is an impairment in motor and/or sensory function of the lower extremities. It is usually the result of
Spinal Cord Injury or a
Congenital condition such as
Spina Bifida which affects the neural elements of the spinal canal. The area of the spinal canal which is affected in paraplegia is either the thoracic, lumbar, or sacral regions. If the arms are also affected by paralysis,
Tetraplegia is the proper terminology.
The causes range from trauma (acute spinal cord injury: transsection or compression of the cord, usually by bone fragments from vertebral fractures) to tumors (chronic compression of the cord), myelitis transversa and multiple sclerosis.
Any disease process affecting the corticospinal or pyrimidal tracts of the spinal cord from the
Thoracic Spine downward may lead to paraplegia. These tracts are responsible for movement or the "instructions" for movement from the
Brain to the
Anterior Horn cells respectively. The most common cause of paraplegis (and all spinal cord injuries) is motor vehicle accidents. Other causes include violence, sports, cancer (tumors) involving the epidural or dural space,
Vertebra l fractures)and
Myelitis Transversa Gunshot wounds to the spine although decreasing are one of the major causes of paraplegic spinal cord injuries (for instance,
Ron Kovic , author of ''
Born On The Fourth Of July '', is a paraplegic as a result of a gunshot wound suffered in the
Vietnam War ). Sometimes,
Paralysis of both legs can result from injury to the brain (bilateral injury of the
Motor Cortex controlling the legs, e.g. due to a
Stroke or a
Brain Tumor ).
Rarer is the type which is caused by damage to the
Nerve s supplying the legs. This form of damage is not usually symmetrical and would not cause paraplegia, but
Polyneuropathy may cause paraplegia if motor fibres are affected. While in theory the arms should also be affected, the fibres that supply the legs are longer and hence more vulnerable to damage.
Larry Flynt , noted
Pornography magnate, sustained this form of nerve damage when he was shot in a
Murder attempt in
1978 , rendering him paraplegic.
While some people with paraplegia can
Walk to a degree, many are dependent on
Wheelchair s or other supportive measures.
Impotence and various degrees of
Urinary and
Fecal Incontinence are very common in those affected. Many use
Catheters and/or a
Bowel management program (often involving
Suppositories ,
Enemas , or digital stimulation of the bowels) to address these problems. With successful bladder and bowel management, paraplegics can virtually prevent all accidental urinary or bowel discharges; it is however another option for the patient to wear undergarments such as
Diapers to further protect from bladder or fecal incontinence. Some prefer diapers for the comfort level they provide.
Due to decreased movement and loss of the ability to run, paraplegia may cause numerous medical complications, many of which can be prevented with vigilant self care. These include
Pressure Sore s (decubitus),
Thrombosis and
Pneumonia .
Physiotherapy and various
Assistive Technology , such as a
Standing Frame , may aid in preventing these complications.
