Definition

What is spinal cord injury?

A spinal cord injury is damage to the spinal cord. It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.

The spinal cord is a bundle of nerves and other tissue that the vertebrae of the spine contains and protects. The vertebrae are the bones stacked on top of each other that make up the spine. The spine contains many nerves, and extends from the brain’s base down the back, ending close to the buttocks.

The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We’re able to perceive pain and move our limbs because of messages sent through the spinal cord.

If the spinal cord sustains an injury, some or all of these impulses may not be able to “get through.” The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.

How common is spinal cord injury?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of spinal cord injury?

The common symptoms of spinal cord injury are:

  • Problems walking
  • Loss of control of the bladder or bowels
  • Inability to move the arms or legs
  • Feelings of spreading numbness or tingling in the extremities
  • Unconsciousness
  • Headache
  • Pain, pressure, and stiffness in the back or neck area
  • Signs of shock
  • Unnatural positioning of the head

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you believe you or someone else has a spinal cord injury, follow the procedure below:

  • Call emergencyright away. The sooner medical help arrives, the better.
  • Don’t move the person or disturb them in any way unless it’s absolutely necessary. This includes repositioning the person’s head or attempting to remove a helmet.
  • Encourage the person to stay as still as possible, even if they feel they’re capable of getting up and walking on their own.
  • If the person isn’t breathing, perform CPR. Don’t tilt the head back, however. Instead, move the jaw forward.

When the person arrives at the hospital, doctors will do a physical and complete neurological exam. This will help them determine whether there’s an injury to the spinal cord and where.

Diagnostics tools that doctors may use include:

  • CT scans
  • MRIs
  • X-rays of the spine
  • Evoked potential testing, which measures how quickly nerve signals reach the brain

Causes

What causes spinal cord injury?

A spinal cord injury is often the result of an unpredictable accident or violent event. The following can all result in damage to the spinal cord:

  • A violent attack such as a stabbing or a gunshot
  • Diving into water that’s too shallow and hitting the bottom
  • Trauma during a car accident, specifically trauma to the face, head, and neck region, back, or chest area
  • Falling from a significant height
  • Head or spinal injuries during sporting events
  • Electrical accidents
  • Severe twisting of the middle portion of the torso

Risk factors

What increases my risk for spinal cord injury?

There are many risk factors for spinal cord injury, such as:

  • Being male. Spinal cord injuries affect a disproportionate amount of men. In fact, females account for only about 20 percent of traumatic spinal cord injuries in the United States.
  • Being between the ages of 16 and 30. You’re most likely to suffer a traumatic spinal cord injury if you’re between the ages of 16 and 30.
  • Being older than 65. Falls cause most injuries in older adults.
  • Engaging in risky behavior. Diving into too-shallow water or playing sports without wearing the proper safety gear or taking proper precautions can lead to spinal cord injuries. Motor vehicle crashes are the leading cause of spinal cord injuries for people under 65.
  • Having a bone or joint disorder. A relatively minor injury can cause a spinal cord injury if you have another disorder that affects your bones or joints, such as arthritis or osteoporosis.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is spinal cord injury diagnosed?

In the emergency room, a doctor may be able to rule out a spinal cord injury by careful inspection, testing for sensory function and movement and asking some questions about the accident.

But if the injured person complains of neck pain, isn’t fully awake or has obvious signs of weakness or neurological injury, emergency diagnostic tests may be needed.

These tests may include:

  • Computerized tomography (CT) scan. A CT scan may provide a better look at abnormalities seen on an X-ray. This scan uses computers to form a series of cross-sectional images that can define bone, disk and other problems.
  • X-rays. Medical personnel typically order these tests on people who are suspected of having a spinal cord injury after trauma. X-rays can reveal vertebral (spinal column) problems, tumors, fractures or degenerative changes in the spine.
  • Magnetic resonance imaging (MRI). MRI uses a strong magnetic field and radio waves to produce computer-generated images. This test is very helpful for looking at the spinal cord and identifying herniated disks, blood clots or other masses that may be compressing the spinal cord.

A few days after injury, when some of the swelling may have subsided, your doctor will conduct a neurological exam to determine the level and completeness of your injury. This involves testing your muscle strength and your ability to sense light touch and a pinprick.

How is spinal cord injury treated?

Unfortunately, there’s no way to reverse damage to the spinal cord. But researchers are continually working on new treatments, including prostheses and medications that may promote nerve cell regeneration or improve the function of the nerves that remain after a spinal cord injury.

In the meantime, spinal cord injury treatment focuses on preventing further injury and empowering people with a spinal cord injury to return to an active and productive life.

Emergency actions

Urgent medical attention is critical to minimize the effects of any head or neck trauma. That’s why treatment for a spinal cord injury often begins at the scene of the accident.

Emergency personnel typically immobilize the spine as gently and quickly as possible using a rigid neck collar and a rigid carrying board, which they’ll use to transport you to the hospital.

Early (acute) stages of treatment

In the emergency room, doctors focus on:

  • Maintaining your ability to breathe
  • Preventing shock
  • Immobilizing your neck to prevent further spinal cord damage
  • Avoiding possible complications, such as stool or urine retention, respiratory or cardiovascular difficulty and formation of deep vein blood clots in the extremities

You may be sedated so that you don’t move and sustain more damage while undergoing diagnostic tests for spinal cord injury.

