Spinal cord trauma involves damage to the spinal cord. The spinal cord lies inside the spinal vertebrae (bones) of the neck, chest, and lower back. It’s a dangerous injury and a medical emergency. Spinal cord injury causes permanent disability or loss of movement (paralysis) and sensation below the injury. Paralysis of both arms and legs is called quadriplegia. These injuries may affect only the lower body (paraplegia).
Traumatic injuries are most common in people 15–25 years old, usually males.
Causes include sudden blows to the spine that fracture, crush, or compress vertebrae. Gunshot or knife wounds, motor vehicle accidents, falls, sports, and recreational activities (e.g., diving) are other causes.
Arthritis, cancer, blood vessel problems, bleeding, inflammation, infections, and spinal disk degeneration are nontraumatic causes. Older people with weakened spines (from osteoporosis) may have injuries from rather simple falls.
Symptoms depend on where the injury is and how severe it is (partial or complete). Injuries that are higher in the spinal cord usually cause more paralysis. Symptoms include weakness, paralysis, and loss of feeling at and below the injury. Breathing and balance problems, loss of bowel and bladder control, spasms, and pain can occur.
The health care provider does a physical examination, including a neurologic examination. The health care provider tests pinprick, light touch, and vibration senses. Additional testing usually includes computed tomography (CT), magnetic resonance imaging (MRI), and x-rays.
Treatment begins at accident scenes, including using a back board with the neck in a collar and checking the ABCs (airway, breathing, circulation). The spine must be stabilized and immobilized. Traction helps align the spine. The steroid methylprednisolone is an option for acute injury if given within 8 hours. Emergency surgery may be done to take out pieces of bones, foreign objects, ruptured (herniated) disks, or broken vertebrae. Surgery may be done to stabilize the spine. Bed rest is important, but early mobilization is critical. Medicines help spasms and pain.
Later, muscle contractions, bed sores, urinary infections, blood clots, and other complications must be prevented and promptly treated when they occur. Treatments include range-ofmotion exercises, skin lotions, soft bed coverings or flotation mattresses, and changing positions often. Management of many possible complications and early rehabilitation are long-term goals. A medical team helps with these goals. This team can include physical and occupational therapists.
People’s living environments may need changing. New devices help independence and mobility. These include modern wheelchairs, computer-controlled tools and gadgets, and electrical stimulation devices.
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