We have put together this information section, not to provide a complete source, but to illustrate the nature of Connor's injury and to highlight links, or particular bits of information, that we as a family have found useful. Paralysis Paralysis is the loss of sensation and voluntary motor control. Not only can you not move any paralysed part of your body, you cannot feel it either. It is the result of nerve damage to the brain or spinal cord due to trauma, disease or a birth defect. Trauma directly to the spinal cord is one of the ways paralysis can occur, which is what happened to Connor. Other causes you may have heard of include brain injury, cerebral palsy, spina bifida, multiple sclerosis, polio, tumours and stroke. Paralysis due to Spinal Cord Injury (SCI) extends down the body according, firstly, to the area or segment of the cord injured, and secondly to the severity of the damage, broadly classified as complete or incomplete. Spinal Cord Segments & the Effects of Trauma Each spinal cord segment is highlighted in a different colour and then each main nerve in that section is numbered. Each section highlights the area that nerve is responsible for, and the area that is paralysed if that nerve cannot send its signal up to the brain and receive signals back. (Illustration courtesy of sci-bc.ca) The following explains in a bit more detail what damage to each segment means to the individual. The higher the injury, the more of the body that is paralysed. The Cervical Segment (purple) contains the Cervical Nerves C1-C8 Injuries at C1 and C2 - entire body paralysis C3 - require ventilator to breathe as chest muscles and diaphragm paralysed C4 - loss of all 4 limb function but some control of neck and shoulders. Often require a ventilator initially but sometimes can survive by breathing using the diaphragm C5 - all 4 limbs still affected but have control of deltoids (lift arms sideways) and biceps (bends elbows). No wrist or hand function C6 - as C5 but wrist extensor function maintained (lift wrists back) C7 - addition of triceps function maintained (straightens elbow) and some finger function C8 - nearly full hand and finger function maintained The Thoracic Segment (green) contains the Thoracic Nerves T1-T12 Injuries at T1- full hand and finger function but paralysed from high chest down T2-T5 - addition of chest muscle control so breathe more easily T6-T12 - chest, intercostal, abdominal and lower back muscle function so have trunk control, very important in maintaining balance The Lumbar Segment (yellow) contains the Lumbar Nerves L1- L5 Injuries at L1-L2 - can bend hips but lower leg paralysed L3 - knees able to straighten L4 - knee and ankle function maintained but feet paralysed L5 - more toe and foot function possible The Sacral Segment (pink) contains the Sacral Nerves S1-S5 Injuries above the sacral level affect toe function and bladder, bowel and sexual function. Connor's injury means that he is classified as "C5" on his left hand side and "C6" on his right hand side (spinal cords can be injured unevenly on each side). Apart from obvious movement deficits, the loss of bladder, bowel and sexual function is a major part of dealing with paralysis. Anyone with an injury above the sacral level will have absent or altered function of bladder, bowel and sexual control, depending on the injury severity. However there are other side effects that are often not appreciated and tend to be worse the higher up the cord the injury is. SCI people are unable to control their own body temperature and are at risk of a condition called Autonomic Dysreflexia (AD). The lack of the effects of gravity and movement of the body puts paralysed people at risk of skin pressure ulcers, respiratory complications, bone loss, urinary tract infections, pain, obesity and depression. This is where the importance of the beneficial effects of exercise cannot be overemphasised! Autonomic Dysreflexia Autonomic Dysreflexia (AD) is a potentially life threatening condition that affects people paralysed at the level of T6 or above. Connor is always at risk of this condition. Any pain experienced by the body is normally signalled straight to the brain which then sends signals back down the spinal cord to the muscles telling them to act appropriately. In a person with SCI above T6, the signal to and from the brain is blocked so the body cannot tell the brain something is wrong and cannot react appropriately. Instead the pain is manifested as a sudden severe rise in blood pressure to the brain which can be life threatening by causing blood vessels to burst. Signs include a sudden sharp headache, blotchy, sweaty skin above the injury and cold, pale skin below the injury. The cause must be identified, eg.an ingrown toenail, blocked bladder catheter tube, skin sore and lifesaving medication given if necessary to lower the blood pressure. Injury Severity - Complete or Incomplete? The severity of the spinal cord injury affects how much function is maintained and if both sides of the body are affected equally. Generally, a complete injury, means that all the connections in the spinal cord are severed at that level. Incomplete injuries allow some signal to pass through the damaged cord and so allows for very differing function levels depending on what combination of fibres and signals survive. It used to be thought that any sensory or motor function below your level of injury meant that you had an incomplete injury. However neuro-consultants worldwide decided to reclassify the meaning of incomplete injuries in order to give a more realistic indicator of prognosis. The data shows that you have more chance of regaining full function after an SCI if you are incomplete to the extent that there are some fibres reaching the sacral segment of the cord, known as "sacral sparing". People with sacral sparing have deep anal sensation and big toe flexion function maintained. However the spinal cord is a complicated and amazing structure and more and more consultants, therapists and patients are moving away from using this classification and concentrating on the beneficial effects of exercise and nerve recruitment programmes (see the Project Walk link for more information). Useful Links - Christopher Reeve Foundation, a wealth of information on living with paralysis and the latest research. - information on initial trial that has led to the treatment being available in Thailand. Gives further details on the   electric epidural stimulator. - explains the concept of stem cell treatment, a breakthrough treatment for SCI. - vital piece of kit for maintaining health and keeping the nervous system active.