text:
Talk:William the Silent

"De Zwijger" should not be translated to "The Silent"
Translating the Dutch "De Zwijger" with "The Silent" gives the wrong impression. It should be "The Taciturn". --146.182.9.9 09:41, 13 July 2006 (UTC)

Please provide a reference that supports this idea; as far as I now the Silent is the accepted translation Arnoutf 16:38, 13 July 2006 (UTC)

 * Hi, it might be prudent to include in the article that the Dutch word "Zwijgen" doesn't have a direct translation into English. You are 'zwijgen' when you are silent, but you are not always 'zwijgen' when you are silent. It's a more active way of choosing to refrain to speak. In Dutch you don't take an oath of silence, you take on the duty to continue to 'zwijg'. -- Vera (talk) 21:06, 1 March 2012 (UTC)
 * Also, I get the impression the Flemish more often use his nickname than do the Dutch. -- Vera (talk) 21:08, 1 March 2012 (UTC)

 * Whatever. It has always been William the Silent IN ENGLISH, and that is all that matters here. Johnbod (talk) 23:06, 1 March 2012 (UTC)

 * Arnoutf asked on July 13th 2006 (UTC) a reference for the claim made by anonimous user 146.182.9.9
 * Apparently User Arnoutf hasn made much of an effort to look for the refence he asked from an anonimous editor. nor had he made any effort to refute the claim made. I'm not sure but Iḿ under the distinct impression that the contributors on this talk-page are not native enlgish speakers.
 * in the library of congress an online pdf version of translated book translated by J.P. Lacroix. written in french book by L.Abelous, Publishe by Nelson& Phillips in 1872 titled "Willian The Taciturn" catalogued with subject "William I, Prince of Orange (1534-1584)
 * next oxford English dictionary translates the dutch word "zwijger" as taciturn and provides following description of the word :
 * Taciturn (of a person) reserved or uncommunicative in speech; saying little.
 * "This quiet and taciturn man has been as responsible as any individual for the rise in England's fortunes."
 * synonimous with : untalkative, uncommunicative, reticent, unforthcoming, quiet, secretive, tight-lipped, buttoned-up, close-mouthed, silent, mute, dumb, inarticulate, reserved, withdrawn
 * I have always learned the man was referred to as "the Taciturn rather then the silent. this position is supported by prof John Whitehead Historian based in Oxford, member of Oriel College, in his weblog page about William I Once I was a clever boy
 * Moreover I don't thin that this page should be named William the Silent after his nickname, but as any hitorical figure by his official name and or title which is William I, Prince of Orange then his nickname can be mentioned in the intro and referring pages can be made for both William I the Silent and William I the Taciturn which is historically correct and encyclopedically much more serious. --DerekvG (talk) 13:35, 7 October 2014 (UTC)

 * Burden of proof lies with the one who wants to change long standing consensus. Was not me - so not for me to provide anything here..... Arnoutf (talk) 17:59, 7 October 2014 (UTC)

Requested move 07 October 2014

 * The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: Withdrawn by nominator. SnowFire (talk) 19:26, 12 October 2014 (UTC)

William the Silent → William I, Prince of Orange – William the Silent is a Nickname and as a matter of fact badly translated nickname, because it should be William the Tacturn see reference to library of congress and Oxford dictionary in sujbect above on this page. DerekvG (talk) 13:49, 7 October 2014 (UTC)

Survey

 * Feel free to state your position on the renaming proposal by beginning a new line in this section with  or  , then sign your comment with  . Since polling is not a substitute for discussion, please explain your reasons, taking into account Wikipedia's policy on article titles.

 * Oppose on grounds offered. What matters is the name used in English which doesn't necessarily have to match a translation of the name in Dutch.  See Johnbod above.  The fact "taciturn" is the Dutch name is irrelevant.  As for "nickname", well, we have William the Conqueror, so Wikipedia doesn't always use the number if such a modifier is better known... SnowFire (talk) 14:50, 7 October 2014 (UTC)

 * Support on the grounds that
 * a) "the Silent" is a literal translation and a tacky translation made by non-native english speakers as the Oxford Dictionary shows translates the dutch word "zwijger" as taciturn and provides following description of the word :
 * Taciturn (of a person) reserved or uncommunicative in speech; saying little.
 * "This quiet and taciturn man has been as responsible as any individual for the rise in England's fortunes."
 * synonimous with : untalkative, uncommunicative, reticent, unforthcoming, quiet, secretive, tight-lipped, buttoned-up, close-mouthed, silent, mute, dumb, inarticulate, reserved, withdrawn
 * and in French William I is not called "le Silencieux" but "le Taciturne", he wasn't silent or "muet" in french, he was uncommunative
 * b) in the library of congress an online pdf version of translated book translated by J.P. Lacroix. written in french book by L.Abelous, Publishes by Nelson& Phillips in 1872 titled "Willian The Taciturn" catalogued with subject "William I, Prince of Orange (1534-1584)
 * c) Morover I have always learned in my history courses that the Stadtholder of the Netherlands was referred to as "the Taciturn" rather then "the Silent". so is is not a fact that he is knwon "in English" as the Silent as user Johnbot claims,
 * d) this latter position is supported by prof John Whitehead Historian based in Oxford, member of Oriel College, in his weblog page about William I Once I was a clever boy, he writes that William should be named the Taciturn rather then "the Silent"
 * e) Moreover this historical figure prime reference should be by his official name and or title which is William I, Prince of Orange in from the 15th century in the Lowcounbtries and in Frande Kings and heads of state would be named with numbers and theri title not by their nickname, William the Conquerer lived in the 11th century and since the end of the Roman empire 476 AD kings and souvereigns were named - like their vassals - by their name and a qualifier, therefore the name he is known by the name William the Conquerer. My request to rename doesn mean that we cannot create referring pages titled  "William I, the Silent" and "William I, the Taciturn"  which is historically correct and encyclopedically much more serious. --DerekvG (talk) 16:21, 7 October 2014 (UTC)
 * f) while checking the Wikipedia page on naming conventions under the sections Neutrality, William the silent is a Colloquialism whereas my proposal to rename the page to "William I, Prince of Orange", is historically a more neutral without compromising the other aspects of naming als recognisability and ease of use and most histroical sources in English will refer to this person by the proposed title. --DerekvG (talk) 16:34, 7 October 2014 (UTC)
 * First off, you're the proposer, not a voter, so there's no need to "support", it's assumed you support your own move proposal.
 * Second: It's not a "colloquialism", it's a cognomen. See WP:COGNOMEN, the Wikipedia naming policy which explicitly endorses cognomens that are the main way a monarch is known.  Many monarchs are much better known by such modifiers - Peter the Great, William the Conqueror, etc.  Real historians use them *as their name*, not merely as a description.  It simply does not matter if you don't think Pyotr Alexeyevich was all that great; he's still "Peter the Great" in English sources.
 * Third: The "more serious" and "more neutral" claim is flatly incorrect. "Serious" English sources use cognomens all the time.  Google scholar hits for William the Silent: ~3500.  Google scholar hits for William I, Prince of Orange: ~176.
 * Fourth: Did you read your own sources? http://onceiwasacleverboy.blogspot.be/2014/07/william-silent.html -> The title of this blog post is "William the Silent" and he is referred to as "William the Silent" throughout the article.  The author says that his "epiphet should better be rendered as the Taciturn" in translation.  The author is not proposing renaming William the Silent, and if he was, he acknowledges that in actual practice, he is still called William the Silent!
 * Your entire argument is founded on a fundamental misunderstanding. Names aren't "correct" or "incorrect", they just are.  If "Willem de Zwijger" was usually known in English as "Lord Brocolli of Mars", that's what his article would be called, no matter how 'incorrect' or 'unserious' a translation it was.  It would not matter that a few books or historians think a different name should be used.  If you'd like to convince us that this article title is wrong, you need to show that "William I" is used in preference to William the Silent with the likes of the Google Scholar hits that I linked above.  (Except that Scholar seems to show William the Silent is what's used.) SnowFire (talk) 17:30, 7 October 2014 (UTC)

 * Re (a) Re-translating using the Oxford dictionary would be original research.

 * Re (b) An originally French book translated into English hardly gives confidence in fewer translation errors than the direct Dutch-English translation. Also, a single source does not constitute sufficient evidence as there are many sources in English that use Silent

 * Re (c) What you have always learned can only be used as input if you actually provide the reliable sources that can be accessed by all that were used in your learning.

 * Re (d) The point that an Oxford professor argues that it should be Taciturn instead of Silent supports that Silent is the more common name (although perhaps not best translated in the past, but that is not for us to judge). Hence the argument of the Oxford professor in fact supports the current title of this article.

 * Re (e) You appear to try to make the point that William the Conqueror should be known by his nickname but William the Silent not. However I just don't follow your arguments as they seem arbitrarily selected without a clear logic. If it is merely about date difference (people before 1500 may known by nickname) Catherine the Great is a point against your claim, as she lived about 200 yrs after William.

