Question about spinal cord injuries

I was wondering . . . whenever someone has a serious spinal cord injury and is paralyzed, you always hear that the degree of paralysis depends on how high or low the damaged vertebra is on the back. A person could be paralyzed from the hips down, from the chest down, or have no sensation whatsoever.

My question is, has there ever been a case where the paralysis has been localized above the waist area and was permanent? The patient could still walk but had issues above the waist? Is this a really stupid question? :dubious:

No question is stupid if you learn from the answer. My dad is a T-10 total so I have a bit of first hand experience.

The reason you don’t see such paralysys as you describe is because of how nerves are distributed. Pretty much everything branches off the spinal cord like in a tree structure. Sever or damage the spinal cord and the brain can’t communicate to anything that branches off on the other size of the injury from the brain. It can get a little more complex as some abdominal functions may have nerves that branch off physically higher than the injry point so you can’t just draw a horizontal line at the injry and say everyting south of the mason-dixon line will not work.

Damage somewhere else than the spinal cord could cause something like you describe but this is less likely in a spinal cord injury.

The nerves carry signals from the brain to the rest of the body. When the spinal column is injured, the nerves can’t signal through the injury, so only the parts of the body between the brain and the injury will function properly.

Occasionally, after injury to the spinal cord, a condition called syringomyelia develops. Very often, this causes weakness in the hands and arms but spares the legs. So, in a way, this gives an affirmative response to your question.

I know a fellow who injured his spinal cord in the neck with a herniated disk, which temporarily paralyzed his arm but left the rest of him working. I think the disk was crushing the nerve root where it branches off from the spinal cord, and am not quite sure what by definition “spinal cord injuries” includes, so I am not certain if this is within your OP question, but am inclined to think so. As far as “permanant” goes, though, he got the use of his arm back by surgical fusion of two cervical vertibrae, and I understand he wouldn’t have gotten it back otherwise.

If you visualize the spine as a freeway with a series of ramps, that’s roughly how it’s set up. There’s two generic scenarios - the first is for an accident on the freeway blocking all traffic. The second is for an accident at a ramp stopping traffic from taking that ramp, but traffic on the freeway continues.

With the spine, the first scenario would be what Padeye’s father has - his spinal cord has been severed at the T10 level - roughly around the level of one’s navel. Nothing’s getting through, so the legs aren’t working. Probably as a self-preservation means, most of the abdominal functons such as bowel and bladder control come from higher-up connections.

I’m a walking example of the second scenario. A neck injury seven years ago left me unable to use my left arm for a while - I had a string of herniations from C4-5 to C7-T1. The spinal cord itself was fine, but the off-ramps were blocked. With time and patience, the herniations reduced to the point that the off-ramps were passable, but cars were getting scratched and dented trying to squeeze past the wreckage. In other words, the arm is usable for the most part, but there’s numbness, tingling, and occasional loss of function.

FWIW my dad’s spinal cord wasn’t severed but injured by a blood clot after spinal fusion surgery in a different area.

I suppose I overlooked that a disk injury can press or damage the nerves branching out. My wife had that happen when a ruptured neck disk caused severe arm pain.

I’m a T5 paraplegic. (T5 is called the “nipple line” though I have function down to the very top part of my stomach muscles, about T7). The “T” stands for thoracic vertebrae. The vertebrae in the upper part of the spine are called “cervical,” followed by thoracic, and than lumbar is the lower part of your back.

The spinal cord can be injured in different ways, and usually are referred to as “complete” (meaning there is no function below the injury site). A complete injury can result from a severed spinal cord, or a bruise bad enough to prevent signals from getting through. An incomplete injury is when there is some sort of function, such as movement or feeling, below the injury. I’ve heard that whatever level of function one has a year after injury is a likely indicator of what that person is stuck with for life. Then again, there are (rare) stories of people regaining function several years after.

Some people get a little function back, some get a lot, some get none. It all depends. Nerves are weird, but anything is possible.