Level of Injury / Severity of the Damage

More is Possible, 25.03.2024

Each individual right after a Spinal Cord Injury (SCI) will first experience the “acute phase”, which is defined to be the first 48 hours after the incident. The spinal shock happened -  a short period during which everything below the injury site goes quiet, all the communication stops cold, even if the spinal cord injury isn’t complete. [2]

This spinal trauma causes inflammation in the spinal cord  because normally inside exists a tightly sealed environment which now gets exposed due to the incident. The seal is called the Blood Spinal Cord Barrier; along with its counterpart, the Blood Brain Barrier, it protects your central nervous system from your own blood. 

The cells in your spinal cord and brain - the neurons and oligodendrocytes - have never met any of the cells in the rest of your body. They’re not ever supposed to come in contact with any of those cells, and certainly not with the cells that form your blood. [2]

This unusual blood flow into the Central Nervous System (CNS) causes a lot of trouble and the body reacts quite intensely to it and tries to stop this blood flow going on and on.

Astrocytes produce molecules that essentially build a wall around the damaged bit of the cord, and that’s the only thing that prevents the entire cord from becoming one giant injury site.[2] But nevertheless all this reactions of the body, even when stopped after a while, produce in the end the so called “Glial scar” which you might have heard of during Rehab or while talking to professionals.

The rehabilitation process for each individual basically starts right after this traumatic experience - but everyone starts from a different point and has a different potential and velocity for regeneration (recovery) → but everybody does have and that’s the most important thing not losing hope.

The most important factors that define the starting point of the individual regeneration process are:

  • Lesion hight (level of damage)
  • Severity of the damage (extend of damage)

Other factors which can have an effect on the regeneration process:

  • age
  • sex
  • how long post (after) injury
  • biology
  • frequent therapy and training
  • handling of the situation
  • believe in progress
  • environment

Level of injury (lesion height)

Depending on the height your spinal cord gets the “damage”, the effect on motor function, sensory and the autonomic nervous system can be more or less. Generally one can say, the higher the lesion the more parts of the body are affected but to keep in mind, that it depends as well on the extent of damage on the segment.

Vertebral segments and innervation of the musculature:

Level of injury severity of the damage_1

Severity of the damage (extend of damage)

Depending on how much the spinal cord is “damaged” on a certain segment, or several segments the loss of motor function and sensory and effect on the autonomic nervous system can be more or less severe.

Detail of vertebral body:

Level of injury severity of the damage_2

Horizontal section through a vertebral segment:

[1]

Level of injury severity of the damage_3

Citation Source Information

[1] The illustrated diagram provides a color coded overview of the general areas affected by the location of the SCI,https://sci-bc.ca/info-centre/spinal-cord-injury/, 2024

[2] Kate Willette, Don’t call it a miracle, 2014, Christopher & Dana Reeve Foundation