Spinal Cord Injury

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KEY POINTS

• Your spinal cord is a bundle of nerves that runs down the middle of your back. It is protected by the bones of your spine, and carries signals between your body and your brain.
• If the spinal cord is bruised or swollen from an injury, your nerves may be able to heal and start to work again days to weeks after the injury. If the cord or nerves are cut or torn, your injury may be permanent.
• Treatment may include traction, surgery, medicine, physical and occupational therapy, and counseling.

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What is a spinal cord injury?

Your spinal cord is a bundle of nerves that runs down the middle of your back. It is protected by the bones of your spine, called vertebrae. Your spinal cord carries signals between your body and your brain.

If the spinal cord is bruised or swollen from an injury, it can make it hard for the nerves to carry signals between your brain and other parts of your body. Your nerves may be able to heal and start to work again days to weeks after the injury. However, if the cord or nerves are cut or torn, they are usually not able to heal and can’t carry signals to and from your brain. This kind of injury is permanent.

A spinal cord injury may be described as complete or incomplete. Incomplete spinal cord injury means that you may still have some feeling or movement below the injury. Complete spinal cord injury means that you do not have feeling or movement below the injury.

What is the cause?

The spinal cord may be damaged if you have an injury that:

• Breaks or dislocates the bones around the spinal cord
• Goes through or between the bones (such as a bullet or knife)
• Damages the disks between the bones and pushes them against the spinal cord

The most common causes of spinal cord injuries are:

• Automobile accidents
• Falls from high places
• Diving into shallow water
• Motorcycle accidents
• Gunshot wounds
• Sports injuries from hockey, football, water skiing, and surfing

The spinal cord may also be damaged by infections or 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 spinal cord is damaged. Nerves in the lower part of the spine control the lower part of your body. If the spinal cord is damaged in the middle or lower back, you may be paralyzed and lose feeling in the lower body and legs. Nerves in the upper part of the spinal cord control your upper body, as well as the lower part of the body. An injury in the neck may paralyze your arms, legs, bladder, bowels, and the muscles that control breathing.

Symptoms of a spinal cord injury may include:

• Numbness and tingling
• Weakness or complete inability to move parts of your body (paralysis)
• Loss of bowel and bladder control
• Trouble breathing

How is it diagnosed?

A healthcare provider will ask about your symptoms and medical history and examine you.

Tests of the spine may include:

• X-rays
• CT scan, which uses X-rays and a computer to show detailed pictures of the spinal cord and the tissues around it
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the spinal cord and tissues around it

You may also have scans of the brain to see if it may have been injured as well.

How is it treated?

A spinal cord injury is a medical emergency. Right after the injury, your spine needs to be kept from moving to prevent further injury. This is done using a rigid collar for the neck and a spine board for the middle and lower back. Extreme care must be taken when moving someone with a spinal cord injury. Later, treatment may include:

• Spinal traction to pull bones back into their proper place
• Surgery to relieve pressure on the spinal cord from a bone or disk that is pushing on it. Broken vertebrae around the injury may be fused together to support the spine and to protect the spinal cord from further injury.
• Medicine (high-dose steroids) to decrease swelling around the cord
• Cooling your body, which helps decrease the swelling around the cord and helps the nerves heal

You may start a spinal cord injury rehabilitation program while you are in the hospital. Rehab will help you make the most of functions you still have and help you learn to cope with some of the functions you may have lost because of the injury. You may have several kinds of therapy:

• Physical therapy is a big part of the treatment. It helps you regain muscle strength and may teach you ways to move safely with weak or paralyzed muscles.
• Occupational therapy helps you relearn ways of eating, dressing, and grooming.
• Speech therapy may help if you have problems with swallowing or speaking.
• Therapy may include skin care and training to help you control your bladder and bowels.
• You may need help with daily activities or you may require round-the-clock help and care.

Counseling should also be part of your recovery. Counseling can help you and your family adjust to living with a spinal cord injury.

How can I take care of myself?

• If your spinal cord injury has affected your ability to chew or swallow, you will need to make some changes in the foods you eat. Ask your provider about the benefits of talking to a dietitian to learn what foods you will be able to eat to have a healthy diet.
• Follow the exercise or rehabilitation treatment plan your healthcare provider prescribes. You may need to do special exercises to keep muscles as strong as possible.
• You may need to make changes to your home in order to use special equipment that will help you with your daily activities.
• You may need to arrange for someone to be with you to help you with your daily activities.

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, when you play sports, and when you use sports equipment, such as trampolines.
• Check the water depth and check for obstacles, such as rocks, before you dive.
• Do not move someone with a possible spinal injury until emergency providers arrive. Movement may make the injury worse. Healthcare providers will protect the neck and spine before moving the person.
• If you have hurt your back or neck, get medical help if you have numbness, tingling, weakness, or problems moving. Contact your healthcare provider even if these feelings come and go.