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Spinal Trauma
The spinal cord is a continuation of the central nervous system which extends down from the brain through a protective canal formed by the spinal bones or vertebrae. When the vertebrae are damaged or fractured, the spinal cord may also become injured, preventing the brain from sending messages down the spinal cord to the peripheral nerves where they need to go. This could result in such things as a loss of sensations (the inability to feel pain, heat or cold, for instance) and/or a loss of motor activities or paralysis (the inability to move certain limbs).
Spinal trauma can result from such things as falls and car or sports accidents. Most of the damage done to the spinal cord occurs at the time of the injury, though swelling in the first 24 hours may worsen the condition, either temporarily or permanently.
Symptoms
Spinal cord injuries are classified as 'complete' or 'incomplete.' Complete injuries mean that all motor activities (movement) of body parts and all sensory feelings (touch, pain, temperature) below the injury site are permanently lost. Incomplete injuries mean some movement and/or feeling below the injury site is present. There is a greater possibility of recovery of lost functions, but no guarantee. Quadriplegia is total loss of movement and feeling in the arms and legs. Paraplegia means total loss, while paraparesis means partial loss, of motor and sensory function of either both arms or both legs.
Testing
Once the spinal trauma has occurred, medical personnel check the respiratory function and vital signs and the physician conducts a neurological examination to determine how much spinal cord has been damaged and how much sensory, motor and reflex function has been lost. You will also be examined for damage to other areas, including the head and heart, and the physician may order an electrocardiogram (EKG) to check for cardiac complications. X-rays are taken of the spine.
 EKG (electrocardiogram)
This is a recording of the electrical activity of the heart. Electrodes are placed on your arms, legs and chest to record a series of heartbeats that will help determine your diagnosis. It is completely painless.
Treatment
Acute Care
All spinal injuries are considered unstable until definitive tests prove otherwise. During this assessment period, all measures are taken to ensure that further injury to the spinal cord does not occur. Treatment of spinal cord injury centers around reduction of spinal cord compression and stabilization of the spine. These fractures can be addressed surgically or non-surgically. It is especially important in incomplete injuries to remove any bone that is compressing the spinal cord, to relieve pressure, maintain the flow of blood and oxygen and limit mechanical damage.
Your doctor may also administer methylprednisolone, a synthetic steroid that was approved in 1990 by the Food and Drug Administration for the emergency treatment for spinal cord injury. It is most effective if administered within three hours of when the injury occurred. It works by suppressing the body's natural inflammatory responses, limiting swelling (and therefore further injury), and it also blocks the formation of free radicals (which can disrupt the membranes of cells that were not initially injured).
Any spinal cord injury requires a multi-disciplinary team, usually consisting of: a neurosurgeon, neurology nurses, physiatrists, physical, occupational, and respiratory therapists, social workers, case managers, and, in some cases, an orthopedic surgeon and psychologist.
Post-acute Care
Once your condition is assessed to be stable, you will begin rehabilitation, including bowel and bladder retraining. The sooner rehabilitation begins, the better, though your specific rehabilitation program and schedule will depend on the site and extent of your injury, as well as your age and medical condition. This is also the time to begin healing emotionally, and for the caregiver(s) and family to adjust. There are many resources available to help with these physical and emotional challenges. Your doctor or nurse will talk with you about what they are, how to access them, and ways you can avoid potential long-term problems, including medical, social, psychological and vocational deterioration.
Research
Research efforts in the U.S. are exploring ways to repair and regrow damaged spinal cord tissue by developing a special combination of nourishing proteins (called neurotrophic factors). Scientists are also looking at the characteristics of the ideal environment in which cells can recover, and examining whether damaged spinal cord neurons would benefit from the presence or absence of various non-neuronal cells. While progress is being made in understanding the molecular and cellular events that occur following spinal cord injury, there remain many unanswered questions, including why the brain and spinal cord do not repair themselves.
Prevention
Most spinal injuries are the result of accidents. The best form of prevention, then, is to take reasonable precautions. Do not dive if you are unfamiliar with the depth of an area, always wear your seatbelt; make sure you wear a helmet when cycling and roller blading. Follow the rules of the sport or activity in which you are participating.
Support Groups/Resources
Many patients and families find great comfort and support in talking with other patients, families and caregivers who have had (or are having) similar experiences. Support group meetings are free of charge, and are facilitated by a trained peer or qualified professional. The following numbers should help you get more information and/or find a group nearest you:
The National Spinal Cord Injury Association
Phone: 1-800-962-9629
The National Spinal Cord Injury Hotline
Phone: 1-800-526-3456
Spinal Cord Society
Phone: (218) 739-5252
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