Spinal cord injury
What is considered a spinal cord injury?
A spinal cord injury could be a bruise, a fracture, or a tear. Because the spinal cord is an important part of your central nervous system, an injury to it can have a serious impact on how your body functions.
There are two types of spinal cord injuries: complete and incomplete. A doctor must examine you to determine which type of injury you have.
Total loss of feeling, movement, and bodily function below the level of the injury
Some feeling, movement, or function below the level of the injury
Incomplete spinal cord injuries include:
Anterior Cord Syndrome
- Damage to the front part of the spinal cord
- Results in the loss of the ability to move and the loss of certain sensations below the level of the injury
- Can occur with acute disc herniation, tumors, and when the head is forced to the chest (cervical flexion)
Central Cord Syndrome
- Damage to the middle part of the spinal cord
- Results in more loss of movement or sensation in the arms than in the legs
- Can occur with hyperextension injuries (when the head is forced backwards), degenerative bone changes, or the narrowing of the canal surrounding the spinal cord
- One half of the spinal cord damaged
- Results in one side of the body being stronger below the injury
- The weaker side is able to feel certain sensations better than the stronger side
- Can occur in some bullet or knife injuries and rarely with acute ruptured discs
Causes and risk factors
The causes of spinal cord injury fall into two groups: traumatic and non-traumatic.
In the United States, 44 percent of all spinal cord injuries are caused by motor vehicle accidents. This is the most common source of traumatic spinal cord injury.
Examples of traumatic spinal cord injuries include:
- Ischemia: decreased blood flow to the spinal cord
- Contusion: bruising of the spinal cord
- Fractures: broken vertebrae (bones) in the spine
- Dislocation: vertebrae have moved out of place
- Penetrating: an object such as a bullet hits the spine
Most spinal cord injuries happen to young, healthy people—particularly men ages 15 to 35.
Risk factors include:
- Participating in risky physical activities
- Not wearing protective gear during work or play
- Diving into shallow water
Older people can also be affected. A minor injury can cause trauma if the spine is already weakened by another condition, such as osteoporosis or rheumatoid arthritis.
Non-traumatic injuries are caused by diseases that affect the bones, nerves, or spinal cord.
Examples of these types of injuries include:
- Degeneration of bone
- Bone spurs
- Infections or tumors in the spine
- Diseases involving the spinal cord, such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), Guillain-Barré syndrome, and transverse myelitis
Spinal injuries do not always require surgery. For less-severe injuries, your doctor may recommend:
An intravenous (IV) steroid infusion can reduce swelling in your back.
Stabilization with cervical (neck) traction/alignment or a brace
These are devices that hold your neck and back in place while they heal or to help realign the spine.
Your doctor may recommend surgery if your injury has left your bones unstable, or if the injury is putting pressure on your spinal cord or spinal nerves. The spine is considered unstable if the bones can move and cause further injury. Surgical treatment options include:
This removes the pressure on the spinal cord. Whatever is causing the pressure — for example, bone, a disc, a blood clot, or a tumor — is removed during surgery.
Internal fixation and instrumentation
Rods, screws, or hooks are applied to the bones of your spine in order to protect the spinal cord or spinal nerves from further injury.
Bone grafting for fusion
When internal fixation and instrumentation is needed, a bone graft will also likely be needed. Bone is taken from the back of your pelvis or rib. This bone is then placed onto the injured bony area of your spine. Usually, within three to six months, this bone will bond to your spinal bones and produce a fusion that makes your spine more stable.