What is the difference between complete and incomplete spinal cord injury?

A spinal cord injury involves damage to the spinal cord, a bundle of nerves and nerve fibers that extends from the base of the brain to the lower back. The spinal cord transmits signals between the brain and the rest of the body. When an injury occurs, these signals are stopped or weakened, which affects sensation, movement, and other bodily functions below the level of the injury [1]. Spinal cord injuries are primarily classified into two types: complete and incomplete; this classification depends on the extent of the spinal cord's ability to send and receive messages to and from the brain.

Complete Spinal Cord Injury

A complete spinal cord injury occurs when the spinal cord is unable to send any nerve signals below the level of the injury. This means there is a total loss of motor and sensory function in the areas located below the injury site [1]. This results in complete paralysis in those areas. For example, if the injury is in the upper part of the spinal cord (cervical vertebrae), it may lead to paralysis of all four limbs (quadriplegia), whereas if the injury is in the lower part (thoracic or lumbar vertebrae), it may only affect the lower part of the body and the legs (paraplegia) [2]. In these cases, there is no muscle control, sensation, or function below the site of injury [2].

Incomplete Spinal Cord Injury

In contrast to a complete injury, an incomplete injury means the spinal cord is still able to send some messages to and from the brain. This means that the injured person may retain some sensation, function, or muscle control below the injury site [2]. The degree of this remaining function can vary significantly between individuals, as there may be some slight movement, partial sensation, or even the ability to move certain muscles to a limited extent. This type of injury often offers a greater opportunity for partial functional recovery through comprehensive rehabilitation programs.

Diagnosis and Immediate Treatment

A spinal cord injury is a medical emergency that requires immediate intervention to reduce long-term effects [1]. When a spinal cord injury is suspected at the scene of an accident, paramedics immobilize the neck and spine to prevent further damage [2]. Diagnosis includes neurological examinations to determine the extent of sensory and motor loss, in addition to magnetic resonance imaging (MRI), computed tomography (CT), and X-rays to detect fractures or other damage [2]. Initial treatment may include medication, the use of braces, or surgery to relieve pressure on the spinal cord [1].

Importance of Comprehensive Rehabilitation

Regardless of the type of injury, comprehensive rehabilitation plays a vital role in helping the injured person adapt and improve their quality of life. Rehabilitation aims to restore as much lost function as possible and develop strategies to cope with new challenges. You can learn more about this topic by visiting Spinal Cord Injuries: Comprehensive Rehabilitation and Adaptive Living (Arabic). The rehabilitation team typically includes physical and occupational therapists, specialized nurses, psychologists, and others [2]. The rehabilitation program depends on the extent of the individual's injury and includes exercises to strengthen muscles, improve fine motor skills, and learn to use assistive devices such as wheelchairs or electronic stimulation devices [2].

Warning Signs and When to Seek Emergency Help

A spinal cord injury is always an emergency. If you suspect someone has a spinal cord injury, it is essential to seek emergency help immediately. Warning signs that require urgent medical care include: severe pain or pressure in the head, neck, or back; weakness or paralysis in any part of the body; numbness or loss of sensation; loss of bladder or bowel control; and difficulty walking or maintaining balance [2]. The injured person should not be moved unless there is imminent danger, and one should wait for trained paramedics to arrive to avoid exacerbating the injury [2].

Medical references

• Spinal Cord Injuries
• Spinal Cord Injury