever used it for therapy before. I had this patient that I really loved and really was rooting for, I had a special connection with her. And to be able to take this thing that was unheard of, put it on her, and go from walking with two canes, to walking without a cane and looking so much more confident, almost immediately, that’s kind of a highlight day for therapists. I would say the second one is when we took it down to a spinal cord Institute in Detroit to see these young men who are so hopeful of regaining function and mobility. We were able to put the NewGait on them and have them be wowed, over and over agin. I love it when people say, “Wow!” I walked out of that building and said, “This has been a very good day.”

“to be able to take this thing that was unheard of, put it on her, and go from walking with two canes, to walking without a cane and looking so much more confident, almost immediately.”

KIM: This device will become like several other devices that I’ve seen over my years in therapy where, initially, it looks novel, and people go, “Hmm, I wonder what that does.” I see that people are going to start to understand what it can do for their clinic and how cost effective it is. I think it will become as common as any other popular rehab tool.