What is Quadriplegia/Tetraplegia?
Quadriplegia, sometimes referred to as tetraplegia, refers to a spinal cord injury above the first thoracic vertebra, or within the cervical sections of the spine (labelled C1-C8). The result is some degree of paralysis in all four limbs—the legs and arms—depending on the location of the injury. For instance, a C5 C6 Quadriplegia/Tetraplegia would have (somewhat) less severe injuries since the C5 and C6 vertebrae are lower on the cervical spinal column than the C1-C4 vertebrae. The degree of paralysis also varies depending on the nature of the injury, the extent to which you’ve undergone rehabilitative therapy, and on other factors that are not well understood yet .
Most doctors now use the term tetraplegia to denote this injury, but patients often continue to use quadriplegia.
Tetraplegia/quadriplegia can be so severe that it interferes with the injured person’s ability to breathe on his or her own. Generally speaking, the higher up the injury is, the more extensive the damage will be. Functional quadriplegia is the complete inability to move, requiring total care for hygiene, feeding, and elimination.
In general, the following symptoms affect quadriplegics:
• Chronic pain; this can develop due to muscle atrophy from disuse or changes in sensory perception. For instance, a quadriplegic who regains some sensation may find that his arms ache due to muscle atrophy.
• Loss of sensation below the site of the injury. For some quadriplegics, sensation loss is complete and permanent. In others, sensations are merely reduced, or you may intermittently feel some sensations, but not others. A “pins and needles” feeling is especially common.
• Inability to move the limbs below the site of the injury. Though some movement may return, the overwhelming majority of quadriplegics continue to struggle with loss of muscle control and generalized weakness.
• Spasticity; Sudden, uncontrolled movements may occur in areas most affected by paralysis.
• Difficulties with elimination; lack of control over bladder and bowels, difficulty eliminating without help, and frequent urinary tract infections can result from the loss of sensation and muscle control below the site of the injury.
• Respiratory infections; the leading cause of death among spinal cord injury survivors, respiratory infections are especially common in the months following an injury.
• Difficulties with sexual function. Men may struggle to get erections, while women may struggle with lubrication. Both sexes often experience changes in libido, difficulties with orgasm, decreases in fertility, and even complete cessation of sexual functioning.
• Pressure sores and other secondary infections due to lack of movement.
• Anxiety and depression, as well as other psychological concerns.
• Difficulties with bodily awareness. Depending upon the extent to which you have lost sensation, you may struggle to know where your legs or arms are without looking.
Unhealthy weight; many quadriplegics can find themselves overweight if they do not reduce their calorie consumption, are unable to exercise, or do not pursue physical therapy.
Quadriplegia is not curable with treatment. However, some quadriplegics do experience significant improvements in symptoms. Few quadriplegics will ever be completely cured and regain all lost sensations, despite the surgeries, drugs, or therapies. Instead, the goals of treatment include improving the long-term prognosis, reducing immediate threats to your life and health, and teaching your brain and spinal cord how to work around the injury. Some treatment options include:
• Brain and spinal cord surgeries.
• Education about quadriplegia, as well as training on your rights under the Americans with Disabilities Act and other relevant laws.
• Family education and support.
• Language and speech therapy.
• Physical therapy.
• Exercise therapy.
Involvement in support groups.
Injuries that cause quadriplegia are unpredictable, since the brain and spinal cord are such delicate and complex structures. Research suggests, for example, that the brain can compensate for even extensive injuries in some areas, but that recovery from injuries in other areas is virtually impossible. Since there is still so much about the brain and spinal cord that we don’t yet know, it can be difficult to give an accurate prognosis to quadriplegics.
Some functions and sensations may return once swelling at the injury has receded. Some tetraplegics even spontaneously recover. Surgery and other treatments can help, particularly if the surgeon is able to remove something that is compressing the spinal cord or impeding the brain’s function. Since it cannot guarantee a full recovery, treatment instead attempts to improve the long-term prognosis, better the quality of life, and adjust to living around the injury.