Injury to the spinal cord results in sensory and physical loss below the level of the lesion. Spinal cord injuries are most often caused by gunshot wounds, falls, automobile accidents and sports related injuries. Permanent paralysis is caused by fractures and dislocations that puncture or transect the spinal cord.

Quadriplegia results from an injury to the cervical area of the cord and causes sensory and motor loss to the arms, trunk and legs. Paraplegia results from an injury to the thoracic and lumbar cord areas and causes sensory and motor loss to the trunk and/or legs.

The extent of the injury will determine the physical abilities of the person injured. Functional loss may be asymmetrical or symmetrical, depending on the location of the lesion. The injury may be "complete" or "incomplete". In an incomplete injury, there is some degree of preservation of sensory and/or motor function below the level of lesion. In a complete injury, total loss of sensory and motor function occurs below the level of the lesion. In addition, the autonomic nervous system may be affected. This system involuntarily regulates a person's breathing, heart rate and digestion. If this system is injured, a person will have problems regulating some or all of the areas mentioned.

Other areas which may be affected by a spinal cord injury are skin integrity, respiratory ability, sexual ability, and bowel and bladder function.

When a spinal cord injury has occurred, the acute-care and rehabilitation settings are crucial to help the patient adjust to and adapt to the injury, as well as to help the patient regain the maximal level of physical independence in his life. Areas of great importance are: basic medical knowledge relating to the injury, skin care, bowel and bladder care, wheelchair propulsion, self-care, assistive equipment, vocational training, and driving training.