If you do have a spinal cord injury, you’ll usually be admitted to the intensive care unit for treatment. You may even be transferred to a regional spine injury center that has a team of neurosurgeons, orthopedic surgeons, spinal cord medicine specialists, psychologists, nurses, therapists and social workers with expertise in spinal cord injury.

  • Intravenous (IV) methylprednisolone (A-Methapred, Solu-Medrol) is a treatment option for an acute spinal cord injury. If methylprednisolone is given within eight hours of injury, some people experience mild improvement. It appears to work by reducing damage to nerve cells and decreasing inflammation near the site of injury. However, it’s not a cure for a spinal cord injury.
  • You may need traction to stabilize your spine, to bring the spine into proper alignment or both. In some cases, a rigid neck collar may work. A special bed also may help immobilize your body.
  • Often surgery is necessary to remove fragments of bones, foreign objects, herniated disks or fractured vertebrae that appear to be compressing the spine. Surgery may also be needed to stabilize the spine to prevent future pain or deformity.
  • Experimental treatments. Scientists are trying to figure out ways to stop cell death, control inflammation and promote nerve regeneration. Ask your doctor about the availability of such treatments.

Ongoing care

After the initial injury or disease stabilizes, doctors turn their attention to preventing secondary problems that may arise, such as deconditioning, muscle contractures, pressure ulcers, bowel and bladder issues, respiratory infections and blood clots.

The length of your hospitalization depends on your condition and the medical issues you’re facing. Once you’re well enough to participate in therapies and treatment, you may transfer to a rehabilitation facility.

Rehabilitation

Rehabilitation team members will begin to work with you while you’re in the early stages of recovery. Your team may include a physical therapist, occupational therapist, rehabilitation nurse, rehabilitation psychologist, social worker, dietitian, recreation therapist and a doctor who specializes in physical medicine (physiatrist) or spinal cord injuries.

During the initial stages of rehabilitation, therapists usually emphasize maintenance and strengthening of existing muscle function, redeveloping fine motor skills and learning adaptive techniques to accomplish day-to-day tasks.

You’ll be educated on the effects of a spinal cord injury and how to prevent complications, and you’ll be given advice on rebuilding your life and increasing your quality of life.

You’ll be taught many new skills, and you’ll use equipment and technology that can help you live on your own as much as possible. You’ll be encouraged to resume your favorite hobbies, participate in social and fitness activities and return to school or the workplace.

Medications

Medications may be used to manage some of the effects of spinal cord injury. These include medications to control pain and muscle spasticity, as well as medications that can improve bladder control, bowel control and sexual functioning.

New technologies

Inventive medical devices can help people with a spinal cord injury become more independent and more mobile. Some devices may also restore function. These include:

  • Modern wheelchairs. Improved, lighter weight wheelchairs are making people with a spinal cord injury more mobile and more comfortable. For some, an electric wheelchair may be needed. Some wheelchairs can even climb stairs, travel over rough terrain and elevate a seated passenger to eye level to reach high places without help.
  • Computer adaptations. For someone with limited hand function, computers can be very powerful tools, but they’re difficult to operate. Computer adaptations range from simple to complex, such as key guards or voice recognition.
  • Electronic aids to daily living. Essentially any device that uses electricity can be controlled with an electronic aid to daily living (EADL). Devices can be turned on or off by switch or voice-controlled and computer-based remotes.
  • Electrical stimulation devices. These sophisticated devices use electrical stimulation to produce actions. They’re often called functional electrical stimulation (FES) systems, and they use electrical stimulators to control arm and leg muscles to allow people with a spinal cord injury to stand, walk, reach and grip.
  • Robotic gait training. This emerging technology is used for retraining walking ability after spinal cord injury.

Prognosis and recovery

Your doctor may not be able to give you a prognosis right away. Recovery, if it occurs, typically starts a week to six months after an injury. However, some people experience small improvements for up to one year or longer.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage spinal cord injury?

The following lifestyles and home remedies might help you cope with spinal cord injury:

  • Drive safely. Car crashes are one of the most common causes of spinal cord injuries. Wear a seat belt every time you drive or ride in a car.Make sure that your children wear a seat belt or use an age- and weight-appropriate child safety seat. To protect them from air bag injuries, children under age 12 should always ride in the back seat.
  • Check water depth before diving. To make sure you don’t dive into shallow water, don’t dive into a pool unless it’s 9 feet (about 3 meters) or deeper, don’t dive into an aboveground pool and don’t dive into any water of which you don’t know the depth.
  • Prevent falls. Use a step stool with a grab bar to reach objects in high places. Add handrails along stairways. Put nonslip mats on tile floors and in the tub or shower. For young children, use safety gates to block stairs and consider installing window guards.
  • Take precautions when playing sports. Always wear recommended safety gear. Avoid leading with your head in sports. For example, don’t slide headfirst in baseball, and don’t tackle using the top of your helmet in football. Use a spotter for new moves in gymnastics.
  • Don’t drink and drive. Don’t drive while intoxicated or under the influence of drugs. Don’t ride with a driver who’s been drinking.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: December 8, 2017 | Last Modified: December 8, 2017

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