How does a spinal cord injury affect the body?

What happens to the body when the spinal cord is injured?

Spinal cord injuries (SCI) result from damage to the vertebrae, ligaments, or disks of the spinal column or to the spinal cord itself. A traumatic SCI may stem from a sudden blow to the spine that fractures, dislocates, crushes, or compresses one or more vertebrae.

When an SCI occurs, the spinal cord starts to swell at the damaged area, cutting off the vital blood supply to the nerve tissue and starving it of oxygen. This sets off a cascade of devastation that affects the entire body, causing the injured spinal tissue to die, be stripped of its insulation, and be further damaged by a massive response of the immune system.

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How does a spinal cord injury affect the body1) Blood flow. The sluggish blood flow at the injury site begins to reduce the flow of blood in adjacent areas, which soon affects all areas of the body. The body begins to lose the ability to self-regulate, leading to drastic drops in blood pressure and heart rate.

2) Flood of neurotransmitters. The SCI leads to an excessive release of neurotransmitters, or biochemicals that let nerve cells communicate with each other.

These chemicals, especially glutamate, overexcite nerve cells, killing them through a process known as excitotoxicity. The process also kills the vital oligodendrocytes that surround and protect the spinal axons with the myelin insulation that allows the spinal nerves to transmit information to and from the brain.

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3) Invasion of immune cells. An army of cells of the immune system speeds to the damaged area of the spine. While they help by preventing infection and cleaning up dead cellular debris, they also promote inflammation.

These immune cells stimulate the release of certain cytokines that, in high concentrations, can be toxic to nerve cells, especially those needed to maintain the myelin sheath around axons.

4) Onslaught of free radicals. The inflammation caused by cells in the immune system unleashes waves of free radicals, which are highly reactive forms of oxygen molecules. These free radicals react destructively with many types of cellular molecules, in the process severely damaging healthy nerve cells.

5) Nerve cell self-destruction. A normally natural process of programmed cell death, known as apoptosis, goes out of control at the injury site. The reasons are not known. Days or weeks after the injury, oligodendrocytes die from no apparent cause, reducing the integrity of the spinal cord.

Additional damage usually occurs over the days or weeks following the initial injury, because of bleeding, swelling, inflammation, and accumulation of fluid in and around the spinal cord.

How does a SCI affect the rest of the body?

After an SCI, many of the body’s functions may change dramatically.

The following issues may arise:

  • Bone loss
  • Obesity
  • Muscle atrophy
  • Pressure ulcers
  • Bladder/bowel disorders
  • Cardiovascular problems
  • Changes in sexual and reproductive functions
  • Pain
  • Depression and adjustment to illness
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In recent decades, individuals with an SCI have been gaining longer life spans, and the importance of understanding the impact of aging on the above issues has become increasingly evident.

What conditions are associated with SCI?

Spinal cord injury is associated with many secondary conditions that have significant impacts on medical rehabilitation management, long-term outcome, and quality of life.

Secondary conditions associated with SCIs include:

  • Breathing problems
  • Bowel and bladder problems, including overactive bladder and incontinence
  • Heart problems
  • Pressure sores
  • Sexual function problems
  • Pain
  • Blood clots
  • Impaired muscle coordination (or spasticity)
  • Pneumonia
  • Autonomic dysreflexia (or hyperreflexia), which causes a potentially lethal increase in blood pressure
  • Increased likelihood of certain cancers, including bladder cancer

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