Lumbar spinal cord injuries

Lumbar Spinal Cord Injuries Explained

The prognosis of any spinal cord injury (SCI) largely depends on factors such as the level at which it has occurred, the severity of the damage and whether the injury is considered complete or incomplete.

The spine is divided into different sections all of which serve various parts of the body. The cervical area near the neck, for example, is the most problematic when it comes to spinal cord injuries. It can mean that a person is left completely paralyzed from the neck down, a condition which requires significant care and support.

Below the cervical vertebrae are the thoracic vertebrae which encompass the mid-chest. Injuries to this area generally occur less frequently but they can result in a significant level of physical impairment for the individual.

Next, we see the lumbar region, or lower back, which consists of a series of 5 vertebrae.

Lumbar spinal cord injury levels  (L1-L5)

Anatomy of the Spine
Anatomy of the human Spine

The lumbar region of the spine is located immediately below the thoracic vertebrae and is a common area for injuries. Chronic lower back pain is one of the most prevalent medical complaints in modern society today.

Injuries to the spinal cord can be complete or incomplete and affect both or just one side of the body. As with other areas of the spine, the exact location of the injury will generally determine what the symptoms are.

  • L1-L2 vertebrae: These are the top vertebrae and damage to one or the other causes similar symptoms. The most obvious we see is loss of hip flexion movement and paraplegia. Individuals may also suffer from bowel and bladder issues and loss of sensation in the legs.
  • L3 vertebrae: The spinal cord does not stretch through all the vertebrae. L3 is the first place it does not reach and the symptoms of an injury are, therefore, less severe. These include loss of sensation, muscle weakness and reduced flexibility in movement.
  • L4 vertebrae: Again, the symptoms of damage to this area are reduced and could include an inability to bend the toes, numbness and weakness. Full paralysis is not seen when an SCI occurs in this area.
  • L5 vertebrae: The individual may see weakness and loss of sensation in the legs, similar to an injury at the L4 level.

Lumbar Spinal Cord Injury Causes

As with other spinal cord injuries, the main causes of damage to this area of the spine are usually traumatic. The most common incidents resulting in lumbar spinal cord injuries include automobile accidents, falls or trauma due to violent acts.

Medical conditions such as degeneration due to age and osteoporosis may also cause injury to this area. In rarer cases, lumbar spinal cord injuries could be caused by birth defects.

Lumbar Spinal Cord Injury Symptoms

The symptoms of a lumbar spinal cord injury will vary depending on the extent of the damage and where it occurs, but they exclusively affect the lower part of the body.

There are some general symptoms that might be evident, however, and these include:

  • Reduced or lost function in the hips and the legs. The higher up toward L1-L2 vertebrae this occurs the more mobility may be impaired. A complete lumbar spinal cord injury in this area can mean the individual is paraplegic and unable to move or feel anything below this point.
  • Another symptom that is generally experienced is the impairment of bowel and bladder control. This can mean loss of voluntary bladder/bowel control but it can be managed effectively with the appropriate support and assistive technology.
  • A person with a partial lumbar spinal cord injury may still have difficulty with mobility and may need to use a wheelchair or walking stick.

Treatment and Recovery Following a Lumbar Spinal Cord Injury

Lumbar spinal cord injury complications range from complete paralysis to just a small impact on mobility. Treatment will depend on the extent of the injury and where it has occurred.

In general, injuries to this region of the spinal cord may be serious, but they are rarely a threat to life in the way that cervical spinal cord injuries can be.

Treatment can include using drugs to reduce swelling and there is evidence that early intervention can improve outcomes. Surgery is used if there is decompression of the nerves. Undertaking this can improve functionality in some individuals.

In most cases where there is a complete injury, the focus is placed on the initial recovery and then physiotherapy and occupational therapy to enable individuals to live as independently as possible. In partial SCI patients, physiotherapy has helped to improve levels of function, but a lot depends on the individual and a host of other factors, including the type of injury sustained.