7 Common Spinal Cord Injury Complications

A traumatic spinal cord injury (SCI) is a severe and often life-altering type of injury that occurs when there is damage to the spinal cord, typically as a result of a sudden, forceful impact or trauma. The spinal cord is a vital part of the central nervous system, responsible for transmitting signals between the brain and the rest of the body. Damage to the spinal cord can disrupt this communication, leading to a loss of function, sensation, and mobility below the level of injury.

Traumatic spinal cord injuries can be caused by various incidents, such as car accidents, motorcycle accidents, cycling accidents, pedestrian accidents, falls, sports injuries, acts of violence (like gunshot or stab wounds), and other traumatic events. The severity of the injury depends on the location and extent of the damage to the spinal cord. Typically, Injuries can be classified as complete or incomplete. A complete occurs when there is a total loss of sensory and motor function below the level of the injury. In such cases, both sides of the body are affected, and there is no sensation or voluntary movement below the injury site. Incomplete spinal cord injuries occur when there is partial damage to the spinal cord, resulting in some degree of function or sensation below the injury site. The extent of the impairment may vary depending on the specific nerve fibers affected.

Traumatic spinal cord injuries can have significant and long-lasting consequences, often requiring specialized medical care, rehabilitation, and adaptive equipment to help individuals regain some level of independence and quality of life.

In addition, traumatic spinal cord injury (SCI) may cause long lasting dysfunction in many organ systems, and together with permanent change of function, leading to chronic health complications, higher morbidity, and a lower quality of life. In this article, our Hamilton Spinal Cord Injury Lawyers examine some of the most common complications which we have seen our clients deal with over the years.

Remember, if you or a loved one has suffered a spinal cord injury, our Hamilton Spinal Cord Injury Lawyers have represented accident victims who have suffered paraplegia, quadriplegia and tetraplegic type injuries since 2003 and have recovered millions for families in Hamilton and throughout all of Ontario. Contact us today, no matter where you are in Ontario by calling us at 1-844-LALANDE or local throughout southern Ontario by calling us at 905-333-8888. Alternatively, you can send us confidential email through our website or chat live with our live chat operator 7 days a week 24-hours a day. Our Hamilton Spinal Cord Injury Lawyers are here to help you recover justice – in a time of need and ensure that you are financially taken care of for life.

An Overview of the Spinal Cord

The spinal cord is a long, thin bundle of nerves that runs through a canal in the center of the spine. It is part of the nervous system, which is responsible for transmitting messages between the brain and the rest of the body.

The spinal cord acts as a relay station for information traveling to and from the brain. It receives sensory information, such as pain or temperature, from different parts of the body and sends that information to the brain. The brain then processes the information and sends back instructions for how to respond, such as moving a limb or adjusting body temperature.

In addition to its role in transmitting information, the spinal cord also contains some reflex pathways that allow for automatic responses to certain stimuli. For example, if you touch a hot stove, your hand will reflexively pull away before your brain even has a chance to process the pain.

Overall, the spinal cord is a vital part of the nervous system that helps us move, sense the world around us, and respond to stimuli. To protect it from injury, the spinal cord is surrounded by 33 vertebrae, which make up the vertebral column or the backbone. The vertebrae are stacked on top of each other with small spaces in between, creating a canal through which the spinal cord passes. The vertebrae provide a bony shield around the spinal cord, preventing it from being compressed or damaged by external forces. The vertebrae also provide support for the body, allowing us to stand upright and move around. Overall, the vertebral column and its protective role are crucial for the proper functioning of the spinal cord and the overall health of the body.

