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Medullar lesions to the spinal cord

THE SPINAL CORD

The spinal cord is part of the Central Nervous System (CNS). Its primary function is the transmission of neural signals from the brain to the limbs, trunk and organs of the body. It is made up of 24 verterbraes (plus 9 fused sacrococcygial verterbraes (=tailbone)

Cervical: 7 vertebrae (C1–C7)
Thoracic: 12 vertebrae (T1–T12)
Lumbar: 5 vertebrae (L1–L5)

The spinal nerves are connected to the spinal cord and provide motor and sensory functions to the limbs, sphincter and perinium

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After trauma, the spinal cord can no longer receive the neural signals sent by the brain below the level of the lesion, resulting in a more or less severe loss of motor and sensory skills.

On the other hand, the nerves located above the medullar lesion remain intact and continue to function normally.

Different functions are affected based on the neurological level of impairment of the spinal cord and on the extent of the injury

SCI POPULATION

There are currently 65,000 spinal cord injured in France. Each year, this number increases by approximately 1,500 new cases. Males represent three times the rate of females and the majority is between 20 and 30 years of age. Quadriplegics, who have suffered a cervical level of injury, make up 43% of SCI patient. Their four limbs are affected with some degree of paralysis, but they also suffer from intestinal as well as cardiovascular dysfunctions.

Paraplegics make up approximately 57% of the SCI population ; their level of injury is thoracic or lumbar : their arms are preserved, but their lower limbs are paralyzed. They also suffer from intestinal and cardiovascular dysfunctions.

There are two types of lesions of the spinal cord: complete lesions and incomplete lesions. In the case of a complete lesion, paralysis affects every part of the body located below the lesion.

In the case of an incomplete injury, only part of the spinal cord is damaged. In this case, some mobility or sensitivity can be maintained.

No only do most people with para- and quadriplegia have to use a wheelchair, but their handicap is also accompanied by less visible disorders, which are the source of many other difficulties or even complications.

RELATED DISORDERS include :

- pain. - sphincter, bladder and intestinal disorders
- genital & sexual disorders.
- respiratory disorders.
- stiffness called spasticity which causes pain.
- in some cases, a total disappearance of tone which is at the origin of significant muscle wasting and other related disorders.

In case of cervical and upper dorsal injury, people suffer from hypothermia in a cold environment, because the nerves are unable to transmit the signal of the cooling of the body to the brain. Extreme heat is also poorly tolerated, because SCI patients do not sweat below the level of the lesion, which prevents the body from cooling down properly.

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