Paraplegia: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Paraplegia is a condition that affects the lower half of the body, resulting in loss of motion and sensation in the legs. It is usually caused by an injury or disease that damages the spinal cord or brain. A person with paraplegia may be negatively affected physically, mentally, and emotionally. The purpose of this article is to explain paraplegia, its causes, symptoms, types, diagnosis, treatment, and prevention.
Definition of paraplegia
A paraplegia is a type of paralysis that affects the lower half of the body. Paralysis occurs when the nerve signals traveling through the spinal cord, the main channel of communication between the brain and the body, are disrupted. The spinal cord is protected by the backbone, which consists of interlocking bone segments known as vertebrae. Each section of the spinal cord has several vertebrae and spinal nerves. The location and extent of spinal cord damage determine the level and severity of paraplegia.
There are two main ways that paraplegia can happen: complete and incomplete.
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Complete paraplegia means a total loss of function, including the ability to feel sensation and move. The person also cannot control automatic functions that rely on the spinal cord for relaying signals, such as controlling the bladder and bowels.
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Incomplete paraplegia means a partial loss of function. The person might still be able to feel or move some body parts below the injury, but usually not as strongly as before the injury.
There are also two main ways that paralyzed muscles act in paraplegia: flaccid and spastic.
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Flaccid paraplegia means that the muscles do not work at all and remain flaccid or limp.
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Spastic paraplegia means that the muscles do not work by themselves and contract uncontrollably.
Causes of paraplegia
The main cause of paraplegia is an injury to the spinal cord or brain, which prevents signals from reaching the lower body. When the brain cannot send signals to the lower body, it results in paralysis. There are many accidents that can cause paraplegia, including:
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Car accidents
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Falls
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Sports accidents
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Being the victim of a crime
Sometimes paraplegia is caused by conditions that damage the spinal cord and brain. These can include:
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Cerebral palsy
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Cancer
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Nerve conditions
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Multiple sclerosis
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Stroke
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Spinal tumors
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Brain tumors
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Hereditary spastic paraplegia, a rare genetic condition
Symptoms of paraplegia
The symptoms of paraplegia can depend on the person and on the severity of their condition. Some symptoms will be present right away and others might develop over time. Symptoms include:
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Loss of feeling in the lower half of the body
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Chronic pain
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Phantom pain in the lower half of the body
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Bladder and bowel trouble
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Difficulty walking and standing
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Weight gain
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Depression
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Sexual difficulties
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Skin breakdowns
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Infections
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High blood pressure
Types of paraplegia
Symptoms of paraplegia vary depending on how high or low the injury is in the spine. Paraplegia generally affects only the legs, but can also affect other parts of the lower body and some arm abilities. There are three sections in the spine: the thoracic (upper back), the lumbar (lower back), and the sacral (tailbone). Each section consists of several vertebrae and spinal nerves. Paraplegia can occur if any of these sections are injured:
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Thoracic spine (T): This section has 12 vertebrae and 12 spinal nerves. An injury in this section can affect your legs, abdominal muscles, chest muscles, and some arm abilities.
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Lumbar spine (L): This section has five vertebrae and five spinal nerves. The spinal cord ends at the first lumbar vertebrae, but several spinal nerves continue downward and exit between the vertebrae below. An injury in this section can affect your legs and hips.
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Sacral spine (S): This section has five fused vertebrae and five spinal nerves. An injury in this section can affect your legs, feet, genitals, bladder, and bowels.
The level of injury is indicated by a letter (T, L, or S) followed by a number (1 to 12 for the thoracic spine; 1 to 5 for the lumbar spine; 1 to 5 for the sacral spine). For example, T6 means the sixth thoracic vertebrae.
Diagnosis of paraplegia
If you are experiencing symptoms, a medical provider can assess your condition. You will generally need medical imaging tests to look for damage that might be causing your symptoms. They will take a detailed medical history and include any recent injuries or illnesses. Imaging tests include:
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MRI (magnetic resonance imaging): This test uses a strong magnetic field and radio waves to create detailed images of your spine and brain.
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X-ray: This test uses a small amount of radiation to create images of your bones and joints.
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CT scan (computed tomography): This test uses a series of X-rays to create cross-sectional images of your spine and brain.
The electromyography (EMG) test can also help determine the extent and location of nerve damage by measuring how the body responds to stimulation of affected muscles.
Treatment of paraplegia
There is no cure for paraplegia, but there are many treatments that can make it easier to manage. Treatment options include:
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Medications: These can help with pain, muscle spasms, bladder and bowel problems, depression, and other symptoms.
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Surgery: This can help repair or stabilize the spine, remove tumors or blood clots, or implant devices that stimulate the nerves or muscles.
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Physical therapy: This can help with strengthening, stretching, balance, mobility, and preventing complications such as contractures (stiff joints) and pressure sores (skin ulcers).
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Occupational therapy: This can help with daily activities, such as dressing, bathing, eating, and using assistive devices.
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Speech therapy: This can help with communication and swallowing problems, especially if the injury affects the chest muscles or the brain.
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Psychotherapy: This can help with coping with emotional and mental challenges, such as grief, anger, anxiety, and depression.
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Rehabilitation: This can help with adjusting to life with paraplegia, learning new skills, finding resources, and accessing support services.
Prevention of paraplegia
Many causes of paraplegia are related to accidents that can be avoided or minimized by taking safety precautions. Some preventive measures include:
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Wearing a seat belt and following traffic rules when driving or riding in a car
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Wearing a helmet and protective gear when riding a bike or motorcycle
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Avoiding diving into shallow water or unknown depths
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Using caution when climbing ladders or working at heights
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Playing sports safely and following the rules
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Avoiding violence and risky behaviors
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Seeking medical attention promptly if you have symptoms of a stroke or a spinal cord infection
An injury or disease affecting the spinal cord or the brain causes paraplegia, a serious condition that affects the lower half of the body. Paraplegia can negatively impact a person's quality of life, affecting their mental, emotional, and physical health. A person with paraplegia can, however, still lead a fulfilling and productive life with proper treatment and rehabilitation.
