What is Paraplegia: Paraplegic Facts and Definition

Introduction

Paraplegia, not to be confused with Hereditary Spastic Paraplegia (HSP), is an impairment in motor or sensory function of the lower extremities.

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When both legs and arms are affected, the condition is called Quadriplegia.

Paraplegia is usually the result of Spinal Cord Injury (SCI) or a congenital condition such as Spina Bifida which affects the neural elements of the spinal canal. The area of the spinal canal which is affected in paraplegia is either the thoracic, lumbar, or sacral regions. If both arms are also affected by paralysis, quadriplegia is the proper terminology. If only one limb is affected the correct term is monoplegia.

Immediately after the spinal cord injury, the loss of movement, sensation, and reflexes below the level of the spinal cord injury can occur. Sexual dysfunction and loss of bowel and bladder control may also occur, depending on where the spinal cord injury occurred and if the spinal cord was completely cut or partially cut.

The extent of the paralysis depends on the level of the spinal cord at which the damage occurs.

For example, damage to the lowest area of the cord may result only in paralysis of the legs, whereas damage farther up on the cord causes possible loss of control over the muscles of the bladder and rectum as well or, if occurring even higher, may result in paralysis of all four limbs and loss of control over the muscles involved in breathing.

While some people with paraplegia can walk to a degree, many are dependent on wheelchairs or other supportive measures. Impotence and various degrees of urinary and fecal incontinence are very common in those affected.

Diseases that cause paraplegia or quadriplegia include spinal tuberculosis, syphilis, spinal tumors, multiple sclerosis, and poliomyelitis. Sometimes when the disease is treated and cured, the paralysis disappears, but usually the nerve damage is irreparable and paralysis is permanent. Treatment of paraplegia and quadriplegia is aimed at helping to compensate for the paralysis by means of mechanical devices and through psychological and physical therapy.

Approximately 11,000 spinal cord injuries reported each year in the United States involve paraplegia. Such events occur as a result of automobile and motorcycle accidents, sporting accidents, falls, and gunshot wounds.

Due to the decrease or loss of feeling or function in the lower extremities, paraplegia can contribute to a number of medical complications to include pressure sores (decubitus), thrombosis and pneumonia. Physiotherapy and various assistive technology, such as a standing frame, as well as vigilant self observation and care may aid in helping to prevent future and mitigate existing complications.

As paraplegia is most often the result of a traumatic injury to the spinal cord tissue and the resulting inflammation, other nerve related complications can and do occur. Cases of chronic nerve pain in the areas surrounding the point of injury are not uncommon. There is speculation that the "phantom pains" experienced by individuals suffering from paralysis could be a direct result of these collateral nerve injuries misinterpreted by the brain.

Life expectancy for people with paraplegia is lower than normal, but has continued to increase over the years. Death rates are significantly higher during the first years after the injury than the later years. This is especially true as the severity of the injury increases.