Spinal Cord Injury

Overview

What is the spinal cord and what does it do?

The spinal cord is made up of bundles of nerves and nerve cells that carry messages from your brain to the different parts of your body. The spinal cord runs from the base of the brain all the way down to the waist. It is protected by your backbone, the bony rings in your back (called vertebra) that make up the spinal column (also called the vertebral column or spine).

 

Funding and support for this material have been provided by Allergan.

Symptoms

What are the symptoms of a spinal cord injury?

The symptoms of a spinal cord injury depend on where the damage occurred and whether the injury is complete or incomplete. If there is an entire loss of muscle control and sensation (feeling), then the injury is called complete. If there is some muscle control and sensation, the injury is called incomplete. Injuries that occur higher up the spinal cord usually result in more severe symptoms.

Paralysis is one of the most common symptoms of a spinal cord injury. Paralysis is a loss of ability to move a part of the body. When this happens, there may also be no feeling or limited feeling in the paralyzed area. If the vertebra in the neck area are damaged, the arms, chest and legs can be paralyzed, as well as the muscles that control breathing. Damage to the vertebra in the chest or lower back areas can result in paralysis of the chest and legs. Other symptoms of spinal cord injury include:

  • Loss of bowel and bladder control
  • Sexual dysfunction
  • Numbness
  • Spasticity
  • Pain

Causes & Risk Factors

How does a spinal cord injury happen?

A traumatic spinal cord injury occurs when there is a severe blow to the spinal column that either damages the spinal cord or the surrounding vertebra or tissue, which can pinch the cord. This type of injury can result from a car accident, a sports injury, a fall or an assault (such as a gunshot or knife wound). Sometimes additional damage can occur in the days following an accident because bleeding, fluid build-up and swelling in the spinal column can put more pressure on the cord. A spinal cord injury can also be caused by disease, such as arthritis or polio. Other risk factors, such as osteoporosis or aging, can weaken the spinal column, making you more susceptible to spinal cord injuries. Spina bifida (“split spine”) is a birth defect that can act like a spinal cord injury.

Diagnosis & Tests

How is a spinal cord injury diagnosed?

If the doctor thinks you have a possible spinal cord injury, you will be kept immobile (unable to move) while tests are done at the hospital. You may have an x-ray, computerized tomography (CT) or magnetic resonance imaging (MRI). These tests take pictures of the vertebra and can show your doctor if there is any damage. Your doctor will also perform a neurological exam to determine how severe the injury is. During the neurological exam, your doctor will see how much muscle control you have and whether or not you can feel different sensations. All of these tests will help your doctor determine the level and completeness of your injury.

Treatment

How is a spinal cord injury diagnosed?

If the doctor thinks you have a possible spinal cord injury, you will be kept immobile (unable to move) while tests are done at the hospital. You may have an x-ray, computerized tomography (CT) or magnetic resonance imaging (MRI). These tests take pictures of the vertebra and can show your doctor if there is any damage. Your doctor will also perform a neurological exam to determine how severe the injury is. During the neurological exam, your doctor will see how much muscle control you have and whether or not you can feel different sensations. All of these tests will help your doctor determine the level and completeness of your injury.

How is a spinal cord injury treated?

Immediate Treatment While you are in the hospital, a team of doctors will decide the best course of treatment for your spinal cord injury. You will likely be given a medicine called methylprednisolone to reduce swelling and inflammation at the site of the injury. You may need to have surgery to remove bone or tissue that may be pressing on the spinal cord or to stabilize the spine. You may also need to be put in traction, which is used to keep your head or your whole body from moving while your spinal column is being stabilized. Long-term Treatment After your spinal column has been stabilized, your doctor will talk to you about the types of long-term treatment that you will need. These types of treatment options can help prevent secondary health problems, such as blood clots, shrinking of the muscles, loss of calcium in the bones and thinning of the skin. Some of these treatment options include:

  • Medicine: Your doctor may talk to you about taking medicine to control some of the symptoms of a spinal cord injury. Muscle spasticity, incontinence and sexual dysfunction can all be helped by taking medicine. Recently, the Food and Drug Administration (FDA) approved the use of botulinum toxin for certain kinds of arm spasticity. Botulinum toxin is injected into the muscle to help stop muscle spasms. Be sure to talk to your doctor about your symptoms so your doctor can help you find the medicine that will work best for you. Your doctor can also help you control any pain that you may be having.
  • Physical therapy: Physical therapy is made up of stretching, strengthening exercises and muscle training. This will help you with flexibility, coordination and strength in your muscles.
  • Occupational therapy: Occupational therapy can help you re-learn daily tasks, such as bathing, getting dressed, cooking and writing. Because of a spinal cord injury, your body may have “forgotten” how to do these tasks. An occupational therapist can also teach you more about your injury and how to prevent secondary health problems.
  • Experimental treatments: Doctors and researchers are working hard to find a cure for spinal cord injuries. Be sure to talk to your doctor about experimental or new treatments that may be available.

Can I recover from a spinal cord injury?

Your recovery will depend on how severe your injury is. Most recovery will take place within the first 6 months after the injury. However, some people continue to make progress beyond that. Your doctor will help you determine what your recovery will be like and how long it may take. Remember that people who have spinal cord injuries can live full, happy lives. They have jobs, get married and have children. They participate in sports, go to movies and concerts and drive cars. Continued medical research is constantly providing new treatment options and technologies aimed at finding a cure for spinal cord injuries.

Bibliography

Questions to Ask Your Doctor

  • What will my life be like after a spinal cord injury?
  • What experimental therapies are available for spinal cord injuries?
  • Will my spinal cord injury heal? How much feeling and movement can I expect to recover?
  • How will a spinal cord injury affect my health? Am I at risk of other health conditions?
  • Can you recommend a support group for people with spinal cord injuries?

What You Should Know in an Emergency

Following a traumatic accident, immediate signs of a spinal cord injury can include pain, weakness, numbness, paralysis, confusion, dizziness and difficulty breathing. If you think that someone has an injury to the head, neck or back, here’s what you should do:

  • Call 911.
  • Don’t move the person who is injured.
  • Roll up blankets or towels and place them on either side of the person’s head, or hold the person’s head between your hands. Try to keep the person’s head and neck still.
  • Perform any first aid that is needed, such as CPR or applying pressure to a wound, but be sure to hold the person’s head and neck still.

Citations

  • Acute spinal cord injury by Young W(Rutgers University W.M. Keck Center for Collaborative Neuroscience 06/16/10, http://sci.rutgers.edu/dynarticles/AcuteSCI.pdf)
  • Spinal Cord Injury Resource Center. Spinal cord 101. Accessed 06/15/10
  • Spinal Cord Injury Information Network. Understanding spinal cord injury and functional goals. Accessed 06/16/10
  • Mayo Foundation for Medical Education and Research. Spinal cord injury. Accessed 06/15/10
  • National Institute of Neurological Disorders and Stroke. NINDS spinal cord injury information page. Accessed 06/15/10

Funding and support for this material have been provided by Allergan.