Paraplegia also refers to as partial paralysis is a form of impairment in function from the waist down. There is usually a deficit in sensation and loss of movement in the legs and pelvic region caused by an injury to the spinal cord, brain or both.
Injury to the spinal cord prevents information from traveling through the spinal cord resulting to the inability of the brain to send signals down to the part below the injury or receive signals coming from below the spinal cord.
It can sometimes be classified as complete and incomplete paraplegia; there is a total loss of ability to move the limb in complete paraplegia whereas the limb can still be move to a certain degree in incomplete paraplegia.
Causes of paraplegia
The spinal cord basic function is to relay information to and from the brain. Paraplegic people have perfectly healthy limb but suffers the loss of information along the pathway as the messenger which is the spinal cord suffers a deficit. The Majority of paraplegic cases are a result of the following:
Car and motorcycle accidents: Over forty percent (40%) of cases of paraplegia are due to motor vehicle injuries.
Falls: About a third of the cases are due to fall, noticed more in postmenopausal women who have osteoporosis. A vertebral column affectation during fall can cause injury to the spinal nerve which explains the increased incidence seen with falls.
Gunshot wounds: Gunshot wounds to the back affecting the spinal cord, can also lead to lower limb paralysis. Other forms of violence like stabbing have also been shown to increase the incidence of
Iatrogenic causes: About 5% of cases are attributed to accidental injury to the spinal cord during surgeries.
Congenital causes: the condition can also be caused by a congenital condition like spinal bifida –a birth defect where there is an incomplete closure of the backbone and surrounding membrane. In birth defect, the paraplegia will be noticed from childhood and can actually resolve with correctional birth defect surgery.
Stroke: this is the commonest cause of non-traumatic paraplegia, a patient with stroke often present with loss of a side of the body or loss of both lower limbs movement.
Alcohol addiction: There have been cases of a direct link between alcohol addiction and paraplegia; much is however left to be understood.
=>> Read More : Spinal Cord Anatomy
Symptoms of paraplegia
The symptoms include
Loss of movement: The primary symptom is an inability to move structures below the waist.
Unexplained sensations: Some patients often complained of unexplained sensation in the affected part. It is often describe as a feeling of numbness, tingling sensation or pins and needles; others complain of feeling movement across their body.
Loss of sensation: The site above the injury is usually unaffected while the site below can have a total loss of sensation. This can often lead to inadvertent injury to the limb.
Loss of bladder and bowel functions: Paralysis to the pelvic muscles causes loss of control of the bowel and urination which results in fecal and urinary incontinence.
Treatment of paraplegia
A lot of researches are still ongoing on the spinal cord. Science is still yet to understand how to fully tackle problems of the spinal cord with limited success marring spinal surgeries. Proper treatment can affect the outcome of paraplegia.
Though, much is still yet to be understood as to why some patient can recover fully even without treatment and some others have worsened condition with treatment. Available treatment however includes:
Medications: To decreased risk of a superimposed infection like urinary tract infection, this is usually seen because of ongoing urinary incontinence. Drugs can also be given to abate inflammatory process.
Surgery: Surgical removal of the tumor can release the cord leading the restoration of function. It might also be done for decompression in patients with spinal cord compression syndrome
Physiotherapy: Majority of affected people shows improvement in function with physiotherapy. Physiotherapy also alt progression and prevents muscle wasting.
Occupational therapy: Paraplegic can lead to significant restriction and the majority of affected people needs a change in occupation. An occupational therapist helps in learning new skills.
Psychotherapy: Psychotherapy helps to combat social and behavioral meltdown.