 * Re (f) Per WP:COMMONNAME we should use the most commonly used name in daily discourse. That is William the Silent by about a factor 10. If you stand by your point this is not true you must give convincing evidence of the opposite; a mere claim will not do. Arnoutf (talk) 18:12, 7 October 2014 (UTC)

Oppose Per WP:COMMONNAME. William the Silent is by far the most common name used in English. Arnoutf (talk) 17:42, 7 October 2014 (UTC)
 * Oppose unless an argument based on principles like using the commonly recognised name is offered. —innotata 05:47, 8 October 2014 (UTC)
 * Oppose. Whether it's a correct translation or not, that's how he's commonly known in English. -- Necrothesp (talk) 13:02, 8 October 2014 (UTC)
 * Oppose on ground of all the arguments mentioned above. Bottom line is: he is in English known as "The Silent"--Watisfictie (talk) 11:23, 8 October 2014 (UTC)
 * Support, as there's a William II, William III etc etc & the nickname can be kept in the intro. GoodDay (talk) 16:42, 8 October 2014 (UTC)

Discussion

 * Any additional comments:

Google searches show use of William the Silent (293000 hits) is 10 times more common than William the Taciturn (28000 hits)  with about 5000 listing both. With William I Prince of Orange scoring 28000 hits, again 10 times less common than William the Silent. Arnoutf (talk) 17:41, 7 October 2014 (UTC)

 * Arnoutf, it's not because google has 153million references "color" that I will start writing that word instead of "colour", neither will 4 million references to "tumor" convince me that the popular spelling of "Tumour" (neoplasm, with only 804 thousnad hits) is better, popular is like education if humanskind settles for what is most popular we would all be illiterates ... --DerekvG (talk) 20:24, 9 October 2014 (UTC)

 * I will try to asnwer some of the arguments:
 * "colloquialism" or cognomen. I agree to the WP:COGNOMEN as a way a monarch is referred to. and I agree tp the statement that "Many monarchs are much better known by such modifiers - Peter the Great, William the Conqueror, etc." however its somewhat like discussing the colour of the sea or the taste of wine. I qualified William the Silent as a colloquialism and a bad translation made by non native speakers therefore I dismiss that name as a cognomen for THIS particular historic figure.
 * the statement that starts with "Real historians use ..." sounds like a "Real men..."-statement
 * The third argument that "The "more serious" and "more neutral" claim is flatly incorrect." is not validated by the number of Google hits, the number of hits validates a popularity-statement and it doesn't mean it's either serious, neutral or encyclopedic, but it does indicate that a referencepage redirecting that title to the correctly titled page is necessary (which I proposed)
 * You may question wether I Did read my sources? Indeed as you elequently quoted "The author says that his "epiphet should better be rendered as the Taciturn" in translation.", I didn't make a claim that "the author IS proposing renaming William the Silent" (neither do I, I think, that wasn't my intention anyway) what I propose doesn't imply that both "William the Silent" or it better variant "William the Taciturn" shoudl ceratinly be mentioned in a article about "William I, Prince of Orange"
 * My argument is not founded on wether names are "correct" or "incorrect", I don't claim they that the silent is incorrect i claim it a bad and litteral translation by non native speakers.
 * "Willem de Zwijger" is also in Dutch a colloquialisn and not the historic and scientific name, it is a validated second reference to the same person. The argument is that kings like Alexander the Great, or "Peppijn de Korte", "Karel Martel", "Karel de Goede" or "Lodewijk de Slechte" medieval kings in the low countries are indeed known by their Cognomen, like William the Conquerer that is what they are known by, that traditon lasted until the last of the brugundy dukes Philip I of Castille, known in the Netherlands by the name of "Philip the Handsome" (Filips de Schone) but from approx 1480 starting with philip's father Roman Emperor Maximilian I (Habsburg) kings and sovereigns in the Netherlands were referred to by their official name and number, starting with Maximillian's grandson and son of Philip Emperor Charles V (Charlesquint, Keizer Karel V) only nobility like Dukes, Counts and Earls etc.. were named without number and by their title designation and their territory. Which is why I qualify the name of "Willem the Zwijger" as a colloquialism rather then a cognomen, therefore i argue that those epiphets are not the best titles for this article.
 * Arnoutf says "Re (a) Re-translating using the Oxford dictionary would be original research."
 * I'm sorry original research would be to find and ethymological rule why Willem should not be translated as William but something else. Using a dictionary or to state the obvious, or using documents as refernce is not OR.
 * An original ninetheenth century translation by a scholar from French to English is indeed more reliable than any modern time Dutch-English translation by an amateur.
 * A single source reference from such a source does have more weight as evidence then are many popular sources
 * I have no access to my schoolbooks any more I'm slightly too old for that
 * The point that an Oxford professor argues that the epiphet should be translated to the Taciturn instead of the Silent actually supports the argument that the popular the Silent is a bad litteral translation and very unscientific
 * you mention that a i arbitrairly use William the Conqueror while being in consequent and prefer William I, Prince of Orange, refer to my earlier argument that the age of William the Conquerer Kings in the netherlands would be named by what seems like a cognomen a tradition that changed at a certain moment in time in England and around 1480 in The Netherlands, actually the Russian never made that change so your counter argument actually suppoprts my thesis because my argument is not linked to date only but to date and place and different for each combination.

Actually the WP:COMMONNAME  is the only valid argument, but then again the we are talking about a popularity contest and not encyclopedic refernce --DerekvG (talk) 20:00, 9 October 2014 (UTC)

 * Very long but I hope to refute some of your points.

 * Bad translation does not matter at all as this is not an original translation/ - What kind of "translation"  is the name Charlemagne?

 * From approximately 1480 onwards. Please note that William is only 1 century later. So unless you give a truckload of references that the last ever cognomen ended before his time, I interpret his lifetime as approximately 1480.

 * Where do you get the idea that the translation William the Silent is a modern translation? The installation of the statue at Rutgers university in 1928 proves it is at least older than that (and that one of the major US universities is ok with the name).

 * If you can't provide the evidence (like your schoolbooks), you cannot bring it to the table - that is one of the core ideas of WP:V.

 * You may consider WP:COMMONNAME a popularity contest, but it is a policy. If you disagree you have to change the policy. As long as it stands it guides how we edit this page. Arnoutf (talk) 21:24, 9 October 2014 (UTC)

 * Translation : a translation happens when some word is taken from a language A and is subsequently translated in another language B . In this case the historic figure "Willem I Nassau, Prins van Oranje" aka. "Willem de Zwijger" Stadthouder of the United Provinces of the Netherlands, both are Dutch names given in the Netherlands, "William the Silent" although popular is a bad translation made by non native speakers, as it should be rendered as "the Taciturn"  and afaik (but I'm looking for a refernce to support that statement) the latter epiphet was also used in England at Elisbethan times,
 * on the matter of the name of "Charlemagne" I don't understand what your are implying so please enlighten me, is it about the use of Charlemagne in English, the name Charlemagne in french, the ducth equivalent? please expatiate.
 * Please Arnoutf, get your history right : I didn't only cite the date I referred clearly to the relevant historic periods : I cited 1480 and  Philip I of Castille (Habsburg) last duke of Burgundy to rule the Netherlands (closes the Burgundy period in the Netherlands, in the historic period of the late middle agea), and was known by his name Philip the Handsome (not by Philip I, which was how he was known in Spain though) in Dcuth history everbody knows Philip II son of Charles V but nobody can answers if you ask who is Philip I though, but they all know Philip the Handsome.. I cited his father MaximillianI and his son Charles V .  Now Maximillian better known as the husband of Isabella concluded the Spanish reconquista in 1492 financed the expeditions of Christopher Columbus to the West over the Atlantic, dat at which  conventionally the renaissance period and the contra reformation mouvement started in the Netherlands.  If you think that "approximately 1480"  the end of the late middle ages is the historic period in which Willem I, Philips II and the Duke of Alva are situated then the hisotrians of the low countries disagree with you. More over I said that the manner in which kings were named differs in the middle ages then in the renaissance period, and the date coincides roughtly 1480 give or take a decennium , not a century ...
 * You are seriously talking about a statue form the 1920-ies in a US university ?? seriously ? a country where history started 200 years ago, and that considers everything before 1779 the field of paleontology, erects a statue for a major european historic figure from the 16th century, and that is something you do not consider a modern translation ??
 * last but not least before you insist on a polocy as commonname, you should als consider the level above that about article titling and the other policies it also cites as equaly important as coomonname, and how it dismisses popularity contests, and yes if you use google citations in this way, it is a popularity contest (aka in Antwerp "de vetten os") --DerekvG (talk) 09:49, 10 October 2014 (UTC)

 * I have one question to you. Who did, for the first time, translate Willem de Zwijger into William the Silent. You repeatedly claim that it was not a native speaker of English so you must have a reliable source claiming who it was. Please enlighten me. Arnoutf (talk) 17:08, 10 October 2014 (UTC)

 * PS While the United States does not have the oldest history of the world - Rutgers University (est 1766) predates the book you quote by more than 100 years. Talking about history. Arnoutf (talk) 17:16, 10 October 2014 (UTC)

 * Arnoutf, without making this personal why do you turn every argument into a pissing contest? what has rutgers universities date of establishment to do with the publication date of a book, inn what does a building constitute a measure for serious reference?  what makes a 1926 statue in a university a more reliable reference then a book ? the statue doesn say anything about who comissioned it , why and who decided on the inscription and what its content was (going to be)  , especially if that monument is not the tombstone monument of the historic figure in question but a decoratiove /perhaps  commemorative monument.  I didn'talk about the library of congress as the reference, i did talk about the biography , a monography translated in english by a serious translator from a established writer , the reference is that book its content and those who wrote it  author and translator  and actually the french book  and the resulting translation in english - that is waht my refernce poits to   ...  sorry about that rant but most google hits,  my date is older than yours ,  ok you piss further then me,  I do admit that,  but perhaps my piss has ended up in the pot not splattered all over the wall , dubiuous comparison but spot on --DerekvG (talk) 19:43, 11 October 2014 (UTC)

 * I have been asking for mainstream support for your claims; if you think of that request and the examples I gave that you would be unlikely to succeed as a pissing contest than I am sorry as that never has been my intention. You may on the other hand also consider your own stubborn repetition of claims without providing additional support your derogatory remarks about the United States; and your repeated claim it was a non native speaker who did the original translation that do not help. Arnoutf (talk) 07:34, 12 October 2014 (UTC)

closing the request
Thank you all contributors, I propose to close this move request and leave the title of the article as it stands, with "Move not executed" as clearly no consensus has been reached in favour of this move. Could a moderator make the closing changes Thank you very much--DerekvG (talk) 10:08, 10 October 2014 (UTC)
 * Actually, no need for a moderator to withdraw a discussion, FWIW. SnowFire (talk) 19:26, 12 October 2014 (UTC)

 * The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

further comments
Arnoutf, I'm sorry I shouldn't have phrased that in a personal way, I probably should have said that the value of a reference is not based on numbers, that itś not a pissing constest to determine which reference carries more weight based on the number of times it was referred to etc... anyway no personal attack intended and my apaologies, and Yes I'm stubborn, my user page confirms that.

