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Depending on the amount of damage done to the spinal cord in a traumatic spinal cord injury, patient can suffer tingling, weakness, spasticity, or even complete paralysis. If the entire substance of the cord is thoroughly injured, the patient will have no motor or sensory function below the level. But if it’s a more subtle, mild injury, they may have tightness of the muscles, some difficulty with coordination, slowing of their walking, tingling and unusual sensations in their hands and feet. If a cervical injury occurs above the level of C3, this can affect the cell bodies which drive the phrenic nerve, or the phrenic nucleus. Phrenic nucleus lives very high in the cervical spinal cord or low in the brainstem. And an injury at this level can interfere with a patient’s ability to take a breath. When this happens, there are surgical procedures to assist with this. Sometimes the nerve can still be stimulated, but the brain can no longer control it.
If this is the case, a phrenic nerve stimulator can be placed and the patient can develop normal breathing artificially by an implanted stimulator and be detached from the ventilator. In other cases, the nerve itself is destroyed, in which case a nerve transfer can be undertaken below the level of injury, transferring the intercostal nerve to the phrenic nerve, and then the stimulator can once again be used to drive the diaphragm and set the patient free from the ventilator. A spinal cord injury is a serious injury resulting in significant loss of function. These can be mild or a patient has some difficulty walking or they can be complete and severe, where a patient is left in a wheelchair requiring significant assistance for the rest of their lives. Almost all of these injuries can be improved by reconstructive procedures. The highest injuries can help get a patient off a ventilator, while slightly lower injuries can reconstruct hand function and triceps function, giving the patient a degree of independence. The patient who’s walking after spinal cord injury but this is impaired, can undergo procedures to improve their walking. There are a number of things that can be done for a patient who has suffered functional loss due to spinal cord injury today, to improve their function and augment their quality of life.
