Spinal injuries – A danger to overall body functioning
The spinal cord is one of the most essential components of our central nervous system. It is a well-known fact that the spine acts as a communication system to transmit messages between the brain and other parts of the body. Any damage or injury to the spinal cord can end up in messing up with this circuit of message transmission.
In order to realize how our body can get affected by a spinal cord injury, it is important to know how the spine works. Several nerves originate from the brain and reach the skin, muscles and body organs through the spinal cord. There are specific levels on the spinal cord from where each nerve enters the cord and leaves it while entering to other body parts. The first seven levels known as the cervical levels are responsible for controlling breathing, neck and arm function. The next twelve levels or the thoracic levels control the chest and torso areas. The five lumbar levels manage the legs and the sacral levels are responsible for bowel, bladder, sexual and leg functions. It is, in fact, the spinal cord that controls our body movements. Thus, damage or injury to the spinal cord may damage the movements and functions of the above-mentioned areas in our body.
How can spinal cord injuries affect body functions?
A spinal cord injury is probably one of the most devastating injuries to a person, not only in terms of the physical disability it can produce but also in terms of its social and psychological implications on the injured person as well as his family. A person with a spinal cord injury can develop several ‘secondary’ complications and issues which need to be addressed from time to time.
Skeletal system: This is one of the body systems that get primarily hit due to a spine injury. Following an injury, some calcium and minerals leave the bones which may gradually get accumulated in the urinary system causing stones. This is why it is advised to remain as much active as possible post a spine injury. Difficulty in movement may result in joint stiffening of knees, elbows, shoulders and may cause pain. Range of Motion (ROM) exercise is of great help by enabling complete movement of joints by correct positioning in bed.
Urinary tract system: Many times, a person with spinal cord injury will not be able to empty his bowel and bladder. In such situations, either a person has to be on a full-time urinary catheter or has to do intermittent self-catheterization. In either of these situations, there is a substantially increased risk of urinary tract infections (Manifests as burning micturition, lower abdominal pain and fever with chills); that need to be treated with antibiotics. Preventing such infections by following hygienic and sterile catheterization techniques is always helpful.
Bowels: Similar to urinary issues, many patients with spinal cord injury also have a difficulty in emptying their bowels resulting in constipation. The abdominal muscles may have to be put on use to push the stool out depending on the extent and level of spine injury. A spinal cord injury can thereby result in bowel accidents, constipation and impaction. Following a spinal cord injury, it is essential to re-train the bowels. A new routine with various techniques, methods and medication, with the help of a gastro-enterologist and a physiotherapist, may help in regaining normal bowel movement and keep bowel accidents at bay.
Skin: The spinal cord sends messages to the skin to protect it from being hurt. Once the spine is injured or damaged, the transmission of these signals may pause and the skin may become numb to certain feelings of discomfort. Also, these patients usually have limited mobility and are confined to bed/ wheel-chair most of the time, increasing pressure on certain points on the skin. It can lead to pressure sores that open the skin to germs which may enter the body and enhance the risk of developing several infections. Daily skincare, regular skin check-ups and avoidance of pressure points by frequent change in positioning can help in these situations.
Respiratory system: Respiratory system may also get affected by a spinal cord injury. The very ability to move air in and out of the lungs depends on muscles which are controlled by the nerves in the spine. An injury to the spine may affect the ability to cough or even take deep breaths which are ways of ensuring complete and healthy functioning of the lungs. An incentive spirometer, a tool that enables deep breathing may come to the rescue and artificially help to take deep breaths. Regular chest physiotherapy and breathing exercises along with early recognition and prompt treatment of respiratory problems can prevent major complications like pneumonia or respiratory failure.
Autonomic function: Spinal cord injury may affect autonomic functions as well. The autonomic nervous system that runs in and out of the spinal cord manages the glands, digestion, heart, temperature, blood pressure and more. A spinal cord injury may result in most of these functions getting affected like temperature and blood pressure regulation and may put one at the risk of autonomic dysreflexia which can be severe.