I will however answer some of your remarks

Maybe my comment about the US could be considered derogatory, no such intention on my part, they are a mere statement of fact based on the lack of historical knowledge both in the general public and among higher educated people or in policy (and idem ditto for geographical awareness). It's my experience that historic events that happened outside the US borders or before the Declaration of independance are considered uninteresting and irrelevant, imho because of ignorance. History and geography are considered specialised fields of study for uni-nerds, and certainly not for the more important uni-jocks, I have not implied that historic study by US historians (also about subject outside that scope) is not valid or not expertly executed, becuase their research is as good as any other historians work.

Looking at history there a a number of reasons why "the silent" should be a bad rendering of the dutch "de zwijger":
 * before any misunderstandings occur my statement doesn't imply that an wikipedia editor has mad that translation, it's much older and don't deny the obvious: "the silent" has been in used widely in different sources.
 * first of all using the translation of "silent" for "zwijgen" or "zwijger" would indicate that the translator lacks english vocabulary, because that translation doesn't grasp the nuances incorporated in the dutch qualifier "de zwijger", whereas the translation "the taciturn" does
 * secondly because if one does the inverse translation of "the silent" (using comparative techniques form literature with other earlier kings of the medieval era and how their names were translated, using french and latin) that would yield in dutch : "de stille". Translating that result back (using the same technique) to french yields "le muet" or in enlgish "the mute". However using the same method of transalting that "de zwijger" would yield in french "le taciturne" and in latin "taciturnus", using the word taciturn in english would require a higher then basic level of vocabulary, and an education that encompases latin and or french.
 * In the article a section is about the epiphet : I quote reference 28 of that section  "den swijger", "den Schweiger": Emanuel van Meteren, 1608 and 1614; cf. "Taciturnus": Famiano Strada, 1635. The Dutch historian Fruin (1864) has argued that this is in fact an erroneous rendering of the phrase "astutus Gulielmus", "cunning William", found in a Latin source of 1574 and attributed there to the Flemish inquisitor Pieter Titelmans. See Leiden University, De Tachtigjarige Oorlog. Willem de Zwijger.
 * Why use complex methods of translation stepping through latin and french? a) we know that the inquisition used primarily Latin, the documents kept in many archives and museums prove that; b) in 16 and 17th century the royalty would use latin or french, contrary to popular belief the dutch court and nobility and at the english court french would be the vehicluar language in that period (dutch and english was for the peasants and the soldiers); and last bust not least c) one would have to look at how such transaltions came to be in that period of hirstory, most certainly in libraries in England documents will reside from the court dating of that period referring to William, Prince of orange in his contacts with the Enlgish court and such a nickname that indicates his gift of a special diplomatic quality (to use silence as a technique to obtain information) would most certainly be notified to the king in order to make sure that they negotiate at an equal level. Diplomats would use french and latin for their communications, such that only their masters and the clergy would be able to decypher the communications.

As for literature references, actually I don't have them readily available, and I would have it go to a library to collect them, which takes time, Yes, ican provide but not immediately.

Futhermore what is mainstream in not necessarily correct, or adequate. Encyclopedic knowledge is correct and dissipates confusing information which might have survived in popular sources. wikipedia should provide correct information. Which is why I did the survey above.

The historical correct information is that this king is called in the netherlands "William I, Prince of Orange". And as I explained contrary to the kings of the medieval period (before approx. 1480) who were known by names such as "Filips de goede", "Karel Martel" - also the last duke of burgundy to rule the Netherlands Philip I of Castille, known in the Netherlands by the name of "Philip the Handsome" "(Filips de Schone)" rather then by his full title by which he was known in Spain - was the last king to be named by a cognomen, in dutch history. In dutch Willem van Oranje, is the most commonly used name rather then the a.k.a. Willem de Zwijger. That was my principal argument --DerekvG (talk) 13:11, 15 October 2014 (UTC)

 * One of the problems with history is that it is either a social science or part of arts and humanities (depending on classification). In these sciences there are hardly any issues that are outright "correct" or "wrong" and in my view the naming of William is one of these.

 * As you say, William is most commonly referred to as William of Orange (and not the rather cumbersome William I, Prince of Orange). However that does not work in English as William of Orange in English is used commonly for William of Orange (king of England) (Stadtholder William III).

 * Personally I still support William the Silent because of WP:Commonname. The first line mentions the other names so confusion is unlikely. Arnoutf (talk) 17:08, 15 October 2014 (UTC)

In the "Epithet" section, there is a long story that begins, "One day, during a stag-hunt . . ." I would recommend deleting this story because it is pointless and borderline nonsensical. I expected that it would explain why he was known as "William the Silent (or Taciturn)" but it really does not. Maybe I am missing something. Perhaps he held his tongue on a divisive issue and people thought he was wise for doing so. If that is the case, one could say as much in a single sentence. Ibnsina786 (talk) 02:11, 26 August 2015 (UTC)

Duchy or County?
In the image description of the picturesque engraving of the city, Nassau-Dillenburg is called a DUCHY... but in the accompanying text, William's rank is always referred to as COUNT of Nassau-Oranien. Wouldn't that mean that Dillenburg should be a literal County? As far as i can tell from going to school in Dillenburg, Graf and Grafschaft are the commonly used level of his aristocracy before the whole rebellion thing. Once he was mostly dealing with the netherlands he is usually referred to as steadholder/Statthalter but that should have no bearing on his german posessions, should it? --176.199.184.48 (talk) 15:01, 29 August 2017 (UTC)
 * Thanks for picking this up. Nassau was a county in the time of William to become a duchy in the 19th century. The wikilink was to the 19th century duchy and I replaced it with a wikilink to the 16th century county. Arnoutf (talk) 17:58, 29 August 2017 (UTC)

title: Talk:William the Silent


text:
Talk:Magdeburg Cathedral

Featured
Wasn't this article featured some weeks ago. Sep 26? --Pjacobi 12:33, 18 Dec 2004 (UTC)
 * No. →Raul654 18:27, Dec 18, 2004 (UTC)

former East Germany
Why does my page on Cathedral of Magdeburg show "East Germany" but when I go to edit it shows "the former East Germany"?

 * Magdeburg is and always was located in CENTRAL Germany. From 1949-1989 it was in the Soviet-occupied "German Democratic Republic" (which used to be called colloquially "East Germany" by some Americans).--dunnhaupt 18:48, 19 February 2007 (UTC)

 * Slight correction: East Germany was the name for the DDR used throughout the English speaking world, not just by "some Americans", also not relevant here, but to try and imply that Soviets were to blame for everything in the "Soviet-occupied DDR" needs challenging. From 1949 onwards the DDR was a sovereign* nation within the soviet bloc.  *This meant it made its own internal decisions, like e.g. the building of the Wall--IsarSteve 09:00, 16 March 2007 (UTC)

foundations
There is a dicussion about what Cathedral was based on here: link. Perhaps this should be corrected in the article? --Piotr Konieczny aka Prokonsul Piotrus 13:30, 22 Dec 2004 (UTC)

What Watt?
418 Watts would be just enough for four 100 W bulbs. I guess you mean kilowatts.--dunnhaupt 18:40, 19 February 2007 (UTC)

Name Change
I would like to suggest changing the name of this article from "Cathedral of Magdeburg" to "Magdeburg Cathedral".

My reasoning for this, the new name sounds more precise. The current name would in any case, NOT be used by someone who uses English as a first Language.

As an example: We don't say "Abbey of Westminster" or "Cathedral of Salisbury" but Westminster Abbey and Salisbury Cathedral.

