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What is the global risk of a spinal cord injury?

By Lara Wood
Rehabilitation Consultant

The most common cause of spinal cord injury is a broken neck or back, which causes damage to the bones of the spine that surround the spinal cord, and often result in damage to the nerves of the spinal cord.

Road traffic accidents are the most common cause of traumatic spinal cord injuries worldwide, but there are global differences.

  • In developed countries, four wheel motor vehicles travelling at high speed in an area of high vehicle density is the primary cause which result in traumatic spinal cord injury. More recently there has been an increase in the number of cyclists on the road which has also lead to an increase in cycling related injuries. Cyclists are more exposed and vulnerable to spinal cord injuries.
  • In developing countries, such as South and Southeast Asia, there has been a rapid increase in the number of drivers on poor roads with failing road surfaces often driving older unsafe two wheeled vehicles, overloaded with passengers and often livestock. Poor traffic management systems and infrastructure add to often hazardous road conditions. Often there is a mix of different sized motorized vehicles, cycles, pedestrians and animals on these poor roads.

In the developing world there is a rapid cause of spinal cord injury from work place accidents relating to steady urbanisation. Rapidly developing agricultural and industrial workforces made up of semi-trained, unskilled workers, sometimes including children in environments where there are no real safety standards, and no enforcement of legislation play a key part. In some developing regions, 75% of spinal cord injury are caused by falls from height and are more common than road traffic accident. Farmers in Nepal often cut leaves from trees to feed live stock, Indian farmers climb electricity power poles to borrow electricity. Pakistan also has a high incidence of falls from height which include falls from roof tops where people sleep in hot weather. Falls also occur in countries such as Malaysia and Bangladesh where people fall from carrying heavy loads on their heads as they attempt to transport goods. Other accidents at work are in relation to unregulated working conditions such as mines, In China, unregulated mines collapse at a rate three times more than government regulated mines.

A spinal cord injury occurs when there is damage to the spinal cord or nerves at the end of the spinal canal from trauma. The spinal cord is a bundle of nerves and other tissue which extends from the brain’s base down to the lower back. The spinal cord is responsible for sending messages from the brain to all parts of the body, it also sends messages from the body to the brain. The reason we can move our arms and our legs is because of the messages sent through the spinal cord. If the spinal cord sustains an injury, some of these messages may not be able to get through.

The symptoms relating to a spinal cord injury depend on the severity of injury and location of the spinal cord. These may include partial or complete loss of sensory function or motor control of the arms, legs and/or body. The most severe spinal cord injury can affect the systems which regulate the bowel/ bladder control, breathing, heart rate, blood pressure, along with causing chronic pain.

The lowest part of the spinal cord which functions normally after injury is referred to as the neurological level of the injury, for example L5. The severity of the injury is often called ‘the completeness’ classified as:

  • Complete. If almost all the feeling (sensory) and all ability to control movement (motor) are lost below the spinal cord injury.
  • Incomplete. If there is some sensory or motor function below the affected area the injury is incomplete. There are varying degrees of incomplete injury.

Spinal cord injury will have a life changing impact for the individual, the degree of which will depend on the level of the injury and the completeness of the spinal cord injury. The impact may include; problems walking, loss of bladder/bowel control, inability to move the arms or legs, numbness or tingling in the extremities, unconsciousness, headaches, pain.

The below link to the spinal association website offering a range of resources in relation to spinal cord injury which offer a range of support and guidance for individuals dealing with a spinal cord inury: