A traumatic incomplete spinal cord injury occurs when the individual retains some function below the level of injury instead of complete and total paralysis. This may lead to a better prognosis and increased chance of recovering function in the lower body. Suffering from an incomplete spinal cord injury can be a challenging and traumatic time in the individual’s life. While the prognosis may be more optimistic, there is still a significant amount of pain and suffering involved in the recovery process. Further, incomplete spinal cord injuries can be difficult to cope with as there is less information and research available for assistance. Understanding the nature of your spinal cord injury is an essential element of your recovery. As Hamilton spinal cord injury lawyers, we have seen many individuals cope with these injuries and have come to understand the resources they need to ease various aspects of their recovery.
Essentially, the severity of the damage to the spinal cord, in addition to its location, will dictate how much paralysis a victim will experience. More specifically, spinal cord injuries are referred to as “complete” or “incomplete” depending on the extent of paralysis.
With a complete spinal cord injury, there is a total disruption of communication between the brain and the rest of the body at the level of damage; no messages can be relayed up or down the spinal cord below the point of injury, to or from the rest of the body, so all voluntary movement and sensation beneath that level is eliminated. Many people assume that the cord must be severed for someone to have such a catastrophic injury, but this degree of paralysis can occur even with just a bruise to the cord. Complete injuries will almost always result in some loss of sexual ability and changes in bowel and bladder control.
With incomplete spinal cord injuries, because the damage is only partial, some exchange of information is still possible between the brain and various body parts through the spinal cord. Subsequently, some motor messages can still get past the area of damage to the arms and legs, and some information about sensation can travel up and be received and interpreted by the brain. Only partial loss of movement and sensation results below the injured area. For example, an individual with incomplete tetraplegia will have some weakness in all four limbs but will still be able to move some muscles in his arms and/or even his legs. Incomplete complete spinal cord injuries offer the best chance for recovery, but how much function returns often depends upon the location and extent of the damage.
Incomplete spinal cord injuries vary in severity depending on the nature of the injury and the area of the spinal cord where damage has occurred. In some cases, motor function may be lost while sensory function is intact, or vice versa. This also affects prognosis and recovery options available.
As mentioned, a complete injury means that the patient has no preserved neurologic function below the level of injury. An incomplete injury means that some function is preserved below that level. There are multiple types of incomplete spinal cord injury, each determined by the area where the individual has been injured. Some are more common than others:
Anterior Cord Syndrome
Antrior Cord Syndrome is characterized by damage to the anterior spinal artery, anterior cord syndrome affects the front two-thirds of the spinal cord. It is the largest part of the spinal cord, and therefore the most commonly injured. With this particular injury, the individual experiences a loss of motor, temperature, and sensory function below the level of injury, while continuing to experience vibratory sense and proprioception.
Central Cord Syndrome
Central cord syndrome occurs when damage is inflicted on the cervical spine (neck), interrupting or compressing the corticospinal tract in the center of the spinal cord. As a result, the upper extremities (arms and hands) are often more affected than the lower body (legs and feet) and function becomes limited or cut off completely.
Posterior Cord Syndrome
The least common type of incomplete spinal cord injury, posterior cord syndrome occurs when the individual suffers damage to the dorsal (posterior) columns at the back of the spinal cord. Victims with this injury experience loss of vibration, fine touch, motor function, and proprioception below the level of injury.
Another extremely rare type of incomplete spinal cord injury, Brown-Sequard syndrome occurs when the individual suffers damage to half of the spinal cord. As a result, they experience different symptoms on each side of the body. The side of the body where the injury occurs undergoes paralysis and loss of sensation, while the opposite side generally experiences loss of temperature and pain sensation.
A conus medullaris injury occurs when damage is sustained at the lower end of the spinal cord, where it tapers in the lumbar region (lower back). It is an uncommon injury that results in loss of function in the lower body, primarily the bowels and pelvic region. While it does not always result in paralysis, weakness to the bladder and lower extremities is a characteristic.
