Paraplegia

Paraplegia affects the motor and sensory function of the lower extremities, which prevents a person from walking. Paraplegia affects many people and substantially changes their lives by causing loss of function in the lower body.

Traffic collisions, fall from height cause many spinal cord injuries that result in paraplegia. Men between 21 and 35 years old have the highest risk of traumatic paraplegia. People with spinal cord injuries face more health challenges than others. On top of that, they have a higher chance of compared to people without such injuries. This article explains everything about paraplegia - what it means, its types, symptoms, causes, and treatments to help you understand this condition that changes lives.

What is Paraplegia?

Damage to the thoracic, lumbar, or sacral segments of the spinal cord causes paraplegia. The brain cannot communicate with the lower body, which prevents voluntary movement of toes, feet, legs, and sometimes the abdomen.

Paraplegia Types

Two main classifications exist:

• Complete paraplegia: Total loss of function, sensation and control below the injury level with lower and bladder involvement
• Incomplete paraplegia: Some movement or sensation remains despite partial loss of function

The muscles respond in two distinct ways:

• Flaccid paraplegia: Muscles become limp and lose function, muscular laxity
• Spastic paraplegia: Muscles experience uncontrollable contractions with stiffness

Symptoms of Paraplegia

Common signs include:

• Lower extremities loss of  movements
• Sensation decreases or disappears below the injury level
• Bladder and bowel control become difficult
• Cervical
• Sexual disability

Causes of Paraplegia

Major causes include:

• Vehicle accidents account for the majority of spinal injury cases
• Falls also cause paraplegia in most older adults
• Sports injuries, diving pose special risks
• Violence including gunshot wounds
• Medical conditions such as tumours, infections, or stroke

Risk of Paraplegia

• Males between 15-35 years face the highest risk. 
• Alcohol plays a role in 25% of injuries. 
• High-impact sports participation create additional risks.

Complications of Paraplegia

Patients experience several long-term challenges: 

• Urinary tract infections 
• Pressure sores 
• Spasticity or laxity
• Respiratory problems
• Chronic pain
• Psychological challenges 

Diagnosis 

Doctors use several diagnostic tools to evaluate patients with suspected paraplegia. The doctor starts with a complete neurological assessment to check reflexes, muscle strength, and sensation below the injury site. Standard medical imaging tests include:

• MRI scans to visualise spinal cord damage, tumours, or inflammation
• CT scans to detect bone fractures, bleeding, or spinal stenosis
• X-rays to identify vertebrae misalignment or fractures
• Electromyography to measure nerve and muscle responses

Paraplegia Treatment 

No cure exists for paraplegia, but several approaches help manage symptoms and improve quality of life. These include:

• Physical therapy helps strengthen the muscles a person still has. It also helps stop muscle wasting and keeps the body flexible.
• Patients learn adaptive techniques for daily tasks through occupational therapy, often with support from assistive devices like wheelchairs or braces.
• Medical treatments include: 
  • Surgery to relieve spinal compression
  • Medications for pain and muscle spasms
  • Nerve stimulation therapy. 
• Psychological support helps patients deal with emotional struggles.

When to See a Doctor

Emergency care becomes essential for any suspected spinal injury. Moving someone with a potential neck or back injury should only happen if absolutely necessary. You need to see a spine surgeon right away if you feel your legs weaken, lose feeling or struggle to move. Getting treated fast can stop more complications from happening. 

Conclusion

Living with paraplegia presents plenty of challenges, and learning about the condition is the first step to adapting to a new life. Life can change in an instant when spinal injuries affect mobility forever. Young men are at higher risk, especially when they participate in vehicle-related activities or sports.

People with paraplegia can achieve fulfilling lives with detailed treatment plans. Physical therapy helps build strength, and occupational therapy teaches essential daily living skills. Assistive devices provide independence and help people direct their lives in different but effective ways.

Medical science advances treatment options each year. Scientists study promising technologies such as exoskeletons, stem cell therapies, and nerve stimulation that could restore function or reduce symptoms. Early intervention is vital to prevent complications and enhance quality of life.

If you notice sudden weakness, numbness in your body or difficulty moving, visit a doctor right away. Quick action helps prevent damage and improves the chance of recovery later on. Knowing this helps people respond smarter in emergencies and support those who live with paraplegia daily.

FAQs

1. Is paraplegia curable?

Right now, doctors haven't found a complete cure for permanent spinal cord damage. Research in stem cell therapy and nerve regeneration shows promise for the future. The damage usually can't be reversed, but treatments can help manage symptoms. Patients can improve their quality of life through rehabilitation and adaptive technologies.

2. Can you still walk with paraplegia?

Some people with paraplegia can walk with support. Patients with incomplete injuries might get some function back because some neural pathways remain intact. Some use leg braces and crutches, while others get help from electrical stimulation devices in their lower backs. Each person's chance of recovery depends on how severe their injury is and their personal circumstances.

3. What is the most common complication of paraplegia?

Pressure ulcers (bedsores) are the most common problem. Other common issues include:

• Urinary tract infections
• Thrombosis
• Breathing problems
• Chronic pain
• Autonomic dysreflexia
• Depression 

4. How long is the recovery for paraplegia?

Most recovery happens in the first six months after the injury. Patients can see improvements for up to 1-2 years. Each person's recovery path is different based on:

• How bad the injury is
• Location of injury
• Patient's health before the injury
• How consistent are you with rehabilitation 

5. What is the difference between quadriplegia and paraplegia?

Paraplegia affects the lower body (legs and sometimes trunk) but leaves arm function intact. Quadriplegia (tetraplegia) causes paralysis below the neck and affects all four limbs. Injuries below the cervical spine usually cause paraplegia, while neck injuries lead to quadriplegia.

Dr. P Venkata Sudhakar

MS Ortho (AIIMS), Mch Spine Surgery (AIIMS) Fellow, Endoscopic Spine Surgery (Asian Spine Hospital, Hyderabad)
CARE Hospitals, Health City, Arilova, CARE Hospitals, Ramnagar, Visakhapatnam

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