Vertebrae are grouped into sections. They are named and numbered from top to bottom according to their location along the backbone:

• Cervical vertebrae 1–7: from the base of the skull to the bottom of the neck
• Thoracic vertebrae 1–12: the upper back (attached to the ribcage)
• Lumbar vertebrae 1–5: the lower back
• Sacral vertebrae 1–5: the hip area
• Coccygeal vertebrae 1–4 fused: in the tailbone

The spinal cord nerves that exit the spinal cord are grouped into bundles called spinal nerves. These spinal nerves are categorized into four main groups based on the region of the vertebral column they emerge from: cervical, thoracic, lumbar, and sacral nerves. Each group of spinal nerves plays a distinct role in innervating different parts of the body and has a unique functional significance.

1. Cervical nerves (C1-C8): There are eight pairs of cervical nerves that emerge from the cervical region of the spinal cord, which is located in the neck. These nerves are responsible for the motor and sensory functions of the neck, shoulders, and upper limbs, as well as the diaphragm (C3-C5), which is essential for breathing. The cervical nerves also contribute to the formation of the cervical and brachial plexuses, which are complex networks of nerves that innervate the upper limbs and shoulders.
2. Thoracic nerves (T1-T12): There are twelve pairs of thoracic nerves that emerge from the thoracic region of the spinal cord, which is located in the upper and middle back. These nerves primarily provide motor and sensory innervation to the chest, back, and abdominal muscles, as well as the skin of the trunk. Unlike the cervical, lumbar, and sacral nerves, the thoracic nerves do not form plexuses but instead directly innervate their target areas.
3. Lumbar nerves (L1-L5): There are five pairs of lumbar nerves that emerge from the lumbar region of the spinal cord, which is located in the lower back. These nerves are responsible for the motor and sensory functions of the lower limbs, hips, and certain abdominal muscles. The lumbar nerves contribute to the formation of the lumbar plexus, which innervates the anterior and medial thigh muscles, and the sacral plexus, which innervates the posterior thigh muscles and most of the lower limb.
4. Sacral nerves (S1-S5): There are five pairs of sacral nerves that emerge from the sacral region of the spinal cord, which is located in the pelvic area. These nerves play a crucial role in the motor and sensory functions of the lower limbs, as well as the pelvic organs such as the bladder, rectum, and reproductive organs. The sacral nerves also contribute to the formation of the sacral plexus, which, as mentioned above, innervates the posterior thigh muscles and most of the lower limb.

An Overview of Common Spinal Cord Injury Complications

Psychological Complications

Spinal cord injury (SCI) victims often experience a variety of psychological challenges and severe emotional reactions as they navigate the consequences of their injury. One common factor is depression, which can arise from the sudden loss of mobility, independence, and quality of life. Experiencing an SCI poses a huge psychosocial challenge and the sense of loss can lead to feelings of helplessness, hopelessness, and a lack of motivation. Other psychosocial factors and changes that can accompany individual who suffer spinal cord injuries are:

• Lack of privacy
• Loss of independence
• Changes to role/lifestyle
• Uncertainty regarding the future
• Sense of helplessness
• Separation from family and friends
• Inability to control basic bodily functions
• Changes in physical health and functional ability
• Changes in body image

Other psychological issues which can affect an individual’s psychological adjustment after an SCI are such factors such as fatigue, chronic pain, boredom, isolation, medical complications and medication requirements.

Anxiety is another prevalent issue for SCI patients, as they may worry about their future, financial stability, and ability to maintain relationships. The uncertainty of their prognosis and the fear of further complications can exacerbate anxiety levels.

Furthermore, SCI victims may grapple with issues of self-esteem and self-image, as they adjust to the changes in their body and its functions. This can lead to social isolation, as they may feel self-conscious or worry about being a burden to their loved ones. In some cases, individuals with spinal cord injuries may develop post-traumatic stress disorder (PTSD) due to the traumatic nature of the injury and its aftermath. PTSD can manifest in flashbacks, nightmares, and heightened emotional reactions to triggers associated with the injury.

