Imagine, someone you know has been in an accident, and then they can't move or feel their legs. This is really scary and shocking, isn't it? This is the condition in which both legs and sometimes the lower abdomen lose their function, which is what we call Paraplegia in medicine. Although this is usually seen as a symptom, it can sometimes occur as a disease. So today, let's talk about everything in a simple way that you can understand.
What exactly is Paraplegia?
Simply put, Paraplegia is the inability to control the muscles in your legs, that is, paralysis. The main cause of this is damage to our nervous system, especially the spinal cord that runs through the spine. This spinal cord is like the 'main cable' that carries messages from our brain to the lower parts of the body, especially the legs. When this cable is damaged, the messages from the brain do not reach the legs. That is when the legs lose their function.
Depending on how this damage occurs, we can see two main types of paraplegia.
| Type of Injury | Description |
|---|---|
| Complete Injury | In this case, the spinal cord is completely damaged. This means that nothing below the point of damage can be felt or moved. Also, there is no control over bowel and bladder function. |
| Incomplete Injury | Here, the spinal cord has been partially damaged. Therefore, there may be some sensation or movement left in the areas below the damage. However, these things cannot be done if the person is as strong as they were before the accident. |
Also, there are two main types based on how the muscles work in this condition:
- Flaccid paraplegia: In this, the muscles are completely lifeless and flaccid. There is no tonus.
- Spastic paraplegia: In this condition, the muscles contract uncontrollably. The legs may be stiff and twitchy.
How do symptoms vary depending on where the back injury occurred?
This is a very important point. The effects of paraplegia depend on the level of the spinal cord that is damaged. Our spine is divided into several parts. These are the cervical part, the thoracic part, and the lumbar and sacral parts. Paraplegia is usually caused by damage to the thoracic (T), lumbar (L), or sacral (S) vertebrae.
See the table below to see how the effect varies depending on the level of damage.
| Location of Injury | Effect |
|---|---|
| Thoracic nerves between T1 - T6 | Complete paraplegia occurs. The muscles of the legs, hips, and abdomen lose their function. There is no sensation. There is loss of bowel and bladder control. At this level of damage, coughing and deep breathing may also be difficult. |
| Thoracic nerves between T7 - T12 | A complete paraplegia condition similar to the above occurs, but the chest muscles are not affected. Therefore, breathing difficulties are less. |
| Lumbar nerves between L1 - L2 | Here too, the legs are paralyzed. But the muscles of the chest and abdomen are not affected. A wheelchair is required for transportation. There may also be loss of bowel and bladder control. |
| Lumbar and sacral nerves between L3 - S5 | The damage to the lower back is more likely to be incomplete. At this level of damage, you may be able to walk with the help of braces or a walker . However, you may have some problems with bowel and bladder control. |
What are the main causes of paraplegia?
The main and most common cause of this condition is injuries to the spinal cord . These injuries can occur in a variety of ways.
- Car accidents: Three-wheeler accidents, bus accidents, and motorcycle accidents are very common in Sri Lanka.
- Falls: Especially from heights (trees, buildings). Also, due to osteoporosis in the elderly, even a simple fall can cause spinal damage.
- Injuries caused by sharp weapons: Things like stabbings or gunshot wounds.
- Sports accidents: In high-impact sports like rugby.
The most important thing is, if you suspect a back injury, do not try to move or lift the person for any reason. That will cause further damage. Call an ambulance immediately (1990).
In addition to these accidents, paraplegia can also be caused by other medical conditions:
- Spine tumors: Compression of the spinal cord due to cancer or benign tumors.
- Infections: The spread of infection to the spinal cord or the membranes surrounding it.
- Ischemia: A rupture or blockage of a blood vessel that supplies blood to the spinal cord.
- Congenital conditions: Birth defects of the spine structure, such as spina bifida.
- Other medical conditions: Autoimmune diseases such as multiple sclerosis, transverse myelitis, and Guillain-Barré syndrome.
- Diabetes Mellitus: Nerve damage caused by uncontrolled diabetes.
- Hereditary conditions: Genetic diseases such as hereditary spastic paraplegia.
What should we do in an emergency?
This is the part you need to remember. Paraplegia is a medical emergency that requires immediate treatment.
If someone is in an accident and says, "I can't feel my legs," or if you see something like that, call 1990 immediately and get an ambulance. Never try to lift, move, or sit the person yourself. Wait until trained professionals arrive and properly transport the patient to the hospital. The only thing you can do is remove the patient from the scene unless there is an immediate danger, such as a fire or explosion. Otherwise, leave them where they are. The doctors in the Emergency Treatment Unit (ETU) at the hospital will do what is necessary.
What is the difference between Paraplegia, Tetraplegia and Hemiplegia?
Although these words sound similar, they have three meanings. It's important to know this difference.
| Condition | Affected Area |
|---|---|
| Paraplegia | Loss of both legs (and possibly the lower abdomen). |
| Tetraplegia (or Quadriplegia) | Both arms and both legs , that is, the loss of all four limbs. This occurs when the spinal cord is damaged at the neck level. |
| Hemiplegia | Loss of consciousness on one side of the body (left or right). This means loss of consciousness on one side of the arm, leg, and face. This usually occurs due to damage to the brain, such as a stroke. |
When it comes to treatment, it depends entirely on the cause of the Paraplegia condition and the extent of the damage. Sometimes, some improvement can be achieved through surgery, physiotherapy, and rehabilitation. However, some damage is permanent. However, your doctor is the one who will best advise you on the most suitable treatment plan and next steps.
Paraplegia is a life-changing experience. However, with proper medical advice, rehabilitation, and mental strength, there are many people in the world who have adapted to this condition and live independent, happy lives.
Take-Home Message
- Paraplegia is the loss of function in both legs. The main cause of this is damage to the spinal cord.
- If you suspect a spinal injury from an accident, do not attempt to move the patient for any reason. Call an ambulance immediately.
- Paraplegia can be caused by accidents as well as various medical conditions. Therefore, it is essential to see a doctor about any paraplegia.
- Treatment options and recovery options vary depending on the cause and extent of the damage. Your doctor is the best person to consult with regarding this.
- Although this is a very challenging condition, with proper support and rehabilitation, it is possible to adapt to this condition and live a successful life.
👩🏽⚕️ Additional questions (FAQs)
💬 What kind of condition is Paraplegia?
This is not just a simple numbness in your legs! 'Paraplegia' is a very tragic condition in which both legs below the waist, either permanently or temporarily, become 100% paralyzed (Complete paralysis), leaving you unable to move your legs or feel anything. In this disease, you not only lose control of your legs, but also lose control of your bowels and bladder (Bowel and bladder incontinence).
💬 What are the main causes of paraplegia (paraplegia)?
The main cause of this is not the brain, but a 'severe spinal cord injury'! 1) This happens when the middle part of the spinal cord (Thoracic/Lumbar Spinal Cord) is completely broken/crushed due to a car accident, falling from a tree, or being shot (Trauma). 2) When a 'cancer' growing inside the spinal cord (Spinal Tumors) presses on the nerve. 3) Neurodegenerative diseases (Multiple Sclerosis) and, 4) Spinal stroke can also cause loss of leg function.
💬 What are the dangerous dangers faced by people with paraplegia? How can they be cared for?
The biggest danger is that they don't feel any pain in their legs (even if they get burned by hot water). So, when they stay in the same position, the skin on their buttocks rots away until the bone is visible, leading to 'bedsores/pressure ulcers' and the patient can die from the germs that spread from them (sepsis) (it is necessary to turn them every 2 hours). The other danger is the severe urinary tract infections (UTIs) that come with urinary catheters!
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