SPINAL CORD INJURIES AND TETRAPLEGIA

Sensory and motor transmissions involving muscle movement are transmitted and received by the brain through the spinal cord. We talk about spinal cord injury when you have a spinal trauma that suddenly interrupts the flow of information, starting at the point where the injury occurs. As a result, the messages of movement, sensitivity, bladder and bowel control, breathing, sexual function as well as temperature and blood pressure control change instantly depending on the severity of the injury.

It is possible to distinguish two consequences according to the area in which the spinal injury occurs:

Conseguenze
	Tetraplegia	Paraplegia
Area of injury	Cervical Region C1 – C8	Thoracic Region T1 – L5
Condition	It causes the absence or limitation of sensitivity and movement to the four limbs, and in the area immediately below the injury.	It does not affect the function of the upper limbs.

Spinal cord injuries are classified as complete and incomplete by the scale defined by the American Spinal Injury Association (ASIA). Through this scale patients are classified according to their functional impairment as a result of injury. Patients are classified from A to D.

American Spinal Injury Association Impairment Scale
Patient classification	Classification	Consequences
A	Complete	No motor or sensory function is preserved in the sacral segments S4-S5.
B	Incomplete	Sensory function is preserved but no motor function is preserved below the neurological level and includes the sacral segments S4-S5.
C	Incomplete	Motor function is preserved below the neurological level; more than half of the key muscles below the neurological level have a muscular degree below 3.
D	Incomplete	Motor function is preserved below the neurological level; at least half of the key muscles below the neurological level have a muscle grade of 3 or more.

Let’s go into the details of the tetraplegia case. Tetraplegia is a paralysis that involves both movement and the senses. Underlying this condition, there may be brain or spinal cord damage. In this second case the problem is localized in the cervical part of the spine and involves a paralysis involving all four limbs and torso; thus causing a total or partial loss of function of the arms and legs.

Depending on the level of injury, the respiratory and motor functions of the person change.

Level	Respiratory Function	Motor Function
C1 – C4	Respiratory incapacity in the absence of mechanical ventilation	Total paralysis of the arms
C5	Difficulty in coughing up. Need for support in cleaning secretions	Paralysis of wrists, hands and triceps muscles
C6		Paralysis of wrist flexors, triceps and hands
C7 – C8		Muscle weakness in the hands resulting in difficulty in grasping and releasing the grip.

Tetraplegia, like other spinal cord injuries, is a complex medical and life condition, for which to this day, there is still no definitive and complete cure. The rehabilitation treatment for paralysis caused by damage to the spinal cord, allows over many months, a certain recovery of motor and sensory functions gone lost.

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