Cauda Equina Syndrome
Similar to a conus medullaris injury, cauda equina syndrome occurs when the lower end of the spinal cord is compressed. Long-lasting consequences of cauda equina syndrome could include incontinence, bladder dysfunction, and potential paralysis of the legs. While it is a rare condition, individuals suffering from this condition must seek immediate and emergency medical attention to prevent long-term consequences.
Most doctors would agree that there are often too many variables and too many unknowns when trying to predict the prognosis for recovery after an incomplete spinal cord injury. The Journal of Spinal Cord Injury Medicine has many informative peer reviewed journals that offers some general guidelines on what to expect for recovery, such as:
1. The severity of the original injury determines whether or not recovery will occur. Unfortunately, there is no test available at this time to measure this severity and predictions must be based on what has happened to others in the past with similar neurological [nerve function] findings.
2. Incomplete injuries have a better chance of further recovery than complete injuries, but even with incomplete injuries there is no guarantee that any further recovery will occur;
3. Most of the recovery that will occur starts early (within the first few weeks). Therefore, each day that goes by without any return of function means that the chances for recovery is unfortunately less;
4. Sadly, no amount of hard work will make the nerves return;
5. Whether or not you have surgery and whether or not you go to therapy are not what determine how much recovery you will have;
6. Rehabilitation will unfortunately not affect the degree of recovery. The purpose of rehabilitation is to improve function in self-care activities (such as dressing, transfers, and wheelchair (mobility) using whatever is available to work with. Since most recovery that will occur tends to start within the first few weeks after injury and by coincidence this is usually the same time therapy is being done, there is a tendency to think the recovery is due to the therapy.
Equally important is emotional therapy or counselling. No doubt, life is changed when one sustains a spinal cord injury. The injury will likely place tremendous strains upon one’s physical health, emotional health, relationships, career, finances, and a host of other life domains. People with spinal cord injuries and their families often become so overwhelmed that the best they can hope for is survival. Emotional therapy may be required for the individual to assist in managing their traumatic shock and psychological distress. This component is required for those who may be prevented from re-integrating into society due to psychological barriers.
Living well with a spinal cord injury can require a lot of rehabilitation, medical care, and special equipment. It also can require making changes to one’s home and work space. These services can be very expensive. If you’ve been hurt by the fault of another who was careless, there may no doubt be insurance coverage which we can pursue to help you live well with your spinal cord injury.
If you’ve suffered an incomplete spinal cord injury it’s vital that you speak to a spinal cord injury lawyer sooner rather than later to assist with the proper insurance funding of your return home, your case manager and occupational therapists and to assist with ensuring that your lifetime costs of care are set in place as soon as possible.
The Christopher & Dana Reeve Foundation have advised that victims with spinal cord injuries can expect to incur more than $1 million in renovations, transportation, rehabilitation, supplies, medical bills and living expenses during the first year alone. The lifetime cost of care can easily surpass $15 million for paralyzed victims which could involve such costs as:
– visits to non-physicians such as services provided by physiotherapists, occupational therapists, psychologists, nurses chiropractors;
– home me modifications and home accomodations for the person with an SCI in their homes and those of their families;
– non-prescription items such as non-prescription pain medication, catheters, dressings and bandages, laxatives, vitamins and rubber gloves;
– adaptive equipment includes breathing/handling aides (e.g. ventilators), mobility aids such as wheelchairs (manual, powered) and wheelchair replacement and maintenance;
– adaptive beds, hygiene aids (e.g. hospital beds, special mattresses, bed or bath lifts, commode seats) and;
– exercise and other miscellaneous items;
– home maintenance expenses;
We understand that a spinal cord injury can have dramatic effects on the person affected and his or her family – and that the financial cost of these injuries can be enormous, depending on the severity and location of the injury. If you need to speak to an experienced spinal cord injury lawyer, call us at 905-333-8888, or toll free where you are in Canada at 1-844-LALANDE or get in touch via our online contact form to book your free consultation now. We would be please to travel to you anywhere in Ontario or Canada to see you to dicuss your legal options, insuance and the costs of funding your life-long disability and recovery.