Lastly, the chronic pain and discomfort that often accompany SCI can contribute to psychological distress. Pain can interfere with sleep, exacerbate mood disorders, and impede the ability to engage in daily activities, leading to a vicious cycle of physical and emotional suffering. In order to address these psychological factors, it is essential for spinal cord injury victims to receive comprehensive care, including mental health support, to aid in their recovery and adjustment to a new way of life.

Urological Complications

Spinal cord injury (SCI) victims often face various urological challenges due to the disruption of nerve pathways that control bladder and bowel function. One common issue is neurogenic bladder, a condition where the bladder’s normal functioning is impaired, leading to difficulties with urine storage or elimination. Depending on the location and severity of the injury, individuals may experience either an overactive bladder, which can cause involuntary contractions and urinary incontinence, or an underactive bladder, which leads to urinary retention and an inability to fully empty the bladder.

Urinary tract infections (UTIs) are another frequent urological complication in SCI patients. The combination of incomplete bladder emptying, catheter use, and impaired sensation increases the risk of infection, which may lead to more serious complications if left untreated. In the Journal of Arch Physical Medical Rehabilitation, doctors Cardenas and Hooton tell us that individuals with spinal cord injury (SCI) have an increased risk of developing urinary tract infections. Certain structural and physiological factors, such as bladder over-distention, vesicoureteral reflux, high-pressure voiding, large post-void residuals, stones in the urinary tract, and outlet obstruction increase the risk of infection.

Additionally, kidney stones can be a problem for some individuals with spinal cord injuries, as the disruption in bladder function may contribute to the formation of stones. Inadequate fluid intake and immobility can also increase the likelihood of kidney stones.

Bowel dysfunction is another common issue faced by spinal cord injury victims. Neurogenic bowel can manifest as either constipation or fecal incontinence, depending on the injury’s location and severity. Constipation can result from decreased motility and sensation in the bowel, whereas fecal incontinence can occur due to the loss of voluntary control over the anal sphincter. These urological challenges can significantly impact the quality of life for individuals with SCI, making it essential for healthcare providers to address these concerns through a combination of medical interventions and lifestyle adjustments.

Cardiovascular Complications

Spinal cord injury (SCI) victims can experience various heart or cardiac problems due to the altered communication between the nervous system and the cardiovascular system. One common issue is orthostatic hypotension, which occurs when a person’s blood pressure drops significantly upon changing positions, such as moving from lying down to sitting or standing. This condition is more prevalent in individuals with higher-level injuries, as the disruption of sympathetic nervous system pathways impairs the body’s ability to constrict blood vessels and maintain adequate blood pressure.

Another cardiac complication in SCI patients is autonomic dysreflexia, a potentially life-threatening condition that affects individuals with spinal cord injuries at or above the T6 level. Autonomic dysreflexia is characterized by a sudden, extreme increase in blood pressure in response to a stimulus below the level of injury, such as a full bladder or bowel, pressure sores, or even tight clothing. This condition can lead to severe headaches, sweating, and flushing above the injury level, and if not promptly treated, may result in stroke, seizure, or even death.

Furthermore, SCI victims may be at a higher risk of developing cardiovascular disease due to factors such as reduced physical activity, altered metabolism, and the presence of other comorbidities. The lack of mobility can lead to decreased aerobic capacity, muscle atrophy, and poor circulation, which contribute to an increased risk of heart disease.

Pressure Ulcers

In the Journal Canadian Best Practice Guidelines for the Prevention and Management of Pressure Ulcers in People with Spinal Cord Injury defines pressure ulcers (also called bedsores, decubitus ulcers, and chronic pressure wounds) as a localized injury to the skin and/or underlying tissue as a result of pressure, or pressure in combination with shear and/or friction. The high wheelchair use in the population with spinal cord injury is responsible for the prevalence of seating-acquired pressure ulcers in the buttock region over the ischial tuberosities or sacrum. Pressure ulcer formation is a complex process that is still not completely understood, and recent reviews have highlighted altered pathophysiologic processes precipitating pressure ulcers in skin that has been denervated due to spinal cord injury.