Apart from these, spinal cord injury may also affect one’s sexual life by causing erectile dysfunction and changes in ejaculation and fertility among men and loss of sensation and feelings among women. A spine injury can put the entire body function at stake and lead to abnormal functioning of several body organs and systems. Hence, it is important to be cautious about the health of the spine and protect it from any sort of injury. Daily exercise, giving adequate rest to the spine, wearing appropriate shoes that support the spine, practicing good ergonomics while sitting and keeping the body active can help a great deal in maintaining a healthy spine.
Authored by Dr. Umesh Srikantha, Consultant – Neurosurgery, Head of Spine Services, Aster CMI Hospital
Let the Truth be known. If you read VB and like VB, please be a VB Supporter and Help us deliver the Truth to one and all.
Zubeen Garg's drowning in Singapore highlights vessel operators' responsibility: legal experts
Singapore (PTI): The drowning of Indian singer-composer Zubeen Garg has brought the spotlight on rules and regulations that concern responsibilities of vessel operators when dealing with intoxicated passengers, according to a media report that cited legal experts.
A cultural icon in India’s northeastern region, 52-year-old Garg travelled to Singapore in September 2025 to perform at a live event. A day before his performance, he went on a yacht trip with a group of people. He drowned while swimming in the sea near Lazarus Island, which is a popular diving spot.
His death shook his home state Assam, where millions came out on the streets mourning. Later, police cases were registered against the organiser of the event, his manager and some others.
Nico Lee, managing director of the Triangle Legal law firm, told The Straits Times that Singapore has Maritime and Port Authority of Singapore (Port) Regulations under which there are provisions to debar drunk passengers.
The owner, agent or captain of the vessel must not allow persons under the influence of alcohol or drugs onboard if they are intoxicated to a point where they endanger safety of the vessel, its crew or any person in it.
“In terms of civil liability, it could be argued that a yacht captain is negligent, as he owes a prima facie duty of care to guests on board under general negligence principles,” Lee was quoted as saying by the newspaper.
The singer and his entourage of about 15 individuals were partying on a chartered vessel, which they had boarded at Marina at Keppel Bay.
A death certificate issued by the Singapore General Hospital listed his cause of death as drowning.
An autopsy report suggested that Garg had 333 mg of alcohol per 100 ml of blood in his system, which was four times the legal limit for driving in Singapore and is likely to have impacted his coordination.
Citing Garg’s case, Lee said the circumstances were serious, as the controller of the vessel knew that the guest was intoxicated. Also, he may not have understood or processed a safety briefing for all passengers.
“That combination makes reliance on an ordinary briefing inadequate. If intoxication reaches a level that endangers the safety of the vessel or persons on board, the person in charge should not permit boarding at all,” he said.
According to Lee, the vessel’s operators could also have assigned a crew member to directly supervise him or ensure that he received a one-to-one explanation when he was capable of understanding.
Part of the responsibility could be attributed to the guest if he chose to enter the water and ignore instructions or behave dangerously despite the yacht owner or charterer’s best efforts, Lee said.
Vanessa Sandhu from Clifford Law LLP told The Straits Times that a key question is whether the yacht captain or operator owed a “duty of care” to the passenger and, if so, whether a breach of that duty caused the death.
“A yacht captain and operator generally owe passengers a duty to take reasonable care for their safety while on board, including swimming or water activities. This may include providing safety equipment and issuing appropriate safety instructions,” the daily quoted Sandhu as saying.
“However, the standard of care is an objective one, based on what a reasonable captain or operator would have done in the circumstances. It is not an absolute obligation to prevent all harm,” she said.
During the coroner’s inquiry, the operators of the vessel had said that no one had forced the singer to consume alcohol or enter the water, and that the entire entourage was informed on the yacht about the necessity of wearing life jackets before going for a swim.
A coroner’s inquiry on March 25 ruled Garg’s death as accidental drowning. On April 1, the police said that investigations into the singer's death had concluded, with no evidence of foul play.
However, in Assam, where seven persons were arrested in connection with Garg’s case, and some of them charged with murder, the matter is being heard in the court. All the suspects have denied any wrongdoing.
