Quadriplegia: paralysis of the arms and legs

Quadriplegia is caused when the spine is severely damaged around the area of the neck. This means that the person's arms and legs are paralyzed and in the most severe cases their breathing too, making them dependent on help from other people for the rest of their lives.


The spinal chord explained

The spinal column is a flexible organ of movement, thanks to which, we are able to walk upright. At the same time it protects the spinal cord, one of the most important vital organs in the human body. All commands from the brain to other parts of the body pass through the nerve cells in the spinal cord. It controls not only complex movements such as walking and gripping, but also breathing and metabolism, bladder movements and sexual functions. Messages from various body parts  about heat and cold, pain, pressure, touch or even a full bladder are sent back to the brain via the spinal cord. On top of that, a number of internal organs, including the lungs, heart and circulation system, stomach and digestive tract, hormones and blood clotting, are all controlled and regulated via the spinal cord.

What is the main cause of quadriplegia and what does it mean?

When the spinal cord is damaged, it can no longer transmit all or some of the messages to the brain. A partial or total injury to the spinal cord causes what we call paraplegia. Accidents involving a break to the spinal column are the main cause of quadriplegia. Other triggers include diseases or tumors, though these are more rare. Paralysis can affect the muscles of the arms, legs, and torso, depending on the location of the spinal injury. The ability to feel touch, pain, and temperature, as well as spatial awareness are all lost. Bladder, bowel and sexual function are also impaired.
Around 60 percent of all people with paraplegia have damage to the cervical spinal cord, which causes quadriplegia (also called tetraplegia). An injury this high in the spinal cord results in paralysis of all four limbs (hence the names, from the Latin quadri and Greek tetra meaning four). The damage to the cervical spinal cord also affects the person's breathing.

Can some of the after-effects be prevented?

Yes. During the first few months following the injury, a patient with quadriplegia requires intensive medical bed care. There is a significant risk of damage to soft skin tissue, which can initially only be prevented and treated in specialist units. Calcification with stiffening of the joints, spasticity, chronic pain syndromes, incontinence (the inability to control the bladder and bowels) and other effects complete this complex, and sometimes very individual condition.

How important is rehabilitation?

In all cases, acute medical treatment takes place in hospital, usually in specialist clinics. Rehabilitation starts almost immediately. The aim is to stabilize the patient's medical condition for the long term, and thus enable them to reintegrate into society. In most cases, patients are unable to resume their former employment and need to retrain. Rehabilitation is particularly important for people with quadriplegia, as they can no longer use their hands. Thanks to modern technological and electronic aids, people with quadriplegia are able to cope with everyday life. Nevertheless, most will continue to depend on the assistance of others.