In our experience representing spinal cord injury victims we have seen that pressure ulcers seem to be a common phenomenon amount spinal cord injury (SCI) victims. The wounds seem to happen when sustained pressure on the skin and underlying tissue leads to decreased blood flow, resulting in tissue damage and eventual breakdown. Individuals with spinal cord injuries are particularly susceptible to pressure ulcers due to factors such as immobility, reduced sensation, and poor circulation. The inability to shift positions regularly, combined with the lack of sensation, means that individuals may not feel the discomfort that typically signals the need to change positions and alleviate pressure.

Pressure ulcers pose significant dangers to individuals with SCI, as they can lead to severe infections, systemic inflammation, and further tissue damage if left untreated. In some cases, these infections can spread to the bones, joints, or bloodstream, potentially becoming life-threatening. Moreover, pressure ulcers can cause significant pain and discomfort, impairing the overall quality of life and complicating the rehabilitation process.

Prevention and management of pressure ulcers in spinal cord injury patients involve a combination of strategies, including regular skin assessments, pressure-relieving devices, and diligent repositioning. Healthcare providers and caregivers must regularly inspect the skin, especially in bony areas, for signs of redness, swelling, or breakdown. Pressure-relieving devices, such as specialized mattresses or wheelchair cushions, can help distribute pressure more evenly and reduce the risk of ulcer formation. Additionally, individuals with SCI should be repositioned frequently, ideally every two hours when lying down and every 15 to 30 minutes when seated.

In the case of existing pressure ulcers, proper wound care is crucial to promote healing and prevent infection. This includes cleaning the wound, applying appropriate dressings, and managing any underlying infections with antibiotics if necessary. In severe cases, surgical intervention may be required to remove dead tissue or reconstruct the affected area. Ultimately, a multidisciplinary approach to prevention, early detection, and treatment is essential to minimizing the impact of pressure ulcers on spinal cord injury patients.

Bladder and Bowel Issues

Individuals with spinal cord injuries (SCIs) often encounter bowel and bladder issues due to the disruption of nerve pathways responsible for controlling these functions. The resulting complications can significantly impact the quality of life and require ongoing management and care.

Bowel dysfunction is a common concern for individuals with SCIs. The extent of the dysfunction depends on the location and severity of the injury, and it can manifest as either constipation or fecal incontinence. Constipation may result from decreased bowel motility and sensation, making it difficult for the individual to sense the need to have a bowel movement or to pass stool effectively. Fecal incontinence, on the other hand, can occur when the injury impairs voluntary control over the anal sphincter. To manage bowel dysfunction, individuals with SCIs may follow a bowel management program, which may involve a combination of dietary adjustments, scheduled bowel movements, medications, and digital stimulation.

Bladder dysfunction is another common issue for individuals with spinal cord injuries. Neurogenic bladder, a condition where the bladder’s normal functioning is impaired, can lead to difficulties with urine storage or elimination. Overactive bladder can cause involuntary contractions and urinary incontinence, while an underactive bladder can lead to urinary retention and an inability to fully empty the bladder. To manage these issues, individuals with SCI’s may use various techniques, including intermittent catheterization, indwelling catheters, or external collection devices. In some cases, medications or surgical interventions may be necessary to improve bladder function and prevent complications.

Both bowel and bladder dysfunctions can increase the risk of complications such as urinary tract infections, kidney damage, and pressure ulcers.

