My injury impacts the 7th and 8th thoracic levels of the spinal cord (a T7/8 injury) and is considered a "complete” injury. We do not know if my spinal cord was “severed” or just severely pinched, which is a commonly asked question. We do know that, according to the neurosurgeon who operated on me, the bone pinched the spinal cord pretty significantly, leaving about 5 millimeters of space for the spinal cord to run through. (You can see that on the picture.) While I was operated on within hours, the impact of the injury no doubt caused immediate and lasting trauma.
It’s also important to recognize that people often have other injuries when they suffer spinal cord injuries, particularly when related to trauma (the most common cause of spinal cord injuries). I suffered several broken ribs and a traumatic brain injury (concussion). [Don’t worry — I passed grueling neurocognitive testing before returning to work as a physician.]
A side cut of the CT SCAN: The 8th thoracic vertebral body is broken (fractured), pinching off the spinal cord — the grey area between bones is the spinal cord.
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Spinal cord injuries come in a variety of forms and from a variety of causes. As far as I can tell, no spinal cord injury is exactly like another. Not only do people sustain injuries in different locations (high in the neck or cervical area, in the middle of the back or thoracic area like mine, or lower in the lumbar area of the back), but the results of their injuries vary widely. Some people have a complete injury (no sensation or function below the injury), while others have an incomplete injury (some residual function); some have limp muscles (flacid) while some have uncontrollable tightening of their muscles (spasticity), and some people experience a variety of different pain while others feel no pain. It’s truly bizarre. While my 8th thoracic vertebra was injured, the impact on my spinal cord was a bit higher, but I have some light sensation on my right side a bit below the injury. What is consistent is that there appears to be no consistency. Learn more at MayoClinic.Org.
Research:
Current research focuses on restoring function to improve quality of life. This includes helping people with spinal cord injuries regain function if their hands or legs, but also to improve control of bowel and bladder function. Current studies use stem cells, magnetic stimulation, and electrical stimulation of the spinal cord (called epidural stimulation, highlighted below), not only to restore function, but to add secondary benefits like improved cardiovascular health. Additional research focuses on the use of powered robotic exoskeleton systems to practice over-the-ground gait simulation to the use of locomotor training in neurorehabilitation to rebuild damaged neural networks and to improve core strength and factors that improve quality of life. Finally, there is ongoing research how people with spinal cord injuries function biomechanically, as well as the long-term impact of spinal cord injury on their lives, bodies, health, and mental and physical wellness.
Promising findings from epidural stimulation research across the globe:
News Summary of Epidural Stimulation Research: Three people with spinal-cord injuries regain control of their leg muscles (31 October 201
Research from Mayo Clinic & Collaborators: Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia.
Research from the University of Louisville & Collaborators: Recovery of Over-Ground Walking after Chronic Motor Complete Spinal Cord Injury
Research from the Courtine Lab at EPFL & Collaborators: Targeted neurotechnology restores walking in humans with spinal cord injury.
Note: This is a non-exhaustive list of current areas of research that interest me, and by no means represent the totality of ongoing research, nor are they necessarily the most up-to-date links to current topic areas. Bias is representative of where my current attention is on today’s research, the topic areas that I follow, and the relationships that I have across clinical practice, research, and industry.
What Resources Are Available?
Resources are available through foundations such as the Christopher & Dana Reeve Foundation and national organizations like the American Spinal Injury Association. These organizations can also serve as advocacy programs in a world not designed for people living with disabilities. Additionally, cities and regions may have a “Center for Independent Living” which is not SCI-specific, but does help people with disabilities learn to live independently. Adaptive sports and recreation programs also provide significant support and resources.
Most importantly are the relationships formed through spinal cord injury, whether with the clinical team (physicians, occupational therapists, physical therapists), or through peer mentor programs - both formal and informal. These relationships and programs can help in the life-long adjustment to spinal cord injury, in facilitating a return to work, in problem-solving the day to day intricacies of life with a spinal cord injury, and in navigating the world in a “new normal.”
Disclosure: Dr. Grossman is paid as a physician at the Mayo Clinic and as a consultant on spinal cord injury research and patient advocacy through grants supporting research at the Mayo Clinic. Additionally, Dr. Grossman is a former employee of Medtronic, a major supporter of epidural stimulation research for spinal cord injury.