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  University of Idaho
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  Psychology Dept.
  University of Idaho
  Design - P&D  CTI

First of all, you need to, if you haven’t done so, you need to review the anatomy of the spinal cord again to make sure you understand where all the different structures are.  You also need to remember is that the spinal cord has a variety of different things, including both gray and white matter  (Gray matter being places where you’re going to have integration of information, white matter primarily being particular pathways).

Spinal cord damage can also be very severe and can cause many, many problems.  The symptoms that one observes with spinal cord damage are basically correlated with the location of the damage.  In addition to that, we need to remember is that spinal cord damage oftentimes can be temporary and not permanent.  This often occurs due to swelling inside the spinal cord as a result of particular damage.  When swelling occurs, the structures are pinched, and you do not get the feeling or movement that you might experience.  But, after a period of time and the swelling goes away, the person may actually get improvement in a particular limb movement or sensation.  Usually, if you have damaged the spinal cord, after about six months what you have is what you will have forever. 

Now there’s a variety of different aspects in relation to spinal cord damage.  The first is shown in slide three and what is called the complete transsection.  Basically below the transsection, (that is a slice across all of the tissue), you get complete loss of sensation.  You also get complete loss of voluntary motor movement, and you can get complete loss of bladder and bowel movement.

However, usually what we have is seen on slide four.  That is what we call a partial transsection.  Here, some of the pathways are spared.  As a result, what you see are distinct patterns of damage or symptoms related to the particular damage.  For example, you might get ipsolateral weakness or muscle spasticity.  Or, you might get a loss of discriminative touch, or other things as well. The symptoms may also occur with tumors as a particular cyst begins to grow on the spinal cord.  Here the symptoms become more subtle and it takes you much longer to recognize there’s an actual problem.  Oftentimes, if you’re fortunate, the cyst grows outside of the actual spinal cord itself and begins to pinching the spinal cord.  As a result, you begin to have problems with things such as muscle weakness or something else.  If it’s within the spinal cord, you may get the same kind of symptoms, is that it’s much more difficult to treat. 

Well let’s talk about particular damage within each structure or each section of the spinal cord.  You can get a lot greater detail in some particular books such as Principles of Neuroscience by Kandal, and other medical books as well.  Well, let’s start talking about what you usually see.  Let’s begin with the damage in the cervical area.  If a complete transsection, what you usually see from damage in the cervical area is complete loss of functioning in the arms and legs (called quadriplegia).  However, oftentimes the damage occurs and the symptoms a person experiences depending upon where the damage is.  For example, if we have damage in C1 or C2 levels, you can get a loss of involuntary functions such as breathing and things like that.  In general, injuries above cervical four areas may require a ventilator just to keep you alive.  If you damage structures, say within the C5 area, you can, may have control over your shoulders and biceps, but no control over the wrist and hands.  While as we see in slide six, with C6 injuries you have wrist control but no hand function, while in C7 and T1 injuries, you can straighten your arms but you have problems with the hands and the fingers.  Again, the particular symptoms that one experiences are very distinctly related to where the damage is within the spinal cord. 

Well, let’s move on and talk about damage within the thoracic region.  Thoracic injuries usually affect the chest and the legs.  As you can see on slide seven, T1 to T8 injuries basically cause poor trunk control, but you also have good hand control, but finally you have poor abdominal muscle control.  This is what is what is called paraplegia.  With T9 through T12 injuries, oftentimes you have good trunk control and may have good abdominal control.  Your sitting balance may also be good.  So, again, the damage and the symptoms one experiences are going to be highly correlated with where the damage is within the spinal cord itself.  Again it depends on if you have complete or partial transsections, or how much damage you’re actually going to experience.

Let’s talk about damage within the lumbar and sacral regions.  As we see in slide eight, damage here usually results in some kind of decreased functioning within the hips and legs.  You also tend to have bladder and bowel problems, and you may also have sexual dysfunction problems as well. 

Within the L2 and L4 damage, you also have the loss of a knee jerk reflex, and generally get decreasing control of hips and structures within the legs as well.  In addition to the problems that I’ve described earlier, you can have a variety of other problems with spinal cord damage as well.  Some of these problems are listed in slide nine. You can have sexual dysfunction, you can have fertility problems (although female fertility tends not to be effected), you can have low blood pressure or the inability to regulate the blood pressure and you can even have the ability not to sweat below the level of the injury.  Some individuals may also experience chronic pain. 

So, in conclusion, and as we see in slide 10, the first thing you don’t want to do is damage your spinal cord.  So, you need to take precautions.  For example, don’t go jumping into the river unless you know how deep the water is.  And be careful when you’re driving the car, etc.  However, if you do damage your spinal cord, physical therapy work can often help immensely, and there’s a variety of good different programs that can help you.  There are also a variety of different support groups and support mechanisms as well.  In addition, there’s lots of research that’s been working on overcoming spinal cord injuries.  As you can see here, there’s the area of stem cell and computer research to help reintervate some of the neurons and the motor neuron areas.  The problem is that neurons often come from higher cortical areas.  This may cause you to have problems of getting the right structures to fire.  You also have other problems as well.  You have to find the right pathways for these neurons to get the reintervation back to get some kind of movement or sensation or whatever it may be. 

So in general, and I want to try to emphasize this again, make sure that you take care of your spinal cord.  It’s the only one you have and if you do damage it, usually the symptoms, the damage, and the problems you experience will remain with you for the rest of your life.

Well in the next section, we continue with different aspects of the nervous system and we begin to move into specific structures related to neurons.  Until then, we hope you have yourself a wonderful day and we will be looking forward to talking to you soon.