About the Spinal Cord
The spinal cord is an extension of the brain and runs from the neck to the lower back. The spinal cord consists of millions of nerve fibres that transmit information to and from the limbs, trunk and organs of the body.
A spinal cord injury happens if pressure is applied to the spinal cord, and/or the blood and oxygen supply to the cord is disrupted.
There are two main types of spinal cord injury, depending on where the damage to the spinal cord occurs.
Quadriplegia or Tetraplegia is the partial or complete paralysis of the upper and lower portion of the body, including legs, trunk arms and hands. Quadriplegia is a neck injury.
Paraplegia is the partial or complete paralysis of the lower portion of the body, including the legs and, in many cases, some or all the trunk. Paraplegia is a back injury.
The damage to the spinal cord may be complete or incomplete, depending on the degree of injury to the nerve fibres. Incomplete injury can result in movement and sensation abnormalities and a complete injury usually means total loss of movement and sensation – permanent paralysis.
Spinal Injuries Facts
- Around 12,000 people in Australia today have a spinal cord injury (SCI).
- 350 to 400 new cases are recorded each year.
- Transport-related injuries account for the majority of spinal cord injuries in Australia.
The following statistics represent the latest available national statistics of spinal cord injuries, from case registrations to the Australian Spinal Cord Injury Registry (ASCIR).
Age and Sex Distribution
- Of reported traumatic spinal cord injury (SCI), 84% are male and 16% female.
- Spinal cord injuries were most frequent in 15-24 year old age group (accounting for 30%)
- A significant increase in the average age at injury is being reported internationally and is likely to be a reflection of the ageing population
- An increase is also seen in the 65-74 year age group sustaining SCI
Individual state/territory incidence (based on usual residence of patient) is as follows (highest to lowest):
- Northern Territory (highest incidence rate)
- Western Australia
- South Australia
- New South Wales
Causes of SCIs in Australia
Approximately 80% of newly reported SCI cases are due to traumatic injury (eg. accident related). These consist of:
- 46% – motor vehicle related incidents
- Of these transport related incidents, 51% were motor vehicle occupants and 49% were unprotected road users, predominantly motorcyclists (79%). The vast majority of unprotected road users were male (92%), and they tended to be younger with more than half (56%) in the 15-34 years of age group.
- 28% – related to falls
- Of all falls related incidents, 64% were from a height of one metre or more, 41% of low falls (same level or less than one metre) involved people aged 65 years or over, compared to only 13% of falls greater than one metre involving this age group.
- 9% – resulted from being hit or struck by an object
- Where a SCI incident happened when working for an income, of these 44% related to transport incidents, 23% as a result of falls over one metre and 23% reported as being struck or colliding with a person or object.
- 9% – were water-related
- The activity being undertaken at the time of SCI was documented in half of the SCI cases. Leisure activities accounted for 35% of these with just over half being attributed to diving, surfing, swimming or jumping into bodies of water.
- 8% – were from other causes
- Other leisure activities documented included: major football codes, pedal cycle races, horse-related activities.
Approximately 21% of newly reported SCI cases are non-traumatic. This group consists of medical conditions such as vascular disorders, degenerative spinal conditions, genetic disorders and cancerous lesions.
Types of SCI
The extent of SCI is relative to the extent of neurological damage, which is either ‘complete’ or ‘incomplete’, as well as the level of the spinal cord that is affected. The extent of the neurological damage provides a predictor for recovery, but the vast majority of people with SCI have long-term neurological loss.
The most common categories of SCI in order are:
Incomplete Quadriplegia (38%) – refers to loss of movement and/or sensation in all four limbs, but there is some nerve function from the spinal nerves furthest from the brain.
Incomplete Paraplegia (27%) – refers to loss of movement and/or sensation in the lower limbs (and trunk), but there is some nerve function from the spinal nerves furthest from the brain.
Complete Quadriplegia (15%) – refers to loss of movement and/or sensation in all four limbs.
Complete Paraplegia (20%) – refers to loss of movement and/or sensation in the lower limbs (and trunk).
Citation: Norton L, Spinal Cord Injury, Australia 2007-08, Australian Institute of Health and Welfare, Injury Research and Statistics Series Number 52. Canberra; 2010
What does a spinal cord injury affect?
A spinal cord injury does not only result in the loss of limb function and sensation. There are many other areas of the body that can be affected, depending on the person’s level of injury. Some include:
• Airways – the ability to breathe and cough
• Bladder – voluntary control of the bladder
• Bowel – control over the rectum and bowel movements
• Bone – the density and strength of bones and the stiffening and fusion of joints
• Pain – nerve sensitivity causing neuropathic pain. This can range from pins and needles to strong pain below the injury level
• Sexuality and fertility – reduced or lack of sexual function, lower sperm quality and count
• Skin – skin break downs producing a pressure sores and tears
• Spasticity – exaggerated response to stimuli causing muscles to contract or spasm
• Temperature control – the inability to regulate the body’s temperature to respond to heat and cold