Chronic Pain

Following the inability to walk and bowel or bladder dysfunction, a significant number of individuals with SCI consider chronic pain as a very disabling complication. Chronic pain is defined as pain persisting for 6 months or more and having the potential to disrupt physical functioning beyond the already terrible parameters imposed by a spinal cord injury. Individuals with spinal cord injuries often experience chronic pain due to the disruption of communication between the brain and the body. This happens because the spinal cord serves as a critical link for sending and receiving messages, and an injury can damage or block these connections. When the brain gets mixed or incorrect signals, it can lead to persistent pain or discomfort. The location and severity of the pain can vary greatly depending on the specifics of the injury. Some people may feel the most intense pain around the injury site, while others might experience it in areas below the level of injury. The severity of the pain can range from mild discomfort to debilitating agony, and it can have a significant impact on the individual’s quality of life. Chronic pain negatively impacts quality of life and interferes with valued life activities, such as employment, sleep, recreational and social activities, therapy, and ability to engage in household chores.

Sexuality

Suffering from an SCI can compromise the person’s ability to express sexuality and participate in satisfying sexual activity.

A spinal cord injury (SCI) can have a significant impact on a person’s sexuality and ability to have and enjoy sex. The extent of these effects varies depending on the severity and location of the injury, as well as the individual’s physical and emotional recovery process. Some common ways in which spinal cord injuries may affect a person’s sexuality and sexual function include:

1. Sensation: Depending on the level of the injury, an individual may experience reduced or altered sensation in the genital area, which can affect sexual pleasure and arousal. Some may have difficulty feeling or recognizing sexual stimulation, while others may experience heightened sensitivity in certain areas.
2. Erectile function: Men with spinal cord injuries may have difficulty achieving or maintaining an erection. This can be due to nerve damage, reduced blood flow, or other factors related to the injury. Some individuals may benefit from medications, devices, or other interventions to help with erectile function.
3. Lubrication: Women with spinal cord injuries may experience reduced vaginal lubrication, which can affect comfort during sexual activity. Using lubricants can help alleviate this issue.
4. Orgasm: Both men and women with spinal cord injuries may have difficulty reaching orgasm or may experience altered orgasms. The ability to achieve orgasm can be affected by changes in sensation, muscle function, and other factors related to the injury.
5. Fertility: Spinal cord injuries can affect fertility in both men and women. Men may experience reduced sperm quality, ejaculation difficulties, or other issues that impact fertility. Women may have irregular menstrual cycles or other reproductive challenges.
6. Body image and self-esteem: A spinal cord injury can result in changes to a person’s body and physical abilities, which may affect their body image and self-esteem. This can, in turn, impact their confidence and comfort in sexual situations.
7. Emotional factors: The emotional impact of a spinal cord injury, such as feelings of depression, anxiety, or grief, can also affect a person’s interest in and enjoyment of sex.
8. Communication and intimacy: A spinal cord injury may require couples to adapt their sexual activities and explore new ways of expressing intimacy. Open communication, creativity, and patience are essential in this process.

It is essential to note that people with spinal cord injuries can still have fulfilling sex lives. With proper support, education, and a willingness to explore different methods and techniques, individuals can continue to enjoy and maintain healthy sexual relationships. Working with healthcare professionals, such as rehabilitation therapists or sexologists, can help individuals and couples address and overcome sexual challenges related to spinal cord injuries.

Have you or a loved one suffered a Spinal Cord Injury?

If you or a loved one has suffered a spinal cord injury, whether in a car accident, motorcycle accident, as a pedestrian or in a bicycle accident – you have the right to pursue legal action against those were responsible. Although we can’t undo the damage you face,  we can fight to provide you with the compensation and financial security you need to begin healing and help go on with your life in the best manner possible.

Lalande Personal Injury Lawyers can help you recover compensation for pain, suffering and the loss of enjoyment of life. We can also help you recover compensation for present or future medical expenses that OHIP will not cover, your lost income and wages, and other associated costs to help protect you, your family and significantly improve your ability to reach maximum recovery. Call us toll-free today, no matter where you are in Ontario  at 1-844-LALANDE or local in the Hamilton / Burlington area at 905-333-8888 or fill in a contact form on our website today. Our personal injury lawyers would be more than happy to provide you and your family a free consultation, with no obligation, to inform you of your legal rights and your options concerning your motorcycle accident related injuries and losses.