I would appreciate your views on this subject.--IsarSteve 21:50, 15 March 2007 (UTC)
 * Searching google for the respective terms (and filtering for Wikipedia related stuff), I get twice as many results for Cathedral of Magdeburg than for Magdeburg Cathedral. In light of this, I would keep the current title, but I can live with either title. -- Chris 73 | Talk 02:07, 16 March 2007 (UTC)
 * Hello Chris, I checked out your links... Hmm.. You are right of course in what you say, BUT Google uses its own form of English "Googlish" which makes it easier to find as many articles as possible by separating the two words with an "of". I would suggest that this is not the best form for the English Wiki to take. Reading through the lines of your reply, I take it you understand what I mean and that you would never advocate using "Abbey of Westminster" when speaking of that place? Gruß aus Berlin--IsarSteve 10:10, 16 March 2007 (UTC)
 * Not quite sure what you mean with "of", but i placed the entire search term in "" and the "Of" should be part of the text. Quickly skimming through the results, i did not see a "Cathedral magdeburg" result. To me it still looks like the current title is used more frequently. Shall we wait for other comments? -- Chris 73 | Talk 10:17, 16 March 2007 (UTC)

Sure, let's wait and see if anyone else (apart from us) "actually reads this bumpf". Regarding the "of" .....check out your link again, and you'll see that "of" is not part of the title!! Cathedral of Magdeburg At the top of the page it says in "blue" Magdeburg / Cathedral connected by an "of" in black, meaning two separate titles! See what I mean? This doesn't mean there is a title "Cathedral of Magdeburg"--IsarSteve 10:26, 16 March 2007 (UTC)
 * In fact, according to Google, the only title "Cathedral of Magdeburg" ..is this one.. here on WiKi. —The preceding unsigned comment was added by IsarSteve (talk • contribs) 10:29, 16 March 2007 (UTC).
 * Nope, sorry, you apparently don't know how Google works -- if you use "Cathedral of Magdeburg" as the search term, it ONLY searches for the full phrase, so it seems Chris is right and the current title also is. — Nightst a  llion  (?) 14:44, 16 March 2007 (UTC)

My .... I can't believe all this idiocy... I just read you entry at another place and really can't believe you can be so....   Cathedral of Magdeburg is wrong, please expalin why we don't say Cathedral of Westminster but Westminster Cathedral ?? You've no answer for that one.. have you? Because es ist schlicht und einfach falsch!! --IsarSteve 15:06, 16 March 2007 (UTC)
 * And by the way, I'm not interested in numbers here (google numbers), as you two obviously seem to be, I am interested in correct English... If you can't up with anything better than that then... Kopfschuttel --IsarSteve 15:09, 16 March 2007 (UTC)

Both "Magdeburg Cathedral" and "Cathedral of Magdeburg" are correct English, so that's not the question to ask. The question is, what is the mostly commonly used name in English? The Google test indicates "Cathedral of Magdeburg" is more common. On the other hand, Magdeburg's official website uses "Magdeburg Cathedral" on |115.3.2&FID=115.3.2 its English-language page. Aren't there more important things to worry about at Wikipedia? —Angr 15:47, 16 March 2007 (UTC)
 * Just because one church is named Westminster Cathedral, not all churches must have this order. See Sea of Japan vs. Caspian Sea, not Japan Sea and Sea of Caspia. Or take Cathedral of Trier as another example, with 21 000 Google hits for Cathedral of Trier and only 580 for Trier Cathedral. IsarSteve, try to relax, life does not hinge on how we call that church. -- Chris 73 | Talk 01:07, 17 March 2007 (UTC)

I'm very much relaxed thanks :o), I accept Angr's argument, even though HE IS an AMERICAN!! :o). BUT I'm still not happy with the title, because in my opinion it looks "Foreign" to English eyes. Once again I repeat, "Cathedral of Madgeburg" is totally correct when used with an article (THE is put in front of it). But as a name standing alone, "Magdeburg Cathedral" is the correct usage. --IsarSteve 00:31, 22 March 2007 (UTC)

Towers
NOT the tallest towers in East Germany, according to the list Stralsund is taller. I corrected this.--dunnhaupt (talk) 15:44, 18 June 2008 (UTC)

Catherine
Do we have a picture of the statue of Saint Catherine? (There is a comment about it in the Magdeburg article and I'm curious about it). RJFJR (talk) 17:13, 15 November 2008 (UTC)

Organ
Construction is scheduled to be completed in 2007, and the new organ will hopefully be used for the first time in 2008.

And was it? Interesting article. Sca (talk) 20:28, 6 January 2009 (UTC)

"Dome"
Interesting article about a fascinating historic structure. One question: It says Otto was also able to complete the interior construction, and formally opened the dome in 1363.... Do we mean the English word "dome," or the German word Dom — which is the German term for cathedral — ?? Sca (talk) 16:15, 18 June 2010 (UTC)

 * The technical term for cathedral in German is "Kathedrale", but it's never used in proper names. Usually cathedrals are either called "Dom" or "Münster" in German. The problem is many big churches are called that way, whether it's a "real" cathedral or not. It's therefore often not correct to translate "Dom" as cathedral. Many of them are indeed collegiate churches (Stiftskirchen) or just big (like the principal Catholic church in Frankfurt). There as well "Dom" is often translated as cathedral, but it has never been one. And nobody calls this church "Kathedrale" in German. --77.181.221.65 (talk) 21:20, 19 August 2010 (UTC)

 * Long time ago, but similar question: not every Dom is a cathedral, a bishop's seat. This one was a cathedral, but is no longer. How would that be reflected in the name? If "Cathedral" is kept in the name, why not Magdeburg Cathedral, similar to others? --Gerda Arendt (talk) 16:49, 11 June 2014 (UTC)

 * Actually, this church is still a cathedral, as it is the seat of the bishop of the Evangelical Church in Central Germany. As for the Magdeburg Cathedral vs Cathedral of Magdeburg issue, there has been a move request, but I should start a new one, I guess. Madcynic (talk) 09:13, 12 July 2015 (UTC)

WWI
I deleted The cathedral survived World War I without major damage because the only parts of then-Germany that suffered major damage in the First World War were certain towns in East Prussia and, possibly, Alsace. Sca (talk)

Rhetoric
''Communist leaders tried to suppress religion as a potential threat to communist doctrine, thus being active in church was a social disadvantage. The eradication of religion could not be accomplished, however, and ....''

 * Is this rather accusatory cold-warish passage really relevant to the history of the cathedral? Sca (talk) 16:28, 18 June 2010 (UTC)

Vague / unclear sentence
Magdeburg became a leader in the Protestant reformation, and was outlawed by the emperor.207.161.191.93 (talk) 00:04, 4 October 2012 (UTC)

Oldest Gothic Church in Germany?
According to the Trier Tourist Bureau and UNESCO, the Liebfrauenkirche (Trier) was the first. This needs clarification. — Preceding unsigned comment added by WIKI1Q2W3E4R (talk • contribs) 21:56, 10 January 2014 (UTC)

Requested move 12 July 2015

 * The following is a closed discussion of the proposal. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the proposal was move per request. In this case the web search disparity matches what is evidenced through Books, Scholar and News searches, indicating the target is the more common name, but for future reference Madcynic, that is not always the case and as is stated in multiple places, such results that concentrate reliable sources should be defaulted to before ever presenting the results of a web search (when search engine results are to be used).--Fuhghettaboutit (talk) 11:10, 19 July 2015 (UTC)

Cathedral of Magdeburg → Magdeburg Cathedral – Once again, I propose to move this page to its common English name. A quick google search gives only about 30k hits for "Cathedral of Magdeburg", while "Magdeburg Cathedral" has almost 700k results. The new page name would be in line with other church articles, e.g. Westminster Abbey, Salisbury Cathedral. Madcynic (talk) 09:23, 12 July 2015 (UTC)
 * Support per nom 76.120.162.73 (talk) 20:34, 13 July 2015 (UTC)
 * Support per nom. Yes, there are a few of these strange constructions around that are clearly just non-intuitive literal translations into English. I've moved many of them over the years. -- Necrothesp (talk) 13:28, 15 July 2015 (UTC)
 * The above discussion is preserved as an archive of the proposal. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

Is Otto I (next to Eagdyth in Magdeburg) holding an orb with no cross?
Please see https://en.wikipedia.org/wiki/File:HerscherpaarMagdeburgCathedral.jpg and note that it is not without question that this IS Otto I and his wife Eagdyth. WHAT is he holding? An orb? A plan-view of a nearly-circular walled city? Something like the breast-plate of the Israelite High Priest?2604:2000:C682:B600:FC9C:4C2:2514:9A8F (talk) 15:49, 18 July 2016 (UTC)Christopher L. Simpson

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Cathedral rock under the church
Hello, the text about "Domfelsen" ist not correct. Look the article in the german wikipedia. The complet Church stands on it, also the south tower, but it are some sediments (5 -10 meters thick) beetween the rock and the church. The Rock is ca. 10 meters unter the cathedral. The cathedral has not a direct contact to the rock. Geological drillings since 1993 found the rock more than 10 m under the church.

Look also the article in the german wikipedia about the eight new bells from 440 kg to 14 000 kg (the second largest bell in germany after the big bell in Cologne Cathedral), will be installed in the next years. The Schuke-Organ from 1970 will be restored in the next time. 32-Fuß-Freak (talk) 16:44, 7 November 2022 (UTC)

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Talk:Magdeburg Cathedral


text:
Spinal cord injury

A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. It is a destructive neurological and pathological state that causes major motor, sensory and autonomic dysfunctions.

Symptoms of spinal cord injury may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury. Injury can occur at any level of the spinal cord and can be complete, with a total loss of sensation and muscle function at lower sacral segments, or incomplete, meaning some nervous signals are able to travel past the injured area of the cord up to the Sacral S4-5 spinal cord segments. Depending on the location and severity of damage, the symptoms vary, from numbness to paralysis, including bowel or bladder incontinence. Long term outcomes also range widely, from full recovery to permanent tetraplegia (also called quadriplegia) or paraplegia. Complications can include muscle atrophy, loss of voluntary motor control, spasticity, pressure sores, infections, and breathing problems.

In the majority of cases the damage results from physical trauma such as car accidents, gunshot wounds, falls, or sports injuries, but it can also result from nontraumatic causes such as infection, insufficient blood flow, and tumors. Just over half of injuries affect the cervical spine, while 15% occur in each of the thoracic spine, border between the thoracic and lumbar spine, and lumbar spine alone. Diagnosis is typically based on symptoms and medical imaging.

