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Thread: Silly question about injury levels

  1. #1
    Senior Member Wesley's Avatar
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    Jul 2003

    Silly question about injury levels

    All things being the same, the lower your injury is the better, right?

    What about when you get to the part of the spine where one loses lower muscle tone and changes from a neurogenic bowel to flaccid? Is it better to have an injury above that point or is the "lower is better" rule consistant?

  2. #2
    This might get interesting...

  3. #3
    After much thought, I'd say the lower the injury the better! But, at this time im still pondering how to relate your question.

    A.should i slam the car door on my finger?
    B.should i have a friend slam the door?
    As if we had a choice,scheeez.


  4. #4
    Just as a clarification, both people with upper motor neuron injuries (usually cervical, thoracic and upper lumbar) and lower motor neuron injuries (usually lower lumbar, sacral and cauda equina) in relationship to the bowel have neurogenic bowel and bladder and sexual function. The difference is that in the former, reflex activity usually remains, while in the latter it usually does not. Both rarely have voluntary control unless they are fairly incomplete.

    For autonomic function, there are definately advantages to having a lower injury (below mid-thoracic). Those with lower injuries do not get AD, and have many fewer problems with temperature regulation, and reduced GI motility, etc. Of course they often have more voluntary muscles and functions and options for mobilitity as well.

    On the other hand, a flaccid bowel is much more difficult to regulate than a reflex bowel, and reflex erections tend to predict better outcomes with ED interventions such as Viagra than do no reflex erections. A flaccid external urinary sphincter is also more difficult in some ways, as leakage with any straining is often more common. FES is also difficult if not impossible with lower motor neuron muscle paralysis. In my experience, more people with conus and cauda equina injuries have serious neuropathic pain as well.


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