Paraplegia Medical Negligence Solicitors - Injury Compensation Lawyers
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Paraplegia is the medical condition that happens whenever there is a disruption of the motor and sensory nerves of the lower extremity and possibly part of the trunk. It is to be distinguished from quadriplegia in which there is injury to nerves supplying both the upper and lower extremities. Paraplegia is generally caused by a traumatic injury to the spinal cord but can be caused by tumors or a stroke in the spinal cord. Injuries to the thoracic, lumbar, or sacral areas of the spinal cord can result in some form of paraplegia. In some cases, only one limb of the lower extremity is involved in a condition called �monoplegia�.
Most paraplegia is of the spastic variety, meaning that the joints are stiff and do not move easily. A small proportion of paraplegic cases are affected by flaccid paralysis, in which the muscles are weak and the person�s extremities are floppy.
In paraplegia, there is generally a loss of sensation and movement to the lower extremities. The spinal cord undergoes structural changes so that they are unable to conduct nerve impulses to and from the legs. Alternatively, there can be a complete loss of spinal nerves at a certain level. This can result from severing the spinal cord in a motor vehicle accident, gun shot wound, or knife wound to the back.
The major symptoms of paraplegia are a complete loss of sensation and volitional movement of the legs on both sides of the body. If there is an injury above T-8, can still be some function of the hands but it is still considered paraplegia if some aspect of arm function persists. Truncal balance is poor if any part of the thoracic spinal cord is affected. This also means a lack of abdominal control as well. Injuries from T9 to T12 mean that truncal control is retained. If there is a lumbar or sacral injury, the hip flexors are damaged and the person might have some difficulty sitting properly in a chair.
Every part of the body is affected by certain spinal nerve levels. If there is damage or loss at a certain level, there will be loss at that level and below that level. Here is an outline of what you can expect:
- Injuries between C2 and C8 result in quadriplegia.
- Injuries at or below T1 result in paraplegia with small movements of the hand possible.
- Injuries to T1 to T12 mean that varying degrees of the trunk are affected along with both legs.
- At T10-L2, a man can still get psychogenic erections.
- Injury at L2 means you may still be able to bend at the hip.
- Injuries at L1-L4 affect thigh extension, knee extension and thigh adduction.
- Injury at L4, L5 and S1 affect thigh abduction, dorsiflexion of the foot, and extension of the toes.
- Injury at L5-S2 means you may still have plantar flexion of the foot, flexion of the toes and hamstring function.
- Damage at S2-S4 means that there can be no reflexive erection.
- S3, S4, and S5 govern the bladder and bowel function. Damage above these levels means you lose these functions.
When you become paraplegic, this is not the end of all your medical troubles. There can be pressure sores caused by sitting or lying in one place for too long. This is called having decubiti. You can also get blood clots in the veins of the lower legs, called deep vein thromboses. These can lead to breaking off of a clot where it travels and lodges in the lungs, a condition called a pulmonary embolus. Pulmonary emboli can be fatal. There can be chronic bladder infections and chronic bowel problems. Pneumonia can result from inadequacy of the breathing musculature. Sexual dysfunction is common in men but women have normal fertility and can participate in sexual activity. New technology and standing frames have made it possible for paraplegics to stand and make steps, reducing some of the complications of the disorder.
When the paraplegic sustains his or her injury, there is secondary inflammation and the individual can get chronic nerve pain at the site of the injury. Phantom pain is common in people who have paraplegia. It is believed to be secondary to collateral nerve injuries that have become misinterpreted by the brain.
The ASIA scale measures the level of impairment a person who has a spinal cord injury:
- �A� is a complete injury in which there is no sacral sensory function preserved.
- �B� is an incomplete injury in which sensory function but not motor function is preserved below S4-S5.
- �C� is an incomplete injury in which there is motor function preserved below the damaged neurological level and there is a muscle grade less than 3.
- �D� is an incomplete injury in which motor function is preserved below the damaged neurological level and at least half of the muscles are grade 3 or more.
- �E� is considered normal.
The treatment of paraplegia is largely supportive and depends on their degree of disability. The goal is to regain as much functionality as possible and to try and regain independence despite the injury. Patients spend many hours with physiotherapists like physical therapists and occupational therapists to learn ways to be functional at home and at work. They work on upper body strength, range of motion, lower extremity stretching and skills in transferring. Almost all paraplegics will be wheelchair bound for the rest of their lives and will need to adjust to life that way. Upper extremity strength is a must for them to be able to transfer into and out of a wheelchair and into a bed. Activities of daily living need to be learned all over again as the person learns how to be a paraplegic and still functional in society and the community.
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here