Efforts to prevent SCI include individual measures such as using safety equipment, societal measures such as safety regulations in sports and traffic, and improvements to equipment. Treatment starts with restricting further motion of the spine and maintaining adequate blood pressure. Corticosteroids have not been found to be useful. Other interventions vary depending on the location and extent of the injury, from bed rest to surgery. In many cases, spinal cord injuries require long-term physical and occupational therapy, especially if it interferes with activities of daily living.

In the United States, about 12,000 people annually survive a spinal cord injury. The most commonly affected group are young adult males. SCI has seen great improvements in its care since the middle of the 20th century. Research into potential treatments includes stem cell implantation, hypothermia, engineered materials for tissue support, epidural spinal stimulation, and wearable robotic exoskeletons.

Classification
Spinal cord injury can be traumatic or nontraumatic, and can be classified into three types based on cause: mechanical forces, toxic, and ischemic from lack of blood flow. The damage can also be divided into primary and secondary injury: the cell death that occurs immediately in the original injury, and biochemical cascades that are initiated by the original insult and cause further tissue damage. These secondary injury pathways include the ischemic cascade, inflammation, swelling, cell suicide, and neurotransmitter imbalances. They can take place for minutes or weeks following the injury.

At each level of the spinal column, spinal nerves branch off from either side of the spinal cord and exit between a pair of vertebrae, to innervate a specific part of the body. The area of skin innervated by a specific spinal nerve is called a dermatome, and the group of muscles innervated by a single spinal nerve is called a myotome. The part of the spinal cord that was damaged corresponds to the spinal nerves at that level and below. Injuries can be cervical 1–8 (C1–C8), thoracic 1–12 (T1–T12), lumbar 1–5 (L1–L5), or sacral (S1–S5). A person's level of injury is defined as the lowest level of full sensation and function. Paraplegia occurs when the legs are affected by the spinal cord damage (in thoracic, lumbar, or sacral injuries), and tetraplegia occurs when all four limbs are affected (cervical damage).

SCI is also classified by the degree of impairment. The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), published by the American Spinal Injury Association (ASIA), is widely used to document sensory and motor impairments following SCI. It is based on neurological responses, touch and pinprick sensations tested in each dermatome, and strength of the muscles that control key motions on both sides of the body. Muscle strength is scored on a scale of 0–5 according to the table on the right, and sensation is graded on a scale of 0–2: 0 is no sensation, 1 is altered or decreased sensation, and 2 is full sensation. Each side of the body is graded independently.

Complete and incomplete injuries
In a "complete" spinal injury, all functions below the injured area are lost, whether or not the spinal cord is severed. An "incomplete" spinal cord injury involves preservation of motor or sensory function below the level of injury in the spinal cord. To be classed as incomplete, there must be some preservation of sensation or motion in the areas innervated by S4 to S5, including voluntary external anal sphincter contraction. The nerves in this area are connected to the very lowest region of the spinal cord, and retaining sensation and function in these parts of the body indicates that the spinal cord is only partially damaged. Incomplete injury by definition includes a phenomenon known as sacral sparing: some degree of sensation is preserved in the sacral dermatomes, even though sensation may be more impaired in other, higher dermatomes below the level of the lesion. Sacral sparing has been attributed to the fact that the sacral spinal pathways are not as likely as the other spinal pathways to become compressed after injury due to the lamination of fibers within the spinal cord.

Spinal cord injury without radiographic abnormality
Spinal cord injury without radiographic abnormality exists when spinal cord injury is present but there is no evidence of spinal column injury on radiographs. Spinal column injury is trauma that causes fracture of the bone or instability of the ligaments in the spine; this can coexist with or cause injury to the spinal cord, but each injury can occur without the other. Abnormalities might show up on magnetic resonance imaging (MRI), but the term was coined before MRI was in common use.

Central cord syndrome
Central cord syndrome, almost always resulting from damage to the cervical spinal cord, is characterized by weakness in the arms with relative sparing of the legs, and spared sensation in regions served by the sacral segments. There is loss of sensation of pain, temperature, light touch, and pressure below the level of injury. The spinal tracts that serve the arms are more affected due to their central location in the spinal cord, while the corticospinal fibers destined for the legs are spared due to their more external location.

The most common of the incomplete SCI syndromes, central cord syndrome usually results from neck hyperextension in older people with spinal stenosis. In younger people, it most commonly results from neck flexion. The most common causes are falls and vehicle accidents; however other possible causes include spinal stenosis and impingement on the spinal cord by a tumor or intervertebral disc.

Anterior spinal artery syndrome
Anterior spinal artery syndrome also known as anterior spinal cord syndrome, due to damage to the front portion of the spinal cord or reduction in the blood supply from the anterior spinal artery, can be caused by fractures or dislocations of vertebrae or herniated disks. Below the level of injury, motor function, pain sensation, and temperature sensation are lost, while sense of touch and proprioception (sense of position in space) remain intact. These differences are due to the relative locations of the spinal tracts responsible for each type of function.

Brown-Séquard syndrome
Brown-Séquard syndrome occurs when the spinal cord is injured on one side much more than the other. It is rare for the spinal cord to be truly hemisected (severed on one side), but partial lesions due to penetrating wounds (such as gunshot or knife wounds) or fractured vertebrae or tumors are common. On the ipsilateral side of the injury (same side), the body loses motor function, proprioception, and senses of vibration and touch. On the contralateral (opposite side) of the injury, there is a loss of pain and temperature sensations.If the injury is above pyramidal decussation there is contralateral hemiplagia, at the level of decussation there is completed motor loss on both sides and below pyramidal decussation there is ipsilateral hemiplagia.

Spinothalamic tracts are in charge for pain and temperature sensation and because these tracts cross to the opposite side and above the spinal cord there is loss on the contralateral side.

Posterior spinal artery syndrome
Posterior spinal artery syndrome (PSAS), in which just the dorsal columns of the spinal cord are affected, is usually seen in cases of chronic myelopathy but can also occur with infarction of the posterior spinal artery. This rare syndrome causes the loss of proprioception and sense of vibration below the level of injury while motor function and sensation of pain, temperature, and touch remain intact. Usually posterior cord injuries result from insults like disease or vitamin deficiency rather than trauma. Tabes dorsalis, due to injury to the posterior part of the spinal cord caused by syphilis, results in loss of touch and proprioceptive sensation.

Conus medullaris and cauda equina syndromes
Conus medullaris syndrome is an injury to the end of the spinal cord the conus medullaris, located at about the T12–L2 vertebrae in adults. This region contains the S4–S5 spinal segments, responsible for bowel, bladder, and some sexual functions, so these can be disrupted in this type of injury. In addition, sensation and the Achilles reflex can be disrupted. Causes include tumors, physical trauma, and ischemia. Cauda equina syndrome may also be caused by central disc prolapse or slipped disc, infections such as epidural abscess, spinal haemorrhages, secondary to medical procedures and birth abnormalities.

Cauda equina syndrome (CES) results from a lesion below the level at which the spinal cord ends. Descending nerve roots continue as the cauda equina at levels L2–S5 below the conus medullaris before exiting through intervertebral foraminae. Thus it is not a true spinal cord syndrome since it is nerve roots that are damaged and not the cord itself; however, it is common for several of these nerves to be damaged at the same time due to their proximity. CES can occur by itself or alongside conus medullaris syndrome. It can cause low back pain, weakness or paralysis in the lower limbs, loss of sensation, bowel and bladder dysfunction, and loss of reflexes. There may be bilateral sciatica with central disc prolapse and altered gait. Unlike conus medullaris syndrome, symptoms often occur only on one side of the body. The cause is often compression, e.g. by a ruptured intervertebral disk or tumor. Since the nerves damaged in CES are actually peripheral nerves because they have already branched off from the spinal cord, the injury has better prognosis for recovery of function: the peripheral nervous system has a greater capacity for healing than the central nervous system.

Signs and symptoms
Signs (observed by a clinician) and symptoms (experienced by a patient) vary depending on where the spine is injured and the extent of the injury.

Dermatome
A section of skin innervated through a specific part of the spine is called a dermatome, and injury to that part of the spine can cause pain, numbness, or a loss of sensation in the related areas. Paraesthesia, a tingling or burning sensation in affected areas of the skin, is another symptom. A person with a lowered level of consciousness may show a response to a painful stimulus above a certain point but not below it.

Muscle function
A group of muscles innervated through a specific part of the spine is called a myotome, and injury to that part of the spinal cord can cause problems with movements that involve those muscles. The muscles may contract uncontrollably (spasticity), become weak, or be completely paralysed. Spinal shock, loss of neural activity including reflexes below the level of injury, occurs shortly after the injury and usually goes away within a day. Priapism, an erection of the penis may be a sign of acute spinal cord injury.

The specific parts of the body affected by loss of function are determined by the level of injury. Some signs, such as bowel and bladder dysfunction can occur at any level. Neurogenic bladder involves a compromised ability to empty the bladder and is a common symptom of spinal cord injury. This can lead to high pressures in the bladder that can damage the kidneys.

Cervical spine
Spinal cord injuries at the cervical vertebrae (neck) level result in full or partial tetraplegia, also called quadriplegia. Depending on the specific location and severity of trauma, limited function may be retained. Additional symptoms of cervical injuries include low heart rate, low blood pressure, problems regulating body temperature, and breathing dysfunction. If the injury is high enough in the neck to impair the muscles involved in breathing, the person may not be able to breathe without the help of an endotracheal tube and mechanical ventilator.

