A spinal cord injury can be life-altering and present in various forms. Depending on where on the spinal cord the injury has taken place, there can be permanent mobility loss ranging from paraplegia to quadriplegia. While paraplegia, as in ‘to be paraplegic’, is well known to be a paralysis of the lower part of the body and when, from the waist down, the body cannot willfully function, understanding quadriplegia is often misinterpreted. To be clear, ‘quadriplegia’ and ‘tetraplegia’ are often used interchangeably, typically meaning the same thing.
What Is Quadriplegia And What Is Tetraplegia?
While paraplegia is paralysis of the lower part of the body, quadriplegia affects both arms and both legs. Also known as tetraplegia, it affects all four limbs and the torso. Most people with tetraplegia are unable to move below the neck however some may have partial quadriplegia wherein they have some mobility in certain areas.
Your arms and legs can be very healthy, with no damage. Even so, a person can still have tetraplegia. The problem is in the spinal cord, the brain, or both, and not the limbs themselves. The spinal cord is what carries signals to and from the brain. When a spinal cord experiences permanent damage that somehow breaks this send-receive channel, that’s where the quadriplegia stems from.
What Are Symptoms of Quadriplegia?
- Numbness or total loss of feeling in the arms and legs as well as surrounding areas in the body.
- Paralysis of the arms and legs as well as muscles in the torso.
- Due to an inability to control the muscles, it is not common for a person with tetraplegia to have urinary retention and bowel dysfunction.
- In some cases, there is difficulty breathing and some require assisted breathing devices.
- It can be difficult to communicate, usually requiring assistive devices to do so.
- There may be additional pain or stiffness in the neck.
- There may be trouble sitting upright and an inability to balance.
How Does Quadriplegia/Tetraplegia Happen?
How tetraplegia occurs is through direct irreparable damage to the spine. The spinal cord is like a soft cable. It is protected by thirty-three bones one on top of the other that make up your vertebral column. Each vertebrae has an inner opening like a donut. Through these openings, the spinal cord runs through. Between each vertebrae is cartilage that cushions the discs and through these, nerves pass through. The spinal nerves move out to the rest of the body. It is when these nerves become damaged that we see symptoms like paralysis.
What is often seen in patients with quadriplegia is damage high in the spinal cord, i.e. the cervical spine between C1 and C7. The higher the injury, the worse the damage. This is true to such a degree that nearly all spinal cord injuries to C1 and C2 are immediately fatal to a person as damage to this area interfered with breathing and other critical body functions.
What Are the Causes of Quadriplegia?
There are several causes of tetraplegia/quadriplegia, the majority of which are spinal cord related. Over half of all spinal cord injuries are from either auto accidents or falls. Less common causes include gunshot wounds, motorcycle accidents, diving accidents, medical or surgical complications, being hit by a flying or falling object, and bicycle accidents.
A traumatic brain injury, or TBI, can also be the cause of quadriplegia. This is when there’s brain damage that doesn’t make it possible to send or receive signals from the arms and legs.
Some diseases or inherited medical conditions can cause tetraplegia. Amyotrophic lateral sclerosis, also known as ALS, is known to eventually lead to permanent paralysis. Muscular dystrophy is another disease that is known to progressively weaken the muscles, resulting in the muscles’ inability to respond to signals sent from the spinal cord.
All things considered, tetraplegia/quadriplegia can affect anyone regardless of gender, race, religion, or socioeconomic status. If you receive a traumatic blow to the spine, fracturing or dislocating vertebrae within the C1-C7 region, you can be affected by tetraplegia.
Spinal Cord Damage C1 to C7
When we take a closer look at the spinal cord, we see several areas where damage can dramatically increase the likelihood of tetraplegia. While damage to the thoracic or lumbar column would normally lead to paraplegia, it’s far higher where we look in order to understand quadriplegia.
- C1-C3 damage is very, very serious. This is where the vertebrae meets the skull. Damage here is likely fatal or, if not, extremely severe. An impact here is likely to result in near-total paralysis and permanent need for specialized devices allowing a person to breathe.
- C4 damage is also severe but may not necessarily lead to total paralysis. A person may experience limited range of motion, as an example. They are likely to see a loss of diaphragm control and require breathing aids, and have trouble with their bowel and bladder.
- C5 damage is likely to result in paralysis to the legs, wrists, and hands, and can affect the vocal cords. A person with C5 damage may be able to breathe unassisted but could experience difficulty talking.
- C6 damage is less likely to cause a complete loss of function in the arms.
- C7 damage rarely results in tetraplegia, however, it can under certain circumstances. Unfortunately, what is common with C7 damage is the feeling of burning pain in the shoulders, back, and/or arms.
Types of Quadriplegia/Tetraplegia
All quadriplegia is not the same. There are several types of quadriplegia, with complete, incomplete, and spastic being the most common, each with important differences.
