Is it common practice to offer amputation to patients recently suffering from a spinal cord injury?

Ok, this is something that I truly cannot wrap my brain around. I am a member of a disability-related message board and I recently posted a story about how a random guy asked me if I’d ever considered “cutting off my legs”, as it’d be so much easier to get around “without all that dead weight hanging off of you.”

Well I told this story as part of a thread entitled “Stupid things people say”. A short time after my post, a woman posts to tell me that it is not a stupid question at all. She says that her doctor, after her spinal cord injury left her a paraplegic, recommended amputation of her legs in order to make it easier for her to transfer in and out of her chair. She said the doctor didn’t think she’d be strong enough to do it with the weight of her legs.

Now this is one of the craziest things I’ve ever heard. How could a doctor do this?
In addition to removing any hope of any future cure or treatment, why wouldn’t a patient work on strengthening their upper body rather than just chopping off their lower body; in order to make transferring easier?:confused:

I always thought amputation was saved as a last-ditch, last-resort type action in order to save the life of the patient. I have never heard of “elective amputation” done in the name of “convenience”. Am I just totally out of it, or is such a thing part of mainstream medicine?

Oh, and by the way, this woman is from the U.K. I don’t know if this matters or not, I just thought I’d say so.

I bet that by the time we have the technology to fix a severed spinal cord, reattaching and/or regrowing new legs would be trivial.

I think I’ve only heard of this in a doctor-TV-show kind of context, but it makes a certain amount of sense, though it does seem to be very extreme.

This is really just WAGing, but could this person have additional complications that make it unlikely that she’d be able to become strong enough to move herself between chairs/bed/whatever without this procedure? I imagine a neck or shoulder injury, or a damaged arm (joint? elbow/wrist?) could make everything that much harder to do and there may be so much other rehabilitation that her upper body won’t reasonably be able to keep up with.

I wonder if an amputation would make the psychological part of recovering/adapting from a spinal cord injury that much worse, though? It seems that it would be that much more of a loss.

My sister-in-law is quadrapelegic and we’ve teased her about getting her limbs amputated (as we all get older, it gets harder and harder to transfer her in and out of bed/her chair/the car). I can’t imagine ever actually doing it, though. They don’t work but they’re still part of her.

From some Google search results it seems that it used to be more frequently indicated in the old days, to prevent the now-permanently-immobile limbs from becoming a possible source of ulcerations and circulatory problems. I would imagine this would be abandoned as patient care criteria evolved, but apparently it’s still in people’s consciousness…
…and yes, I’d have to believe there’d be a difference in how it hits someone to lose* use* of a body part, vs. losing it altogether.

An independent wheelchair transfer requires legs. The person pivots on his legs and swivels his butt into the chair. Requiring some arm strength.

I’ve seen physical therapists teach paraplegic patients while I was in rehab after knee surgery.

No legs at all. You’d have to be super strong. You’d have to lift the entire body with no pivot on the ground. Amputees learn to do it, but I can’t imagine anyone asking for their healthy legs to be removed.

:dubious: I don’t know you or your sister-in-law, or any quadrapelegics, but joking about that seems very wrong to me.

I don’t know. Humor is what keeps us all sane, esp. when something awful happens. Through my divorce and my injury (broken back) I and my friends upon my starting it made fun of my situation. Without the humor I don’t think I could have gotten through it.

My son (only 9 but still) will occasionally get my cane, limp around the house while holding his back an moan, doing a great impression of me. He isn’t doing it to be mean, just poking a little fun.

This thread seems appropriate.


I volunteered with a disability organisation when I was a teenager, and I did hear the same point that the OP posed quite a few times - probably more than the OP does, because these people were well-meaning and trying to be polite, so they’d ask me things they wouldn’t of the person with the disability.

They didn’t realise - and neither did I beforehand - that many quadriplegics have some ability to move their legs, just not enough to actually walk on. And even if you can’t use your legs in that way, they can at least provide some leverage. Also it looks better - and artificial limbs can itch like hell.