Lumbosacral
The effects of injuries at or above the lumbar or sacral regions of the spinal cord (lower back and pelvis) include decreased control of the legs and hips, genitourinary system, and anus. People injured below level L2 may still have use of their hip flexor and knee extensor muscles. Bowel and bladder function are regulated by the sacral region. It is common to experience sexual dysfunction after injury, as well as dysfunction of the bowel and bladder, including fecal and urinary incontinence.

Thoracic
In addition to the problems found in lower-level injuries, thorax (chest height) spinal lesions can affect the muscles in the trunk. Injuries at the level of T1 to T8 result in inability to control the abdominal muscles. Trunk stability may be affected; even more so in higher level injuries. The lower the level of injury, the less extensive its effects. Injuries from T9 to T12 result in partial loss of trunk and abdominal muscle control. Thoracic spinal injuries result in paraplegia, but function of the hands, arms, and neck are not affected.

Autonomic dysreflexia
One condition that occurs typically in lesions above the T6 level is autonomic dysreflexia (AD), in which the blood pressure increases to dangerous levels, high enough to cause potentially deadly stroke. It results from an overreaction of the system to a stimulus such as pain below the level of injury, because inhibitory signals from the brain cannot pass the lesion to dampen the excitatory sympathetic nervous system response. Signs and symptoms of AD include anxiety, headache, nausea, ringing in the ears, blurred vision, flushed skin, and nasal congestion. It can occur shortly after the injury or not until years later.

Other autonomic functions may also be disrupted. For example, problems with body temperature regulation mostly occur in injuries at T8 and above.

Neurogenic shock
Another serious complication that can result from lesions above T6 is neurogenic shock, which results from an interruption in output from the sympathetic nervous system responsible for maintaining muscle tone in the blood vessels. Without the sympathetic input, the vessels relax and dilate. Neurogenic shock presents with dangerously low blood pressure, low heart rate, and blood pooling in the limbs—which results in insufficient blood flow to the spinal cord and potentially further damage to it.

Complications
Complications of spinal cord injuries include pulmonary edema, respiratory failure, neurogenic shock, and paralysis below the injury site.

Muscle atrophy
In the long term, the loss of muscle function can have additional effects from disuse, including muscle atrophy. Immobility also can lead to pressure sores, particularly in bony areas, requiring precautions such as extra cushioning and turning in bed every two hours (in the acute setting) to relieve pressure.

In the long term, people in wheelchairs must shift periodically to relieve pressure. Another complication is pain, including nociceptive pain (indication of potential or actual tissue damage) and neuropathic pain, when nerves affected by damage convey erroneous pain signals in the absence of noxious stimuli. Spasticity, the uncontrollable tensing of muscles below the level of injury, occurs in 65–78% of chronic SCI. It results from lack of input from the brain that quells muscle responses to stretch reflexes. It can be treated with drugs and physical therapy. Spasticity increases the risk of contractures (shortening of muscles, tendons, or ligaments that result from lack of use of a limb); this problem can be prevented by moving the limb through its full range of motion multiple times a day. Another problem lack of mobility can cause is loss of bone density and changes in bone structure. Loss of bone density (bone demineralization), thought to be due to lack of input from weakened or paralysed muscles, can increase the risk of fractures. Conversely, a poorly understood phenomenon is the overgrowth of bone tissue in soft tissue areas, called heterotopic ossification. It occurs below the level of injury, possibly as a result of inflammation, and happens to a clinically significant extent in 27% of people.

Cardiovascular and respiratory complications
People with spinal cord injury are at especially high risk for respiratory and cardiovascular problems, so hospital staff must be watchful to avoid them. Respiratory problems (especially pneumonia) are the leading cause of death in people with SCI, followed by infections, usually of pressure sores, urinary tract infections, and respiratory infections. Pneumonia can be accompanied by shortness of breath, fever, and anxiety.

Deep venous thrombosis
Another potentially deadly threat to respiration is deep venous thrombosis (DVT), in which blood forms a clot in immobile limbs; the clot can break off and form a pulmonary embolism, lodging in the lung and cutting off blood supply to it. DVT is an especially high risk in SCI, particularly within 10 days of injury, occurring in over 13% in the acute care setting. Preventative measures include anticoagulants, pressure hose, and moving the patient's limbs. The usual signs and symptoms of DVT and pulmonary embolism may be masked in SCI cases due to effects such as alterations in pain perception and nervous system functioning.

Urinary tract infection
Urinary tract infection (UTI) is another risk that may not display the usual symptoms (pain, urgency, and frequency); it may instead be associated with worsened spasticity. The risk of UTI, likely the most common complication in the long term, is heightened by use of indwelling urinary catheters. Catheterization may be necessary because SCI interferes with the bladder's ability to empty when it gets too full, which could trigger autonomic dysreflexia or damage the bladder permanently. The use of intermittent catheterization to empty the bladder at regular intervals throughout the day has decreased the mortality due to kidney failure from UTI in the first world, but it is still a serious problem in developing countries.

Clinical depression
An estimated 24–45% of people with spinal cord injuries have major depressive disorder, and the suicide rate is as much as six times that of the rest of the population. The risk of suicide is worst in the first five years after injury. In young people with SCI, suicide is the leading cause of death. Depression is associated with an increased risk of other complications such as UTI and pressure ulcers that occur more when self-care is neglected.

Causes
Spinal cord injuries are most often caused by physical trauma. Forces involved can be hyperflexion (forward movement of the head); hyperextension (backward movement); lateral stress (sideways movement); rotation (twisting of the head); compression (force along the axis of the spine downward from the head or upward from the pelvis); or distraction (pulling apart of the vertebrae). Traumatic SCI can result in contusion, compression, or stretch injury. It is a major risk of many types of vertebral fracture. Pre-existing asymptomatic congenital anomalies can cause major neurological deficits, such as hemiparesis, to result from otherwise minor trauma.

In the U.S., motor vehicle accidents are the most common cause of SCIs; second are falls, then violence such as gunshot wounds, then sports injuries. Another study from Asia, found that the most common cause of the SCI is fall (31.70%) from various sites such as fall from roof-tops (9.75%), electric pole (7.31%), fall from tree (7.31%) etc. Whereas road traffic accidents count for 19.51%, firearm injuries (12.19%), slipped foot (7.31%) and sports injuries (4.87%). As a result of injury, 26.82% In some countries falls are more common, even surpassing vehicle crashes as the leading cause of SCI. The rates of violence-related SCI depend heavily on place and time. Of all sports-related SCIs, shallow water dives are the most common cause; winter sports and water sports have been increasing as causes while association football and trampoline injuries have been declining. Hanging can cause injury to the cervical spine, as may occur in attempted suicide. Military conflicts are another cause, and when they occur they are associated with increased rates of SCI. Another potential cause of SCI is iatrogenic injury, caused by an improperly done medical procedure such as an injection into the spinal column.

SCI can also be of a nontraumatic origin. Nontraumatic lesions cause anywhere from 30 to 80% of all SCI; the percentage varies by locale, influenced by efforts to prevent trauma. Developed countries have higher percentages of SCI due to degenerative conditions and tumors than developing countries. In developed countries, the most common cause of nontraumatic SCI is degenerative diseases, followed by tumors; in many developing countries the leading cause is infection such as HIV and tuberculosis. SCI may occur in intervertebral disc disease, and spinal cord vascular disease. Spontaneous bleeding can occur within or outside of the protective membranes that line the cord, and intervertebral disks can herniate. Damage can result from dysfunction of the blood vessels, as in arteriovenous malformation, or when a blood clot becomes lodged in a blood vessel and cuts off blood supply to the cord. When systemic blood pressure drops, blood flow to the spinal cord may be reduced, potentially causing a loss of sensation and voluntary movement in the areas supplied by the affected level of the spinal cord. Congenital conditions and tumors that compress the cord can also cause SCI, as can vertebral spondylosis and ischemia. Multiple sclerosis is a disease that can damage the spinal cord, as can infectious or inflammatory conditions such as tuberculosis, herpes zoster or herpes simplex, meningitis, myelitis, and syphilis.

Prevention
Vehicle-related spinal cord injury is prevented with measures including societal and individual efforts to reduce driving under the influence of drugs or alcohol, distracted driving, and drowsy driving. Other efforts include increasing road safety (such as marking hazards and adding lighting) and vehicle safety, both to prevent accidents, such as routine maintenance and antilock brakes. and to mitigate the damage of crashes, such as head restraints, air bags, seat belts, and child safety seats. Falls can be prevented by making changes to the environment, such as nonslip materials and grab bars in bathtubs and showers, railings for stairs, child and safety gates for windows. Gun-related injuries can be prevented with conflict resolution training, gun safety education campaigns, and changes to the technology of guns, including trigger locks to improve their safety. Sports injuries can be prevented with changes to sports rules and equipment to increase safety, and education campaigns to reduce risky practices such as diving into water of unknown depth or head-first tackling in association football.

Diagnosis
A person's presentation in context of trauma or non-traumatic background determines suspicion for a spinal cord injury. The features are namely paralysis, sensory loss, or both at any level. Other symptoms may include incontinence.

A radiographic evaluation using an X-ray, CT scan, or MRI can determine if there is damage to the spinal column and where it is located. X-rays are commonly available and can detect instability or misalignment of the spinal column, but do not give very detailed images and can miss injuries to the spinal cord or displacement of ligaments or disks that do not have accompanying spinal column damage. Thus when X-ray findings are normal but SCI is still suspected due to pain or SCI symptoms, CT or MRI scans are used. CT gives greater detail than X-rays, but exposes the patient to more radiation, and it still does not give images of the spinal cord or ligaments; MRI shows body structures in the greatest detail. Thus it is the standard for anyone who has neurological deficits found in SCI or is thought to have an unstable spinal column injury.

