What is spinal trauma? A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material or ligaments bruise or tear into spinal cord tissue.
Most injuries to the spinal cord don't completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy the axons, extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.
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.
What are the symptoms? Symptoms include various levels of movement or sensory loss in body parts. 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.
How is it diagnosed? 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. Patients 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.
How is it treated? Improved emergency care for people with spinal cord injuries and aggressive treatment and rehabilitation can minimize damage to the nervous system and even restore limited abilities.
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.
Respiratory complications are often an indication of the severity of spinal cord injury About one-third of those with injury to the neck area will need help with breathing and require respiratory support. The steroid drug methylprednisolone appears to reduce the damage to nerve cells if it is given within the first eight hours after injury.
Rehabilitation programs combine physical therapies with skill-building activities and counseling to provide social and emotional support.
Rehabilitation will follow once a patient is stable.
What research is being done? Research efforts in the United States 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.
For the latest on spinal trauma research, visit these sites:
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Spinal Injury Foundation --
The National Spinal Cord Injury Association --
National Institute of Neurological Diseases and Stroke Can spinal injuries be prevented? Most spinal injuries are the result of accidents. The best form of prevention 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, skateboarding, for example. Follow the rules of the sport or activity in which you are participating.
Sources: --
Spinal Injury Foundation --
The National Spinal Cord Injury Association --
National Institute of Neurological Diseases and Stroke --
MedlinePlus