Spinal Cord Injury

The symptoms you experience with a spinal cord injury depend on both the severity of the injury and its location. Different parts of the spine send signals to different parts of the body. The higher in the spinal cord the injury, the more function is lost.

There are two overall areas that are affected. One is movement, as your spinal cord delivers messages from your brain to your muscles. The other is sensation, as the spinal cord itself enables you to feel, touch, and experience heat, cold, and pain, as it sends signals back to the brain.

Someone who has all or part of the trunk, legs, and pelvic organs affected is said to have paraplegia. The terms quadriplegia or tetraplegia refer to the condition of having those areas, plus the arms and hands, affected.

Taking all this into account, immediate symptoms can include:

• Loss of movement
• Altered or lost sensation (no feeling, or unable to recognize heat or cold)
• Loss of bladder or bowel control
• Spasms
• Pain
• Difficulty breathing

If, after an accident or injury, you are or someone else is experiencing weakness, lack of coordination, numbness, or paralysis, get immediate medical attention. Extent of injury is not always evident, as swelling or bleeding may occur slowly around the spinal cord. Always assume that a trauma will cause an injury, and call 911. The time between injury and treatment is critical.

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Most spinal cord injuries are the result of trauma. In the United States, motor vehicle accidents are responsible for almost half of all new spinal cord injuries each year, with falls — in those over 65 — representing another 15 percent. Violent crimes, including gunshots or knife wounds, account for 12 percent, with sports and recreation (impact sports and diving, for example) another 10 percent.

Overwhelmingly — 80 percent — of spinal cord injuries are experience by males, and most are between 16 and 30.

In cases where there is no trauma, the injury can be caused by arthritis, cancer, inflammation, infection or disk degeneration — all conditions that can cause compression of the nerves of the spinal cord.

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After a spinal cord injury, there are many issues that need to be addressed depending on the extent of the injury and its location. At St. Luke’s, you will work with a team that includes physical and occupational therapists, rehabilitation nurses and psychologists, physiatrists, neurologists and social workers.

You may need to employ a caregiver. There may be medications to help your circulation and breathing, to regain or improve bladder, bowel and sexual function, and to control any pain. You will need to learn how to maintain and strengthen your body, from food to exercise, to prevent complications, and possibly relearn fine motor skills using adaptive techniques. You may want to install modifications such as ramps, grab bars and levers instead of doorknobs for easier turning, and need to use prosthetic devices that are computer or voice controlled. Motorized or manual wheelchairs may be necessary.

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In the case of trauma, the physician will first do a visual inspection and then test for sensory and motor function. If you can talk, the doctor will ask questions about the accident and get any information about your medical history, medications and family history. What might seem on the surface to be a minor injury can be much more significant if you have a pre-existing condition such as arthritis or disk degeneration, for example.

A magnetic resonance imaging (MRI) scan is the most helpful test to find bone damage as well as herniated disks, blood clots, and other masses that could be pressing on your spinal cord. Other tests, such as X-rays, can show disturbances to your vertebrae.

Often, a more comprehensive neurological exam is performed a day or so after the trauma, after swelling has a chance to subside. This exam would check for muscle strength and responsiveness to touch and sensation.

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At St.Luke’s, you will find neurosurgeons, orthopedic surgeons, neurologists, skilled therapists and others who will make up your spinal cord injury team.

Surgery is a front-line treatment for spinal cord injury. It is performed to remove fragments of bone or foreign objects that might be putting pressure on the spine; to stabilize the spinal cord; or to prevent future pain or deformity.

Often, there are secondary problems that result from spinal cord injury after any life-saving treatments have been administered. Muscles need to be reconditioned. Bowel and bladder issues, as well as sexual function, need to be addressed. You may have a respiratory infection or an increased risk of blood clots. Different medicines, exercises and treatments are available to treat these and other conditions.

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