Paraplegia

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Classification and external resources
ICD-10	G 82.1
ICD-9	334.1, 344.1
MeSH	D010264

Paraplegia is an impairment in motor or sensory function of the lower extremities. The word comes from Ionic Greek: παραπληγίη "half-striking". 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 both arms are also affected by paralysis, quadriplegia is the proper terminology. If only one limb is affected the correct term is monoplegia.

Spastic paraplegia is a form of paraplegia defined by spasticity of the affected muscles, rather than flaccid paralysis.

1 Causes
2 Disability
3 Complications
4 See also
5 References
6 Support organizations

Causes

Paraplegia is most often a result of a traumatic injury to the spinal cord nervous tissue or the resulting inflammation and swelling that occurs around the point of injury. Paraplegia can also be caused by non-traumatic and congenital factors such as spinal tumors, scoliosis, or spina bifida. Scoliosis is an abnormal curving of the bones that make up the structure surrounding the spinal cord. Spina bifida is a birth defect in which parts of bones that make up the structure surrounding the spinal cord do not come together properly. Spinal cord injuries resulting in paraplegia are known as either "complete" or "incomplete". For a "complete" injury, no level of feeling or function exists for the patient below the point of injury. An "incomplete" injury results in the patient retaining some level or feeling or function below the point of injury.

Disability

While some people with paraplegia can walk to a degree, many are dependent on wheelchairs or other supportive measures. Impotence and various degrees of urinary and fecal incontinence are very common in those affected. Many use catheters 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 prevent virtually all accidental urinary or bowel discharges. Some paraplegics prefer the use of diapers as an alternative.

Complications

Due to the decrease or loss of feeling or function in the lower extremities, paraplegia can contribute to a number of medical complications to include pressure sores (decubitus), thrombosis and pneumonia. Physiotherapy and various assistive technology, such as a standing frame, as well as vigilant self observation and care may aid in helping to prevent future and mitigate existing complications.

As paraplegia is most often the result of a traumatic injury to the spinal cord tissue and the resulting inflammation, other nerve related complications can and do occur. Cases of chronic nerve pain in the areas surrounding the point of injury are not uncommon. There is speculation that the "phantom pains" experienced by individuals suffering from paralysis could be a direct result of these collateral nerve injuries misinterpreted by the brain.