Spinal cord trauma is damage to the spinal cord. It may result from direct injury to the cord itself or indirectly from disease of the nearby bones, tissues, or blood vessels.
Symptoms vary, depending on the location of the injury. SCI causes weakness and loss of feeling at, and below the injury. How severe the symptoms are depends on whether the entire cord is severely injured (complete) or only partially injured (incomplete).
An injury at and below the first lumbar vertebra does not cause SCI. But, it may cause cauda equina syndrome. This is an injury to the nerve roots in this area. This is a medical emergency and needs surgery right away. Injuries of the spinal cord at any level can cause:
Increased muscle tone (spasticity)
Loss of normal bowel and bladder control (may include constipation, incontinence, bladder spasms)
Numbness
Sensory changes
Pain
Weakness, paralysis
The diagnosis of primary spinal cord tumors is difficult, mainly due to their symptoms, which in early stages mimic more common and benign degenerative spinal diseases. MRI and bone scanning are used for diagnostic purposes. This assesses not only the location of the tumor(s) but also their relationship with the spinal cord and the risk of cord compression.
The spinal cord contains the nerves. These nerves carry messages between your brain and body. The cord passes through your neck and back down to the first lumbar vertebra.
Spinal cord injury (SCI) can be caused by anything from falls, work place and car accidents to sports injuries. A minor injury can damage the spinal cord. Conditions, such as rheumatoid arthritis or osteoporosis can weaken the spinal cord. Injury can also occur if the spinal canal protecting the spinal cord has become too narrow (spinal stenosis). This occurs during normal aging.
Direct injury or damage to the spinal cord can occur due to:
Bruises if the bones or disks have been weakened
Fragments of bone (such as from broken vertebrae, which are the spine bones) in the spinal cord
Fragments of metal (such as from a traffic accident)
Sideway pulling or pressing or compression from twisting of the head, neck or back during an accident or intense chiropractic manipulation
Bleeding, fluid buildup, and swelling can occur inside or outside the spinal cord (but within the spinal canal). This can press on the spinal cord and damage it.
Most high impact SCIs, such as from motor vehicle accidents or sports injuries, are seen in young, healthy people. Men ages 15 to 35 are most often affected.
Low impact SCI often occurs in older adults from falls while standing or sitting. Injury is due to a weakened spine from aging or bone loss (osteoporosis).
SCI is a medical emergency that needs medical attention right away. Your health care provider will perform a physical exam, including a brain and nervous system (neurological) exam. This will help identify the exact location of the injury, if it is not known. Some of the reflexes may be abnormal or missing. Once swelling goes down, some reflexes may slowly recover.
Tests that may be ordered include:
CT scan or MRI of the spine
Myelogram (an x-ray of the spine after injecting dye)
Spine x-rays
Electromyography (EMG)
Nerve conduction studies
An SCI needs to be treated right away. The time between the injury and treatment can affect the outcome. Medicines called corticosteroids are sometimes used to reduce swelling that may damage the spinal cord, though there is no clear evidence that they are useful.
If spinal cord pressure is caused by a growth that can be removed or reduced before the spinal nerves are completely destroyed, paralysis may improve.
Surgery may be needed to:
Realign the spinal bones (vertebrae)
Remove fluid or tissue that presses on the spinal cord (decompression laminectomy)
Remove bone fragments, disk fragments, or foreign objects
Fuse broken spinal bones or place spinal braces
Bed rest may be needed to allow the bones of the spine to heal.
Spinal traction may be suggested. This can help keep the spine from moving. The skull may be held in place with tongs. These are metal braces placed in the skull and attached to weights or to a harness on the body (halo vest). You may need to wear the spine braces for many months.
You will probably need physical therapy, occupational therapy, and other rehabilitation after the injury has healed. Rehabilitation will help you cope with the disability from your SCI.