Neurological evaluations to help determine the degree of impairment are performed initially and repeatedly in the early stages of treatment; this determines the rate of improvement or deterioration and informs treatment and prognosis. The ASIA Impairment Scale outlined above is used to determine the level and severity of injury.

Pre-hospital treatment
The first stage in the management of a suspected spinal cord injury is geared toward basic life support and preventing further injury: maintaining airway, breathing, circulation, and restricting further motion of the spine.

Spinal motion restriction
In the emergency setting, most people who has been subjected to forces strong enough to cause SCI are treated as though they have instability in the spinal column and have spinal motion restricted to prevent damage to the spinal cord. Injuries or fractures in the head, neck, or pelvis as well as penetrating trauma near the spine and falls from heights are assumed to be associated with an unstable spinal column until it is ruled out in the hospital. High-speed vehicle crashes, sports injuries involving the head or neck, and diving injuries are other mechanisms that indicate a high SCI risk. Since head and spinal trauma frequently coexist, anyone who is unconscious or has a lowered level of consciousness as a result of a head injury is spinal motion restricted.

Devices
A rigid cervical collar is applied to the neck, and the head is held with blocks on either side and the person is strapped to a backboard. Extrication devices are used to move people without excessively moving the spine if they are still inside a vehicle or other confined space. The use of a cervical collar has been shown to increase mortality in people with penetrating trauma and is thus not routinely recommended in this group.

Modern trauma care includes a step called clearing the cervical spine, ruling out spinal cord injury if the patient is fully conscious and not under the influence of drugs or alcohol, displays no neurological deficits, has no pain in the middle of the neck and no other painful injuries that could distract from neck pain. If these are all absent, no spinal motion restriction is necessary.

If an unstable spinal column injury is moved, damage may occur to the spinal cord. Between 3 and 25% of SCIs occur not at the time of the initial trauma but later during treatment or transport. While some of this is due to the nature of the injury itself, particularly in the case of multiple or massive trauma, some of it reflects the failure to adequately restrict motion of the spine. SCI can impair the body's ability to keep warm, so warming blankets may be needed.

Early hospital treatment
Initial care in the hospital, as in the prehospital setting, aims to ensure adequate airway, breathing, cardiovascular function, and spinal motion restriction. Imaging of the spine to determine the presence of a SCI may need to wait if emergency surgery is needed to stabilize other life-threatening injuries. Acute SCI merits treatment in an intensive care unit, especially injuries to the cervical spinal cord. People with SCI need repeated neurological assessments and treatment by neurosurgeons. People should be removed from the spine board as rapidly as possible to prevent complications from its use.

Blood pressure
If the systolic blood pressure falls below 90 mmHg within days of the injury, blood supply to the spinal cord may be reduced, resulting in further damage. Thus it is important to maintain the blood pressure which may be done using intravenous fluids and vasopressors. Vasopressors used include phenylephrine, dopamine, or norepinephrine. Mean arterial blood pressure is measured and kept at 85 to 90 mmHg for seven days after injury.

The CAMPER Trial led by Dr Kwon and subsequent studies by the UCSF TRACK-SCI group (Dhall) have shown that spinal cord perfusion pressure (SCPP) goals are more closely associated with better neurologic recovery than MAP goals. Some institutions have adopted these SCPP goals and lumbar CSF drain placement as a standard of care. The treatment for shock from blood loss is different from that for neurogenic shock, and could harm people with the latter type, so it is necessary to determine why someone is in shock. However it is also possible for both causes to exist at the same time. Another important aspect of care is prevention of insufficient oxygen in the bloodstream, which could deprive the spinal cord of oxygen. People with cervical or high thoracic injuries may experience a dangerously slowed heart rate; treatment to speed it may include atropine.

Steroid treatment
The corticosteroid medication methylprednisolone has been studied for use in spinal cord injury patients with the hope of limiting swelling and secondary injury. As there does not appear to be long term benefits and the medication is associated with risks such as gastrointestinal bleeding and infection its use is not recommended as of 2018. Its use in traumatic brain injury is also not recommended.

Surgery
Surgery may be necessary, e.g. to relieve excess pressure on the cord, to stabilize the spine, or to put vertebrae back in their proper place. In cases involving instability or compression, failing to operate can lead to worsening of the condition. Surgery is also necessary when something is pressing on the cord, such as bone fragments, blood, material from ligaments or intervertebral discs, or a lodged object from a penetrating injury. Although the ideal timing of surgery is still debated, studies have found that earlier surgical intervention (within 12 hours of injury) is associated with better outcomes. This type of surgery is often referred to as "Ultra-Early", coined by Burke et al. at UCSF. Sometimes a patient has too many other injuries to be a surgical candidate this early. Surgery is controversial because it has potential complications (such as infection), so in cases where it is not clearly needed (e.g. the cord is being compressed), doctors must decide whether to perform surgery based on aspects of the patient's condition and their own beliefs about its risks and benefits. Recent large-scale studies have shown that patients who do undergo earlier surgery (within 12–24 hours) experience significantly lower rates of life-threatening complications and spend less time in hospital and critical care.

However, in cases where a more conservative approach is chosen, bed rest, cervical collars, motion restriction devices, and optionally traction are used. Surgeons may opt to put traction on the spine to remove pressure from the spinal cord by putting dislocated vertebrae back into alignment, but herniation of intervertebral disks may prevent this technique from relieving pressure. Gardner-Wells tongs are one tool used to exert spinal traction to reduce a fracture or dislocation and to reduce motion to the affected areas.

Rehabilitation
Spinal cord injury patients often require extended treatment in specialized spinal unit or an intensive care unit. The rehabilitation process typically begins in the acute care setting. Usually, the inpatient phase lasts 8–12 weeks and then the outpatient rehabilitation phase lasts 3–12 months after that, followed by yearly medical and functional evaluation. Physical therapists, occupational therapists, recreational therapists, nurses, social workers, psychologists, and other health care professionals work as a team under the coordination of a physiatrist to decide on goals with the patient and develop a plan of discharge that is appropriate for the person's condition.

In the acute phase physical therapists focus on the patient's respiratory status, prevention of indirect complications (such as pressure ulcers), maintaining range of motion, and keeping available musculature active.

For people whose injuries are high enough to interfere with breathing, there is great emphasis on airway clearance during this stage of recovery. Weakness of respiratory muscles impairs the ability to cough effectively, allowing secretions to accumulate within the lungs. As SCI patients have reduced total lung capacity and tidal volume, physical therapists teach them accessory breathing techniques (e.g. apical breathing, glossopharyngeal breathing) that typically are not taught to healthy individuals. Physical therapy treatment for airway clearance may include manual percussions and vibrations, postural drainage, respiratory muscle training, and assisted cough techniques. Patients are taught to increase their intra-abdominal pressure by leaning forward to induce cough and clear mild secretions. The quad cough technique is done lying on the back with the therapist applying pressure on the abdomen in the rhythm of the cough to maximize expiratory flow and mobilize secretions. Manual abdominal compression is another technique used to increase expiratory flow which later improves coughing. Other techniques used to manage respiratory dysfunction include respiratory muscle pacing, use of a constricting abdominal binder, ventilator-assisted speech, and mechanical ventilation.

The amount of functional recovery and independence achieved in terms of activities of daily living, recreational activities, and employment is affected by the level and severity of injury. The Functional Independence Measure (FIM) is an assessment tool that aims to evaluate the function of patients throughout the rehabilitation process following a spinal cord injury or other serious illness or injury. It can track a patient's progress and degree of independence during rehabilitation. People with SCI may need to use specialized devices and to make modifications to their environment in order to handle activities of daily living and to function independently. Weak joints can be stabilized with devices such as ankle-foot orthoses (AFOs) or knee-ankle-foot orthoses (KAFOs), but walking may still require a lot of effort. Increasing activity will increase chances of recovery.

For treatment of paralysis levels in the lower thoracic spine or lower, starting therapy with an orthosis is promising from the intermediate phase (2–26 weeks after the incident). In patients with complete paraplegia (ASIA A), this applies to lesion heights between T12 and S5. In patients with incomplete paraplegia (ASIA B-D), orthoses are even suitable for lesion heights above T12. In both cases, however, a detailed muscle function test must be carried out to precisely plan the construction with an orthosis.

Prognosis
Spinal cord injuries generally result in at least some incurable impairment even with the best possible treatment. The best predictor of prognosis is the level and completeness of injury, as measured by the ASIA impairment scale. The neurological score at the initial evaluation done 72 hours after injury is the best predictor of how much function will return. Most people with ASIA scores of A (complete injuries) do not have functional motor recovery, but improvement can occur. Most patients with incomplete injuries recover at least some function. Chances of recovering the ability to walk improve with each AIS grade found at the initial examination; e.g. an ASIA D score confers a better chance of walking than a score of C. The symptoms of incomplete injuries can vary and it is difficult to make an accurate prediction of the outcome. A person with a mild, incomplete injury at the T5 vertebra will have a much better chance of using his or her legs than a person with a severe, complete injury at exactly the same place. Of the incomplete SCI syndromes, Brown-Séquard and central cord syndromes have the best prognosis for recovery and anterior cord syndrome has the worst.

