What Is It?

The spinal cord carries nerve signals from the brain to the rest of the body. Trauma to the spinal cord can result from a number of injuries, most commonly from motor-vehicle accidents, falls and violence. More than 80 percent of cases of spinal-cord trauma occur in people between the ages of 15 and 35, and approximately 80 percent of those affected are male. Most spinal-cord injuries occur in the area of the neck called the cervical region. Trauma can result from bruising to the spinal cord itself, loss of blood flow to the cord or cuts in the cord. Cuts or a complete severing of the spinal cord are quite rare. Spinal-cord injuries are serious and can cause diminished strength, coordination and sensation as well as other functions, such as bladder control.

The symptoms of spinal-cord trauma vary, and depend on the location and severity of the injury. Complete spinal-cord trauma — trauma that results in a total loss of sensation or the ability to move — occurs at about the same level as the injury. For example, a person injured in the middle of the neck will lack feeling and be unable to move below the middle of the neck. Almost one-half of all spinal-cord injuries are complete. Complete injuries that take place in the upper neck can compromise breathing ability and require the person to use a mechanical ventilator.

Other signs that can accompany spinal-cord injury include neck, head or back pain or pressure, or significant bruising and swelling of the skin over the injured area.

Injuries to a specific side of the spinal cord or its center will produce characteristic patterns of symptoms, such as weakness or paralysis of arms or legs, or one side of the body. In an injured person who is unconscious, the degree of neurological injury may be much harder assess, so doctors must have a high degree of suspicion that a spinal-cord injury has taken place and take steps to protect the spinal cord. This usually is done by using a cervical collar to immobilize the neck or by strapping the person to a stiff backboard for transport.

The possibility of spinal-cord trauma should be considered in anyone who has been in a severe automobile accident or who has experienced significant injury to the head or neck. If you are conscious, you will be asked about neck pain and whether you can feel and move your arms and legs. You also will be assessed for recent use of drugs or alcohol, for whether you have other painful injuries that may be diverting attention from a neck injury, and for the presence of other signs of spinal-cord injury. X-rays, computed tomography (CT) scans and magnetic resonance imaging (MRI) also may be used to evaluate your spine and the spinal cord.

A cervical collar to keep your neck immobilized often will be left in place until the results of tests are available. If a spinal-cord injury is suspected, the collar may be left in place for at least several days, even if tests are negative, in case an injury does exist but hasn’t been detected because of swelling or muscle spasm.

Complete spinal-cord injuries are diagnosed when total loss of sensation and control occurs. Incomplete injuries cause variable amounts of sensory loss, weakness or paralysis, depending on the site of the injury.

The duration of the symptoms of spinal-cord injury depends on the nature and extent of the injury. Minor bruising may resolve over time, although full recovery sometimes takes weeks or months. More serious injuries often will result in permanent loss of function. Strategies for helping neurons recover after injury is an area of active research.

Preventing spinal-cord injury requires preventing traumatic injury to the spinal column, especially the neck. The leading causes of spinal-cord injury include automobile accidents, falls, sports, diving accidents and firearms. To prevent spinal-cord injury:

• Wear seat belts.
• Don’t drink and drive.
• Don’t dive into water of unknown depth.
• Dive only in water at least nine to 12 feet deep, with your arms in front of you.
• Wear protective equipment when playing sports.
• Protect yourself against falls.
• Prevent children’s access to guns.

Most treatment of spinal-cord injuries involves a “wait and see” approach. If the injury is minor, only time will reveal the extent of recovery. For those with major injuries, a complete recovery is highly unlikely, and treatment consists of providing supportive care, teaching new skills and developing coping strategies. Surgery sometimes is required for spinal-cord trauma when damage to the bony structures surrounding the spinal cord must be stabilized or a blood clot must be removed. Active areas of research include nerve-cell transplant, nerve regeneration and medication therapies to improve recovery of neurologic function.

All cases of actual or potential spinal-cord trauma require immediate evaluation by a doctor.

Spinal-cord trauma may resolve over time without further problems, or it may result in permanent deficits, depending on the location and severity of the injury.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.