Complete quadriplegia is a total loss of control over the arms and legs. This is a person who is unable to move their extremities aside from their head. This is caused by a severe and complete spinal cord injury or a traumatic injury to the brain. Though there are complete quadriplegia therapy options, the recovery is a lot more difficult, unpredictable, and near-impossible in some situations.
Incomplete quadriplegia means that a person still has some function or sensation in their arms and/or legs. This is often what happens when there is a partial spinal cord injury or if it’s the quadriplegia stems from an inherited condition. Depending on the cause, there may be hope to improve one’s ability to control their limbs with certain therapies and exercises. That said, unfortunately, some do see incomplete quadriplegia eventually become complete quadriplegia.
Spastic quadriplegia is when there are muscle spasms in the paralyzed limbs even though the person is unable to consciously control their arms or legs. This person may have hyperactive reflexes or involuntary muscle tightness that makes it difficult to relax. This is often caused by cysts that develop after a major spinal cord injury, an infection in the nervous system, or other blockages.
How Do You Live With Tetraplegia or Quadriplegia?
Individuals with tetraplegia require daily assistance. Nearly 50% of all Canadians with complete spinal cord injuries suffer from tetraplegia. For them, long-term recovery and life can be very difficult. The treatment for quadriplegia begins with available medical solutions. For example, completing a surgery to repair the spin, stabilize the injury, or reduce pain is often proposed.
After the initial medical treatments are completed to give a person their best chance at recovering strength and minimize the risk of other possible long-term health issues, therapies and treatments turn their attention to ongoing care. Without control over one’s arms and legs, assistance is needed for going to the bathroom, preparing and eating meals, and various daily activities.
There are over a dozen major health risks that someone with quadriplegia faces, including cardiovascular issues, respiratory issues, pressure ulcers, blood clots, syringomyelia, urinary and bowel complications, osteoporosis, pain syndromes, bone fractures, and spasticity issues.
There is a period of adjustment for anyone living with tetraplegia, as they learn how to do their daily activities again within their given limitations. Over time, it’s not uncommon for there to be more difficulties. Sores can develop from being in the same position for a prolonged period of time. Urinary tract infections do become fairly common as the loss of bladder control makes a person unable to clear the urethra of contaminants. Muscles will atrophy from lack of use. Weight gain, respiratory infections, and loss of sexual function are also all common to a degree. Furthermore, spinal cord injuries are often tied to experiencing chronic pain from the damaged nerve connections. That said, this does vary from person to person and involves various factors.
What is The Cost Of Tetraplegia/Quadriplegia?
Between the costs that the medical system has to put forth, in addition to what loved ones are tasked with paying, caring for someone with a spinal cord injury can cost millions of dollars over the course of their life. Here are just a few of the areas in which costs have to be allocated.
- Physical therapy.
- Occupational therapy.
- Vocational assistance and career guidance.
- Skin supplies and inspection mirrors.
- Adapted vehicles.
- Hoyer lift and slings.
- Portable ramps.
- Shower devices.
- Transfer devices.
- Supplies for ADLs and bowel and bladder.
- PSW and rehab therapists.
- Recreational therapy.
- Adaptable home renovations.
- Power bed and no-turn air mattresses.
- Psychological assistance or counseling.
- Manual or power wheelchairs and
any associated batteries, chargers,
cushions, and maintenance.
- Ongoing medications.
The average cost of tetraplegia or quadriplegia in the first year is over a million dollars and for every subsequent year, it is easily above $100,000 according to most calculations. The ongoing medical care and assistance needed for these individuals is costly, but this isn’t necessarily an expense that the family has to bear on their own.
There may be liability involved if your quadriplegia is tied to another party’s negligence or intentional misconduct. You may be able to recover compensatory damages by bringing forth a claim, such as if your tetraplegia stems from a motor vehicle accident. If you can prove negligence or misconduct, it may be possible to obtain compensation that can be dedicated towards paying down some of the enormous costs that a person with a major spinal cord injury could face.
How A Spinal Cord Injury Lawyer Can Help With Tetraplegia or Quadriplegia
It’s key to remember that a serious spinal cord injury, i.e. tetraplegia or quadriplegia, doesn’t determine how a person is to live their life. Lots of people with paralysis are able to resume activities, i.e. work or school, with the appropriate assistance.
You can have quality of life with paralysis, adjusting to a reality of quadriplegia/tetraplegia. However, to be successful at this adjustment, one must not have only the openness and emotional resources to do so but also the appropriate social and financial supports. This is where a spinal cord injury lawyer can help.
There may be funds available to you from your insurance company and/or the insurance company of the person that hurt you. Meeting with a spinal cord injury lawyer, they can understand your needs and struggles, and offer guidance in what options, if any, may be available to you as you continue to recover and regain your independence.