Represented by damage brought to the vertebrae, ligaments or spinal cord itself. The injuries cause changes in motor abilities, sensory aspects and bodily functions below the place of injury – a lumbar (lower back) injury can affect the legs, bowel and bladder control and also sexual functions; a cervical (neck) injury can affect the ability to breathe. After an injury, the lowest part of the spine that functions normally is called the neurological level of the injury. Severity is assessed as being: complete (if all feeling and movement control is lost below the place of injury) or incomplete (if there is some sensory or motor function below the place of injury).

Causes

The damage caused by traumatic spinal cord injuries can consist in:

 

Fractures, dislocations, crushes or compressions of one or more vertebrae

 

Penetrations and cuts of the spinal cord due to gunshots or knives/sharp objects

 

Additional damage can appear after a period (days, weeks) and can be caused by bleeding, inflammation and/or fluid build-up in or around the spinal cord

 

Non-traumatic spinal cord injury causes: arthritis, spinal disks degeneration, infections, inflammation, cancer

 

Common causes:

 

Motor vehicle accidents

 

Falls (25% of all spinal cord injuries)

 

Violence (gunshots, knife wounds)

 

Impact sports or risky hobbies

Symptoms and signs

 

Loss of movement

Loss of sensation (temperature, pressure)

Loss of bladder and bowel control

Spasms

Pain

Stinging sensation

Difficulty breathing

Extreme back pain or neck pressure

Lack of coordination

Numbness in the extremities (hands, fingers,feet, toes)

Infertility

Advice

 

Spinal cord injuries are not always immediately observable

 

Time between injury and treatment is in most cases crucial due to possible complications and length of recovery time

 

Tests that can help diagnose a spinal cord injury: CT scans (computerized tomography) – provides cross-section images of the spine, MRI (magnetic resonance imaging) – useful in identifying spinal disk problems, blood clots or masses that compress the spinal cord, X-rays – to detect tumors, vertebrae problems, fractures

 

Unfortunately, spinal cord damage is irreversible and treatments aim to stop further complications and stabilize a person’s medical situation

 

Spinal cord injuries require an urgent visit to the intensive care unit but treatment often begins at the scene of the accident

 

The first stages of treatment imply: maintaining the patient’s ability to breathe, preventing further damage through immobilization and avoiding complications such as urine retention, cardiovascular problems or blood clots formation

 

Medication: intravenous methylprednisolone (for acute spinal cord injuries, if administered in the first 8 hours mild improvement can be observed – reduced damage to the nerve cells and decreased inflammation around the place of injury); in the rehabilitation stage, medication is focused on pain and muscle spasm control, bladder and bowels control and sexual function improvement

 

Immobilization and in some cases traction to realign the spine

 

Surgery is required in severe cases where bone fragments/foreign objects have to be removed, disks repositioned or fractured vertebrae stabilized

 

Secondary problems that may occur: muscle contractures, pressure ulcers, blood clots, infections, respiratory, bowel and bladder issues

 

A rehabilitation team (physical therapist, occupational therapist, rehabilitation psychologist, dietician, rehabilitation nurse, social worker, physiatrist) will work with the patient after his/her condition is stabilized

 

The emphasis falls on maintaining and strengthening existing muscles and acquiring new skills that help in daily activities

 

Various devices can help: wheelchairs (getting more and more hi-tech), computer adaptations (such as voice recognition), electronic aids to daily living (EADL), electrical stimulation devices (stimulate arms and legs muscles, help with walking, standing, holding, reaching)

MISCONCEPTIONS
  •  

    Men/women with spinal cord injuries can never have children

     

    Every person that suffers a spinal cord injury will have depression

     

    Spinal cord injury rehabilitation ends the moment you are discharged from the hospital

     

    The effects of a spinal cord injury remain the same throughout a person’s life

     

    Positive thinking does not help very much in a spinal cord injury situation

Statistics

 

35% of the spinal cord injuries that occur in a year are due to motor accidents

 

15% of spinal cord injuries are due to acts of violence

 

9% of spinal cord injuries come from sports or dangerous hobbies

 

In the USA, 12,500 new spinal cord injuries appear each year

 

Around 280,000 people in the US have suffered and are living with a spinal cord injury

 

82% of the cases are men

Did you know?

 

You must not move a person that possibly has a spinal cord injury because you could paralyze him/her. The best way to help is to keep the person still, call for specialized help and don’t let the head or neck move

 

Around 20% of the people with spinal cord injury have major depression (the general belief is that every person that suffered a spinal cord injury is depressed)

 

The leading causes of death in people with spinal cord injury: pneumonia, pulmonary embolism and septicemia