One in the same?

In this post, I’d like to talk about spinal injuries in general, but specifically how different they can be. Read on if you want to learn a little (or a lot) and be bogged down with really annoying medical terms!

I think one of the first things I need to explain is that I, despite having a spinal cord injury, am no expert on the subject. There are so many types of injury, so many nuances, that it would be impossible for me to even pretend to understand them all. Another point is that ‘better’ and ‘worse’ are really poor words when it comes to talking about injuries, as they are not comparable. As such, I’ll try my best to not compare anything, but if I do it’s purely to show the differences. I do not intend to cause any offence, or to discriminate against any injury etc. On that fun note, let’s dive in!

There are a few points I aim to cover in this post, which include spinal injury vs spinal cord injury, complete vs incomplete injury, and levels of injury. As I’ve said before the topic is so broad and far reaching it is impossible to cover everything; in fact I doubt there is anyone alive that could claim to be an expert in every part of the world of spinal injuries. That said, I do have a very rudimentary understanding, purely through sustaining my own injury and learning as I go.

So, where to start. Well, I guess at the back; more commonly known as the spine! I’ll mention a bit of basic anatomy, that way we’re all on the same page. The spine, in a very basic way, is a collection of little round bones known as vertebrae. These bones are sectioned into 5 groups: starting at the top there are 7 cervical vertebrae (which make up the neck), 12 thoracic vertebrae, 5 Lumbar vertebrae, the sacrum and the coccyx (which together form the back). The last two are solid, whereas the first three sections are separate bones, which is what allows us to bend and move freely.

If you were to break your back, chances are that it would be bone damage much like breaking your arm, and it would heal good as new. Whilst painful and obviously potentially dangerous, this is not the type of injury that will leave you paralysed. The problems start when the spinal cord, which runs through the middle of the bones, is damaged.

The spinal cord is essentially an extension of the brain, and carries the nerves that control the body. The nerves branch off at different levels of the spine, and the level at which the spinal cord is damaged dictates what type of injury occurs. So for instance if someone broke their back and damaged the spinal cord at the level of the 4th Thoracic vertebrae, the nerves which branch off below that level cannot send or receive messages from the brain, and therefore anything below the level of that injury is paralysed. Obviously the whole thing is a lot more complicated than that, however in basic terms thats how a spinal cord injury works.

The next part is complete vs incomplete injuries. This is a very complicated topic, but thankfully can be summed up in a very succinct way: a complete injury refers to a spinal cord injury in which the spinal cord is damaged to such a degree that there is no sensation or movement at or below the site of injury. An incomplete injury is still a spinal cord injury, however there is some muscle control and sensation retained at and below the injury level. Neither of the two is better or worse than the others, and they both come with their own set of issues. That said, no two injuries are the same. Two people with exactly the same injury can display vastly different signs and symptoms. With an incomplete injury, it is possible that the person will walk again, and may be able to live what is considered by many to be a more ‘normal’ life. However, incomplete injuries are still a spinal cord injury, and they are still a huge deal.

With both complete and incomplete injuries, there are a few common themes: difficulty in controlling the bladder and bowel, reduced touch sensation, and the need for long term, intense physio and rehabilitation. People with incomplete injuries often need the use of wheelchairs just as those with complete injuries do, and anyone with a spinal cord injury is just as valid as another whether complete or incomplete.

A final point I’d like to raise is that there are many causes for both complete and incomplete spinal injuries. When you imagine the reason behind someone becoming paralysed, chances are that you think of something traumatic like a car crash, falling off a roof, or something spectacular like a climbing accident. However, that’s not always the case, in fact it rarely is. Conditions such as infections, tumours, and many many other amount of things result in people having a spinal cord injury, and as such it is important to bare in mind that whether traumatic in nature or not, an SCI is a life changing event. There are complications during surgery, Cauda Equina Syndrome, genetic conditions… the list goes on and on.

I think that’s a good place to leave this post. I hope this has been somewhat educational (if you’ve made it this far) and I hope that it has been a small window into other people’s realities. If anyone has questions feel free to get in touch, whatever it’s about I’ll do my best to answer. There are some awesome charities to provide support and information, and I’m always happy to signpost. Take care folks!

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