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Because the spinal cord is the main connection between the brain and the nerves supplying the arms, legs, and trunk, spinal cord injury usually results in both motor and sensory loss. Motor loss refers to weakness or paralysis. Sensory loss refers to the absence of bodily sensation (such as the senses of pain, touch, and temperature), a condition called anesthesia, or to a reduction in this sensation. Both kinds of loss usually affect all or part of the body below the level of the injury. Other types of sensory changes include paresthesia, tingling or “pins and needles,” and dysesthesia, pain caused by damage to the nervous system. Bowel and bladder control may also be affected.
The location of the spinal cord injury determines the parts of the body that are paralyzed or that lose sensation or function. To help you understand your injury, consider the effects of injury in the four main regions of the spinal cord.
Cervical spinal cord (CI through C8) injury causes paralysis or weakness in both arms and legs (quadriplegia, sometimes also called tetraplegia). All regions of the body below the neck or the top of the back may be affected. Frequently, though not always, quadriplegia is accompanied by loss of physical sensation, loss of bowel and bladder control (incontinence or retention), and sexual dysfunction.
Thoracic spinal cord (T1 through T12) injury is less common because the rib cage protects and stabilizes this middle area of the body. When these injuries do occur, they again affect the area below the level of injury. Thoracic spinal cord injuries may cause paralysis or weakness of the legs (paraplegia), loss of sensation, sexual dysfunction, and problems with bowel and bladder control. Arm and hand functions are usually unaffected.
Lumbar spinal cord (LI through L5) injury usually results in paralysis or weakness of the legs (paraplegia), loss of sensation, sexual dysfunction, and problems with bowel and bladder control. Shoulder, arm, and hand function are unaffected by lumbar spinal cord injury.
Sacral spinal cord (SI through S4) injury primarily causes loss of bowel and bladder control and sexual dysfunction. Some sacral injuries may also cause weakness or paralysis of the hips and legs.
An incomplete spinal cord injury results in a large variety of neurological impairments. Most spinal cord injuries are incomplete, causing greater weakness and sensory loss in some areas of the body than others. Some individuals have only minor weakness and numbness but no bowel or bladder problems. In others, the spinal cord is damaged on one side only, producing weakness of muscles on the same side and a complex pattern of sensory loss. Injuries of the central region of the spinal cord typically result in greater weakness of the arms than the legs. Injuries of the cauda equina may cause weakness, paralysis, and sensory loss in the legs, as well as loss of bowel and bladder control.
With this anatomical understanding, we can now discuss what is involved in the early treatment of spinal cord injury. The nature of early interventions corresponds mainly to the level of injury.

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