Life with Spinal Cord Injuries

According to the National Spinal Cord Injury Statistical Center, an estimated 291,000 people in the U.S. are living with a spinal cord injury.  Many of whom experience changes in both bladder and bowel function.

Spinal cord injuries don’t cause damage to the structure of the bowel and bladder, but disrupt communication between the brain and the two structures.  With damage to the spinal cord and its components, the ability to go as we please is no longer under our control.

What is the Spinal Cord?

Diagram of the spinal cord

The spinal cord is a long, tube-like structure running from the brain through the end of the spinal cord.  As part of the central nervous system, the spinal cord relays information between the brain and the rest of the body, playing a vital role in maintaining bodily processes.  

The spinal cord has four regions: cervical, thoracic, lumbar, and sacral.  Each region is responsible for communication within a different area of the body.  Therefore, the effects of a SCI depend heavily on which region the injury occurs.

What is a Spinal Cord Injury?

A spinal cord injury (SCI) is damage to the spinal cord which results in a loss of function and mobility below the level of injury. Injuries to the spinal cord can damage the spinal nerves and nerve cells, which will no longer carry signals between the brain and the rest of the body.  While some people with spinal cord injuries recover significantly, most live with long-term effects.

Spinal Cord Injury Causes

The main causes of SCI are:

  • Vehicle crashes
  • Falls
  • Violence
  • Sports
  • Medical/Surgical

Spinal Cord Injury Symptoms and Complications

People with spinal cord injuries may experience the following symptoms:

  • Loss of mobility
  • Paralysis
  • Loss of sensation
  • Muscle spasms
  • Sexual dysfunction
  • Loss of bowel and bladder control
  • Digestive problems
  • Respiratory problems
  • Severe pressure or pain in the head, neck, or back
  • Pressure sores
  • Abnormal lumps on the head or spine
  • Abnormal positioning of the neck or back
  • Burning sensation
  • Numbness or tingling
  • Changes in heart rate or blood pressure

Spinal Cord Injury Levels and Functions

We can characterize SCI in the following ways:

Is the injury complete or incomplete?

Complete vs Incomplete Spinal Cord Injuries

  1. Incomplete Injuries: some sensation or function below the level of the injury
  2. Complete Injuries: no sensation or function on both sides of the body, below the level of the injury

Which parts of the body are functioning?

  1. Quadriplegia: the most severe form of SCI, resulting in loss of sensation or function in all limbs 
  2. Paraplegia: loss of sensation or function in the lower half of the body
  3. Triplegia: loss of sensation or function in one arm and both legs, usually as a result of an incomplete SCI

Many people also refer to themselves as quad, para, and tri, respectively!

Where in the spinal column is the level of the injury?

  1. Cervical SCI (C1-C7)
    • The most severe injury type
    • Results in quadriplegia
    • Potential loss of sexual function, bladder and bowel control, respiratory function, sensation, and body temperature regulation
  2. Thoracic SCI (T1-T12)
    • Results in paraplegia
    • Potential loss of sexual function, bladder and bowel control, and core strength
  3. Lumbar SCI (L1-L5)
    • Results in paraplegia
    • Potential loss of sexual function, bladder, and bowel control
  4. Sacral SCI (S1-S5)
    • May result in a loss of sexual function, bladder, and bowel control, as well as leg and hip function

American Spinal Injury Association (ASIA) Impairment Scale:

The ASIA rates SCIs on a scale of A-E.

ASIA Impairment Scale spinal cord injuries

Spinal Cord Injuries Effects on the Bowel

Neurogenic Bowel Diagram

SCIs often affect the digestive system by causing a condition called Neurogenic Bowel. Neurogenic Bowel causes a loss of bowel function due to damaged connection between the brain and large intestine.  There are two types of Neurogenic Bowel:

  1. Reflex Bowel (occurs in injuries at or above T-12): results in fecal incontinence, in which waste is excreted involuntarily when the bowel is full; often occurs at inappropriate times
  2. Non-Reflex Bowel (occurs in injuries below T-12): waste excretion is not triggered naturally, only leaking out when the rectum is too full  

An effective Bowel Program can help manage Neurogenic Bowel.  Unique to each individual, Bowel Programs performed on a regular basis to cause a bowel movement. Programs may include changes in medication, diet, fluid intake, or exercise. 

Spinal Cord Injury Effects on the Bladder

Neurogenic Bladder Diagram

Similarly, Neurogenic Bladder is another common effect of SCIs.  You can read more about Neurogenic Bladder in our previous blog post, here. In short, there are two types of Neurogenic Bladder:

  1. Reflex Bladder (occurs in injuries at or above T-12): results in urinary incontinence, in which urine is excreted involuntarily when the bladder is full, often occurs at inappropriate times
  2. Non-Reflex Bladder (occurs in injuries below T-12): urine is not excreted, only leaking out when the bladder is too full

Therefore, people with these bladder problems find alternative ways to empty their bladder. These alternatives may include urinary catheters, medications, surgical intervention, or electrical stimulation therapy.

Leaving urine in the bladder for too long can cause a variety of complications such as UTIs, bladder damage, bladder stones, and kidney damage. Fortunately, many people with SCI have found that inserting a small tube called a catheter, into the bladder, is an effective way to manage this problem. 

There are three main types of urinary catheters:

  • Intermittent Catheters: allows users to self-cath (catheterize by themselves) by inserting a catheter multiple times a day to drain the bladder either directly into the toilet, or into a bag
  • Foley Catheters (Indwelling): inserted by a professional and left for long periods of time, draining into a bag to collect urine.  One type of indwelling catheter is a subrapubic catheter, which you can read more about here.
  • Condom Catheters (External): a male catheter, worn like a condom which is then connected to a bag to collect urine.  Read more about condom catheters here.
compactcath intermittent catheter
CompactCath’s Intermittent Catheter

 

Moreover, many people choose to self-catheterize as it offers the most independence compared to other forms of catheterization. For those looking to self-cath, CompactCath’s discreet, easy-to-use, intermittent-catheters are a great option! CompactCath is the only 16”catheter that comes pre-lubricated, fits in the palm of your hand, and is 100% non-touch! Click below for a free sample box of our award-winning catheters.

compactcath free samples

Living with Spinal Cord Damage

Meet Daniel: “An Emergency Medicine Physician, business leader, healthcare innovator, patient advocate, and wheelchair user” among much else, Daniel lives with a T7/8 SCI after a mountain biking accident in 2017. Since then, Daniel has not only learned to navigate the effects of his injury, but also use it to accomplish more both personally and professionally.

Meet Misty: While Misty’s spinal cord damage comes from a neurological condition rather than a SCI, she faces many of the same challenges.  A talented wheelchair basketball and sled hockey, Misty is now training in hopes to one day make the U.S. Women’s National Sled Hockey Team!

Meet Tamara: An award-winning “bilingual motivational speaker, actress, host, model, ambassador, survivor and eternal optimist”, Tamara has created a platform for herself after a car accident that left her with a T2 SCI. Tamara is widely recognized for her advocacy as she continues to inspire people to reach their full potential.