UC San Diego Health System has a multidisciplinary program for restoring function to people with spinal cord injuries.
Unlike the peripheral nerves, cells in the spinal cord do not regenerate after an injury. Damage to the spinal cord can impact body function, strength and sensation, causing loss of feeling, weakness and paralysis.
Level of Spinal Cord Injury: Restoring Function
Breathing using phrenic nerve pacer or ventilator.
Basic arm function (elbow flexion) using a nerve transfer.
Grasp and release function, and triceps function
More sophisticated grasp and release and finer hand movements.
|Intrinsic balance to the hands.|
| T2-T9||Sensation to lower extremities via nerve transfer. Possibility of improving lower extremity function using spinal cord stimulation.*|
| T10-T12||Some hip movement and extension as well as sensation to proximal legs.|
| L1-L2||Hip extension with a nerve transfer (nerve transfer only used for those with some hip movement).|
L3-L4||Improved walking with a nerve transfer (transfers only used in those who have some hip flexion and knee extension).|
L5-S1||Ankle stability via a nerve or tendon transfer.|
*NOTE: All patients with some movement in lower extremities may be considered as candidates for epidural stimulation to improve movement or reduce spasms.
epidural spinal cord stimulation, we can improve standing and walking in people who have cervical and thoracic level injury.
Spinal Cord Injury: Surgery & Treatment
Recovering even partial arm and hand function after a spinal cord injury can have an enormous impact on independence and quality of life. Our surgeons use the latest surgical techniques and treatments to improve level of functioning.
Surgical and nonsurgical treatment techniques we use:
Nerve transfer: Nerves with the best control are transferred to the most important muscle groups to improve function in that limb.
Tendon transfer: The most common procedure for restoring function. A tendon is moved from one point to another to improve joint function. Tendon transfers offer functional gains for an estimated 70 percent of tetraplegic patients.
Selective peripheral neurotomy: Nerves are trimmed to reduce spasticity.
Phrenic nerve stimulator: Patients dependent on a ventilator have the option of a surgically implanted phrenic nerve stimulator which frees them from ventilator dependency.
Spinal cord stimulation: Electrodes placed in the space outside of the
dura reduce pain and spasticity through nerve stimulation. Can also help with movement control.
Did You Know?
In the United States, there are approximately:
- 12,000 new spinal cord injuries each year.
- 300,000 people currently living with a spinal cord injury.
The human spinal cord is divided into 31 segments. A spinal cord injury is classified depending on where it occurs:
Cervical: Injuries that occur in the top part of the cervical vertebrae C1-C8 are the most severe of spinal cord injuries. Can cause paralysis in the legs, arms, hands and trunk.
Thoracic: Includes thoracic vertebrae T1-T12. Usually affects legs, trunk, and muscles in back, upper chest and abdomen.
Lumbar sacral (lower back): Includes lumbar vertebrae L1-L5 and sacral vertebrae S1-S5. Often results in impaired hip and leg function.
When the spinal cord is damaged, all functions below the point of injury are affected. This means that the higher the injury, the more dysfunction can occur. Our team can help bring back life to paralyzed limbs for all levels of injury through the latest surgical techniques.
Complete or Incomplete
Spinal cord injuries are either complete or incomplete. In a complete SCI, the brain and spinal cord are unable to communicate with the rest of the body below the point of injury. In an incomplete SCI, the spinal cord still has the ability to send messages from or to the brain.
The impact of a spinal cord injury on overall bodily function is assessed by the
American Spinal Injury Association (ASIA) impairment scale.