People with nontraumatic causes of SCI have been found to be less likely to develop complete injuries and some complications such as pressure sores and deep vein thrombosis, and to have shorter hospital stays. Their scores on functional tests were better than those of people with traumatic SCI upon hospital admission, but when they were tested upon discharge, those with traumatic SCI had improved such that both groups' results were the same. In addition to the completeness and level of the injury, age and concurrent health problems affect the extent to which a person with SCI will be able to live independently and to walk. However, in general people with injuries to L3 or below will likely be able to walk functionally, T10 and below to walk around the house with bracing, and C7 and below to live independently. New therapies are beginning to provide hope for better outcomes in patients with SCI, but most are in the experimental/translational stage.

One important predictor of motor recovery in an area is presence of sensation there, particularly pain perception. Most motor recovery occurs in the first year post-injury, but modest improvements can continue for years; sensory recovery is more limited. Recovery is typically quickest during the first six months. Spinal shock, in which reflexes are suppressed, occurs immediately after the injury and resolves largely within three months but continues resolving gradually for another 15.

Sexual dysfunction after spinal injury is common. Problems that can occur include erectile dysfunction, loss of ability to ejaculate, insufficient lubrication of the vagina, and reduced sensation and impaired ability to orgasm. Despite this, many people learn ways to adapt their sexual practices so they can lead satisfying sex lives.

Although life expectancy has improved with better care options, it is still not as good as the uninjured population. The higher the level of injury, and the more complete the injury, the greater the reduction in life expectancy. Mortality is very elevated within a year of injury.

Epidemiology
Worldwide, the number of new cases since 1995 of SCI ranges from 10.4 to 83 people per million per year. This wide range of numbers is probably partly due to differences among regions in whether and how injuries are reported. In North America, about 39 people per every million incur SCI traumatically each year, and in Western Europe, the incidence is 16 per million. In the United States, the incidence of spinal cord injury has been estimated to be about 40 cases per 1 million people per year or around 12,000 cases per year. In China, the incidence is approximately 60,000 per year.

The estimated number of people living with SCI in the world ranges from 236 to 4187 per million. Estimates vary widely due to differences in how data are collected and what techniques are used to extrapolate the figures. Little information is available from Asia, and even less from Africa and South America. In Western Europe the estimated prevalence is 300 per million people and in North America it is 853 per million. It is estimated at 440 per million in Iran, 526 per million in Iceland, and 681 per million in Australia. In the United States there are between 225,000 and 296,000 individuals living with spinal cord injuries, and different studies have estimated prevalences from 525 to 906 per million.

SCI is present in about 2% of all cases of blunt force trauma. Anyone who has undergone force sufficient to cause a thoracic spinal injury is at high risk for other injuries also. In 44% of SCI cases, other serious injuries are sustained at the same time; 14% of SCI patients also have head trauma or facial trauma. Other commonly associated injuries include chest trauma, abdominal trauma, pelvic fractures, and long bone fractures.

Males account for four out of five traumatic spinal cord injuries. Most of these injuries occur in men under 30 years of age. The average age at the time of injury has slowly increased from about 29 years in the 1970s to 41. In Pakistan, spinal cord injury is more common in males (92.68%) as compared to females in the 20-30 years of age group with a median age of 40 years, although people from 12-70 years of age suffered from spinal cord injury Rates of injury are at their lowest in children, at their highest in the late teens to early twenties, then get progressively lower in older age groups; however rates may rise in the elderly. In Sweden between 50 and 70% of all cases of SCI occur in people under 30, and 25% occur in those over 50. While SCI rates are highest among people age 15–20, fewer than 3% of SCIs occur in people under 15. Neonatal SCI occurs in one in 60,000 births, e.g. from breech births or injuries by forceps. The difference in rates between the sexes diminishes in injuries at age 3 and younger; the same number of girls are injured as boys, or possibly more. Another cause of pediatric injury is child abuse such as shaken baby syndrome. For children, the most common cause of SCI (56%) is vehicle crashes. High numbers of adolescent injuries are attributable in a large part to traffic accidents and sports injuries. For people over 65, falls are the most common cause of traumatic SCI. The elderly and people with severe arthritis are at high risk for SCI because of defects in the spinal column. In nontraumatic SCI, the gender difference is smaller, the average age of occurrence is greater, and incomplete lesions are more common.

History
Spinal cord injury has been known to be devastating for millennia; the ancient Egyptian Edwin Smith Papyrus from 2500 BC, the first known description of the injury, says it is "not to be treated". Hindu texts dating back to 1800 BC also mention SCI and describe traction techniques to straighten the spine. The Greek physician Hippocrates, born in the fifth century BC, described SCI in his Hippocratic Corpus and invented traction devices to straighten dislocated vertebrae. But it was not until Aulus Cornelius Celsus, born 30 BC, noted that a cervical injury resulted in rapid death that the spinal cord itself was implicated in the condition. In the second century AD the Greek physician Galen experimented on monkeys and reported that a horizontal cut through the spinal cord caused them to lose all sensation and motion below the level of the cut. The seventh-century Greek physician Paul of Aegina described surgical techniques for treatment of broken vertebrae by removing bone fragments, as well as surgery to relieve pressure on the spine. Little medical progress was made during the Middle Ages in Europe; it was not until the Renaissance that the spine and nerves were accurately depicted in human anatomy drawings by Leonardo da Vinci and Andreas Vesalius.

In 1762, Andre Louis, a surgeon, removed a bullet from the lumbar spine of a patient, who regained motion in the legs. In 1829, Gilpin Smith, a surgeon, performed a successful laminectomy that improved the patient's sensation. However, the idea that SCI was untreatable remained predominant until the early 20th century. In 1934, the mortality rate in the first two years after injury was over 80%, mostly due to infections of the urinary tract and pressure sores, the latter of which were believed to be intrinsic to SCI rather than a result of continuous bedrest. It was not until the second half of the century that breakthroughs in imaging, surgery, medical care, and rehabilitation medicine contributed to a substantial improvement in SCI care. The relative incidence of incomplete compared to complete injuries has improved since the mid-20th century, due mainly to the emphasis on faster and better initial care and stabilization of spinal cord injury patients. The creation of emergency medical services to professionally transport people to the hospital is given partial credit for an improvement in outcomes since the 1970s. Improvements in care have been accompanied by increased life expectancy of people with SCI; survival times have improved by about 2000% since 1940. In 2015/2016 23% of people in nine spinal injury centres in England had their discharge delayed because of disputes about who should pay for the equipment they needed.

Research directions
Scientists are investigating various avenues for treatment of spinal cord injury. Therapeutic research is focused on two main areas: neuroprotection and neuroregeneration. The former seeks to prevent the harm that occurs from secondary injury in the minutes to weeks following the insult, and the latter aims to reconnect the broken circuits in the spinal cord to allow function to return. Neuroprotective drugs target secondary injury effects including inflammation, damage by free radicals, excitotoxicity (neuronal damage by excessive glutamate signaling), and apoptosis (cell suicide). Several potentially neuroprotective agents that target pathways like these are under investigation in human clinical trials.

Stem cell transplantation is an important avenue for SCI research: the goal is to replace lost spinal cord cells, allow reconnection in broken neural circuits by regrowing axons, and to create an environment in the tissues that is favorable to growth. A key avenue of SCI research is research on stem cells, which can differentiate into other types of cells—including those lost after SCI. Types of cells being researched for use in SCI include embryonic stem cells, neural stem cells, mesenchymal stem cells, olfactory ensheathing cells, Schwann cells, activated macrophages, and induced pluripotent stem cells. Hundreds of stem cell studies have been done in humans, with promising but inconclusive results. An ongoing Phase 2 trial in 2016 presented data showing that after 90 days, 2 out of 4 subjects had already improved two motor levels and had thus already achieved its endpoint of 2/5 patients improving two levels within 6–12 months. Six-month data was expected in January 2017.

Another type of approach is tissue engineering, using biomaterials to help scaffold and rebuild damaged tissues. Biomaterials being investigated include natural substances such as collagen or agarose and synthetic ones like polymers and nitrocellulose. They fall into two categories: hydrogels and nanofibers. These materials can also be used as a vehicle for delivering gene therapy to tissues.

One avenue being explored to allow paralyzed people to walk and to aid in rehabilitation of those with some walking ability is the use of wearable powered robotic exoskeletons. The devices, which have motorized joints, are put on over the legs and supply a source of power to move and walk. Several such devices are already available for sale, but investigation is still underway as to how they can be made more useful.

Preliminary studies of epidural spinal cord stimulators for motor complete injuries have demonstrated some improvement, and in some cases to enable walking to some degree bypassing the injury.

In 2014, Darek Fidyka underwent pioneering spinal surgery that used nerve grafts, from his ankle, to bridge the gap in his severed spinal cord and olfactory ensheathing cells (OECs) to stimulate the spinal cord cells. The surgery was performed in Poland in collaboration with Prof. Geoff Raisman, chair of neural regeneration at University College London's Institute of Neurology, and his research team. The OECs were taken from the patient's olfactory bulbs in his brain and then grown in the lab, these cells were then injected above and below the impaired spinal tissue.

There have been a number of advances in technological spinal cord injury treatment, including the use of implants that provided a "digital bridge" between the brain and the spinal cord. In a study published in May 2023 in the journal Nature, researchers in Switzerland described such implants which allowed a 40-year old man, paralyzed from the hips down for 12 years, to stand, walk and ascend a steep ramp with only the assistance of a walker. More than a year after the implant was inserted, he has retained these abilities and was walking with crutches even when the implant was switched off.

title: Spinal cord injury