Tetraplegia is a condition that describes paralysis caused by spinal cord injury, which often is the result of an accidental trauma to the spine. People with this condition have a spinal cord injury to one or more of the cervical sections of the spine, located in the neck. This injury prevents the transmission of nerve signals between the brain and all muscles and tissues below the point of injury. As a result, a person who has tetraplegia cannot move any muscles or feel any sensations below the neck or upper chest and might require a ventilator to breathe. This condition is also known as quadriplegia.
Like all spinal cord injuries, the effects of tetraplegia on any given individual are highly dependent on the exact location of the injury. This is largely because of the structure of the spinal cord and vertebral column. The spinal column is a linear arrangement of 33 vertebrae and 31 spinal cord segments. Each segment of the spinal cord transmits information between the brain and various locations in the body. The cervical segments of the spinal cord are a conduit for sensory information entering and exiting the neck, shoulders, upper chest and arms.
The way that the spinal cord is structured means that a person with a spinal cord injury in C1, the highest of the cervical vertebrae, is likely to have less motor control than a person with an injury in C7, the last cervical vertebrae. For example, a person with a C1 injury is very likely to require a ventilator to breathe. By contrast, a person who has a C4 or C5 injury generally is able to breathe unaided and might have limited shoulder movement.
A person who is tetraplegic is at risk of developing both mild and potentially life-threatening complications. Most of these complications are because of the loss of muscle control and the loss of control of bodily functions. For example, the risk of cardiovascular disease, deep vein thrombosis and osteoporosis are all increased, largely because someone with tetraplegia has a greatly reduced ability to exercise.
One of the most common complications is the development of pressure sores, which are the result of long periods of time spent sitting or lying in the same position. Caregivers must ensure that the individual is regularly moved to new positions to prevent the development of pressure sores. Another increased risk is that of respiratory problems because of the loss of the cough reflex.
One of the most serious complications of tetraplegia is autonomic dysreflexia. This condition is characterized by a sudden, dangerous increase in blood pressure and results from the body’s inability to regulate its temperature, blood pressure and heart rate. Autonomic dysreflexia must be treated immediately when it occurs, in order to prevent a stroke.
Tetraplegia generally is not a curable condition. Experimental treatments, such as the use of stem cells to repair spinal cord damage, typically are not available to the public except during clinical trials. Instead, treatment focuses on helping a tetraplegic person learn how to deal with the physical and psychological stress of the injury and helping him or her learn new strategies for self-care. The main objective of rehabilitation after injury is to help the person learn skills that will enable him or her to live as independently as possible.
