The main goal when treating an SCI is to keep the highest level of function possible. Treatment is also aimed at preventing complications and further injury. Treatments may be non-surgical and/or surgical.
Non-surgical treatments
Steroid infusion: Intravenous (IV) steroid infusions may be given for an SCI that happens suddenly (trauma). The goal is to lower swelling from the injury. When appropriate, the steroid treatment is started soon after injury.
Stabilization with cervical (neck) traction/alignment: These types of traction are often needed to reduce or re-align the spine:
- Halo traction
- Gardner-Wells Tongs traction
Bracing: Based on the level of injury and doctor’s recommendation, a brace may be placed. Pictures of the braces are on the next two pages. These braces may be used before and/or after surgery if needed.
Cervical (neck) and high thoracic (upper chest) injuries
Lower thoracic and lumbar injuries
Surgical treatments
Surgery may be needed when the injury has caused the bones to be unstable or when there is pressure on the spinal cord or spinal nerves. The spine is not stable if, in spite of bracing, the bones can move and cause further injury.
Decompression: This is removing the pressure on the spinal cord. The cause (bone, disc, blood clot, tumor) of the pressure on the spinal cord or spinal nerves is removed.
Internal fixation and instrumentation: Internal fixation means to put metal rods, screws, and/or hooks (instrumentation) on the vertebrae to protect the spinal cord or spinal nerves from further injury. Think of this as a brace on the inside of the body. Often a bone graft is also done. The three figures below show how this looks, with the titanium screws, hooks, and rods.
- Left: Titanium rods, screws, and hooks next to the lumbar spine
- Middle:X-ray side view of neck with rods and screws (cervical spine)
- Right: X-ray side view of low back with rods and screws (lumbar spine)
Bone grafting for fusion: When internal fixation and instrumentation is needed, a bone graft will also mostly likely be needed. The bone graft may be taken from the back of the pelvis or rib. This bone is then placed onto the injured bony area. Often, this bone will bond to the vertebrae and fuse within 3 to 6 months. When the vertebrae have completely fused, this further stabilizes the spine.