Sacrum (The Pelvis)

Vertebrae S1-S5

There are five vertebrae and five pairs of spinal nerves in the pelvis connecting to the buttocks, bladder, bowel, reproductive organs and parts of the legs and feet. They are fused and not mobile - in contrast to the vertebrae above from C1-L5

Complete Paraplegia

Complete paraplegia is the result of an injury to the spinal cord anywhere below the mid back. Damage will usually occur in the thoracic region of the spine; however, paraplegia has also been known to be caused by an injury to the lumbar and sacral regions too.

The effects of complete paraplegia

Paraplegia causes complete loss of movement and feeling in the legs, and is sometimes known to affect the torso but not the arms. Paraplegia at L1/S1 if complete can still affect:

• Control of the torso
• Balance when sitting
• Bladder and bowel movements, and sexual function
• Fertility/reproduction
• Function in the legs

The loss of function and sensation in the lower body caused by complete paraplegia can result in a number of further complications, which can be minimised by proper medical care and rehabilitation. These can include:

• Chronic nerve pain, which can vary from a short stabbing pain to a prolonged pricking, tickling or burning sensation
• Deep vein thrombosis, which is the formation of a blood clot within a deep vein usually found in the legs
• Decreased fertility, which can occur a number of years post-injury in men
• Osteoporosis, which is a condition where bones lose their strength making them more likely to break due to not weight-bearing
• Skin deterioration or pressure sores
• Spasticity, which is a condition that causes muscles to be continuously contracted
• Urinary tract infections
• Bowel, bladder and sexual dysfunction and incontinence
• Psychological effects of disability and adjustment

Recovering from complete paraplegia

Somebody that suffers from complete paraplegia will be required to stay in hospital, usually in a spinal cord rehabilitation unit, for approximately five months. Here, a programme of rehabilitation, skill-building and physiotherapy will be provided to help people adapt to the physical challenges in their day-to-day activities.

When a person is released from the hospital, they will usually be able to live independently with the ability to look after themselves, for example, eat, groom, bathe and dress. Most paraplegics will use a manual wheelchair to assist with mobility. Those capable of standing or walking with assistance for short periods of time may use braces or a walker to move about; although, this can take a great deal of strength and determination.

Anterior cord syndrome

Anterior cord syndrome is caused by an impact that damages the artery that runs along the front of the spinal cord. This is usually done by a fragment of a bone or a slipped disc. This injury causes loss of strength below the point of injury and loss of temperature and pain sensations. However, sensations, such as vibration and position awareness, are preserved and some movement may be able to be restored.

Central cord syndrome

This is an injury to the centre of the spinal cord that prevents the brain from sending information to the rest of the body. The main effects of central cord syndrome are loss of arm functionality and reduced functionality in the legs; however, it is occasionally possible to recover and gradually improve function in the legs if it is very incomplete. Bladder and bowel control can also be lost if damage is severe.   

Posterior cord syndrome

This rare syndrome is an injury to the artery at the back of the spinal cord that can cause difficulties in coordination and the loss of deep touch, vibration and position sensations. However, strength is preserved along with pain and temperature sensations. 

Brown-Sequard syndrome

This is a rare injury to one side of the spinal cord, which causes inverted complications. For instance, one side of the body below the region of the spine-injured can completely lose movement but retain sensations of pain and temperature, while on the other side, the opposite is true.  

Cauda equina syndrome

This is an injury to the group of nerves at the base of the spine usually caused by trauma that compresses the nerves, resulting in back pain. Cauda equina syndrome can also result in partial or complete loss of movement and sensation, as well as bladder and bowel dysfunction. 

If the nerves have not been severely damaged, they may regrow, restoring some movement to the body.