Spinal Cord Injury

What is a spinal cord injury?

Spinal cord injury is damage to the thick bundle of nerves that runs from the brain to the lower back. This bundle of nerves (spinal cord) is enclosed in the spinal canal, a bony passageway that is formed by the holes in the middle of every vertebra. The spinal cord carries sensations and messages to and from the brain and the rest of the body. This means that a spinal cord injury can affect sensation and control of movement of the whole body.

The spinal cord may be injured if you have an injury to the back that:

• breaks or dislocates the bones around the spinal cord
• penetrates through or between the bones (such as a bullet)
• crushes the disks between the bones and pushes them into the spinal canal.

When the spinal cord is crushed, stretched, or torn, the nerves are damaged. If the damage is bruising or swelling, the nerves may be able to heal. However, if the nerves are crushed, cut, or torn, they are usually not able to grow back.

How does it occur?

Common causes of spinal cord injuries are:

• automobile or motorcycle accidents
• falls from high places
• dives into shallow water
• sports such as hockey, football, water skiing, and surfing
• penetrating injuries from weapons such as bullets or knives.

The spinal cord may also be damaged by stabbing or gunshot wounds or by tumors growing into the spinal cord.

What are the symptoms?

The symptoms of spinal cord injury depend on how much and what part of the cord is damaged. The nerves in your body allow you to feel hot and cold, touch and texture. They allow you to control your muscles. They also control body functions that happen without your thinking about them (like breathing while you're sleeping). This means that when the nerves are damaged, any or all of these functions may be lost. For example, spinal cord injury can cause:

• numbness
• tingling
• inability to move parts of your body (paralysis)
• inability to control your bowel and bladder (incontinence).

Nerves in the lower part of the spine control functions and feelings lower in your body (such as your legs). Nerves in the upper end of the spinal cord control the lower part of the body as well as movement and feelings higher in your body (such as your arms). This means that injuries at the upper end of the spinal cord affect more nerves and body functions than injuries that are lower in the spine. For example, damage at the middle or lower back affects the lower body and legs. An injury in the neck may paralyze arms, legs, bladder, bowels, and even the muscles that control breathing.

How is it diagnosed?

Your health care provider will diagnose the injury based on how you were injured and your symptoms (such as numbness, tingling, or being unable to move parts of your body). You will have a physical exam to confirm which parts of the body are affected. Tests you will have include:

• x-rays to look for broken or dislocated bones
• CT and MRI scans to look at the cord and the tissues around it.

How is it treated?

The treatment for spinal cord injury depends on the injury. Sometimes traction is used to pull bones back into their proper place. You may need surgery to relieve pressure on the cord from a bone or disk that is pushing on it. The vertebrae around the injury may be fused together to provide support for your spine and to protect your spinal cord. You may be given medicine (high-dose steroids) to decrease swelling around the cord.

If you are partially paralyzed, you may recover some movement if the nerves are only bruised. Physical therapy is a major part of the treatment. Long-term medical care may require skin, bladder, and bowel care, and training. You may need help with daily activities. You may also need career retraining.

How long will the effects last?

If some of the injured nerves were just bruised, they might start to work again days to weeks after the injury. However, nerves that were badly damaged will die. They will not grow back and the injury is permanent.

How can I help prevent spinal cord injury?

Most of the time spinal cord injury is the result of accidents. To help avoid spinal cord injury:

• Wear a seat belt when you are riding in a vehicle. Children should be properly restrained in car seats or booster seats.
• Wear a helmet when you ride a bike or motorcycle.
• Use safety equipment at work and when you play sports.
• Check the water depth before you dive.
• Do not move someone with a possible spinal injury until emergency providers arrive. It may make the injury worse to move him or her. Health care workers will protect the neck and spinal column before moving the person.
• If you have injured your back or neck, look for any changes. Report all signs of numbness, tingling, weakness, or problems moving. Consult your health care provider right away, even if these feelings come and go.