But my Grandad did have a lower limb amputation due to an old war wound leading to blood clots that would have got worse if his lower leg hadn’t been amputated. I also knew a few older people who had their lower limbs amputated to cut off, literally, the spread of cancer. These are also the kind of people where using the remaining limbs as levers is not as useful because the rest of the body is also kinda knackered.

It’s possible the older lady you’re talking about was thinking more about people like them, Ambivalid.

I don’t think you’d have to be quite that strong to move yourself about with just your arms if you don’t have your legs. Your legs make up a pretty good portion of your weight, nevermind being without both of them.

I think your arms would be able to adapt to the new strength requirements and it would not be outside the range of what regular gym goers are capable of with their arms.

But if you can think of the movements you’d usually need to make, then having something to push against/make an arc with would be helpful. It’d be far easier than catapulting yourself from place to place.

First of all, she’s not old. She’s in her forties. And if she had any complications involving her spinal cord injury that might have made amputation a more sane option, she didn’t mention them. She only said that her doctor “recommended” amputation upon learning of her paraplegia because of the reduction in overall bodyweight and the subsequent “ease” of transferring that would result.

Now what if the patient, for whatever peculiar individual reason, decided that they wanted such an amputation after a SCI? Would a doctor be obliged to perform such a draconian procedure?

I think it might, maybe, indicated in some instances where a paraplegic is also diabetic and is already suffering from peripheral artery disease. Under those circumstances, it would be extremely easy for one of the legs to take an unnoticed injury that became infected or gangrenous. They might also be at higher risk for bed sores or skin breakdown, especially if they were overweight.

I have no idea if a person were both paraplegic and morbidly obese if amputating the legs might lower the demand on their cardiovascular system or what.

On an anecdotal note, my mom had a cousin who suffered a terrible arm injury (caught in a baler? It was on a farm, at any rate), that destroyed the nerve at the shoulder. He couldn’t sense or move his arm in any way. Shortly after the accident, his doctor offered to amputate the arm, but he turned it down, because he wanted to remain as whole as possible. A year later, he asked the doctor to go ahead and amputate, because he kept damaging the arm - getting it caught in doors, lying on it too long while asleep, that sort of thing. He ended up happier with the arm amputated.

I’ve heard of elective amputations, but they were for different situations. In your case, (not you, but the one you presented, duh) it’s for convenience. In the ones I’ve seen in documentaries, it was for psychological issues. These were people who truly believed they weren’t supposed to have the limbs they wanted amputated in much the same way as someone who wants a sex change feels like they were born the wrong gender. I remember one person that wanted one (or both) leg amputated and decided to do it himself with a shotgun. Hoping that either he would take it off himself or the injury would be bad enough that it would have to be removed.
But like I said, this is something totally different.

Having said that, if the person wants it, can afford it and is of sound mind when they ask for it, I’m not sure if I could argue against it.

“He ended up happier with the arm amputated.”
Hmm. That’s interesting.

But doesn’t amputation, in and of itself, carry some fairly significant medical risks? I would think such a procedure would (and I thought is) be reserved for only medically necessary cases.

That was different though. She didn’t have her legs amputated to get rid of the dead weight, it was to get rid of an unnoticed bed sore that had infected her pelvic bone and left her with only a year or two to live.

Yes, but so does every medical procedure. Sure, having your leg or legs amputated is a much higher risk then, say, breast implants, gastric bypass or probably even sex reassignment surgery, but if someone is so depressed they’re willing to do it on their own with a shotgun, it’s probably for the better.

Anyways, it’s altogether different.

What you’re talking about is probably more akin to people that have those giant 100 or 200 pound tumors removed (though the tumors themselves may be life threatening, I’m really not sure).

So what you are saying is a doctor is obliged to perform a procedure if it’s something that the person wanting it is willing to do on their own? So if a person comes to a doctor and says “Doc, I’m so depressed I can’t take it anymore. If you don’t chop off both my feet and both my hands, I’m gonna do it myself in a meat grinder”, that doctor would be obliged to amputate this person’s appendages (assuming the financial aspects are in order)? That doesn’t seem likely.