Overview
A spinal cord injury is damage to any part of the spinal cord or nerves at the end of the spinal canal (cauda equina). This often causes permanent changes in strength, sensation, and other body functions below the site of the injury. Spinal cord injuries can result from damage to the vertebrae, ligaments, or disks of the spinal column or to the spinal cord itself. The severity of the injury is classified as complete or incomplete, depending on the extent of the loss of feeling and control of movement below the injury. Symptoms can include loss of movement, altered sensation, loss of bowel or bladder control, exaggerated reflex activities or spasms, and pain. Tetraplegia and paraplegia are terms used to describe paralysis affecting different parts of the body.
Understanding the disease
Symptoms
Symptoms of spinal cord injury may include:
- Extreme back pain or pressure in the neck, head, or back
- Weakness, incoordination, or paralysis in any part of the body
- Numbness, tingling, or loss of sensation in the hands, fingers, feet, or toes
- Loss of bladder or bowel control
- Difficulty with balance and walking
- Impaired breathing after injury
- An oddly positioned or twisted neck or back
- Loss of movement
- Loss of or altered sensation, including the ability to feel heat, cold, and touch
- Loss of bowel or bladder control
- Exaggerated reflex activities or spasms
- Changes in sexual function, sexual sensitivity, and fertility
- Pain or an intense stinging sensation caused by damage to the nerve fibers in the spinal cord
- Difficulty breathing, coughing, or clearing secretions from the lungs The severity and symptoms of a spinal cord injury depend on the location and extent of the injury. In some cases, the symptoms may be immediate, while in others, they may develop gradually.
Risk Factors
The risk factors for developing spinal cord injury are:
- Being male
- Being between the ages of 16 and 30
- Being 65 and older
- Alcohol use
- Engaging in risky behavior
- Having certain diseases (such as osteoporosis) These factors can predispose a person to a higher risk of experiencing a spinal cord injury.
Development
The spinal cord injuries develop either as traumatic or nontraumatic injuries. Traumatic spinal cord injuries result from sudden, traumatic blows to the spine that fracture, dislocate, crush, or compress one or more vertebrae. They can also result from gunshot or knife wounds that penetrate and cut the spinal cord. Nontraumatic spinal cord injuries, on the other hand, can be caused by conditions such as arthritis, cancer, inflammation, infections, or disk degeneration of the spine. In both cases, additional damage may occur over days or weeks due to bleeding, swelling, inflammation, and fluid accumulation in and around the spinal cord. The severity of the injury and the location of the injury on the spinal cord determine the extent of the damage and the resulting effects on the body.
Assessment and Diagnosis
Triage
You should see a doctor immediately if you suspect a spinal cord injury due to any of the following signs and symptoms:
- Extreme back pain or pressure in your neck, head, or back
- Weakness, incoordination, or paralysis in any part of your body
- Numbness, tingling, or loss of sensation in your hands, fingers, feet, or toes
- Loss of bladder or bowel control
- Difficulty with balance and walking
- Impaired breathing after injury
- An oddly positioned or twisted neck or back Remember, it's safest to assume that trauma victims have a spinal injury until proved otherwise, as serious spinal injuries may not always be immediately obvious. If someone has a back or neck injury, don't move them, and call 911 or your local emergency medical assistance number right away.
Diagnosis
To diagnose a spinal cord injury, a doctor may start with an examination, testing for sensory function and movement, and asking questions about the accident. If the injured person shows signs of weakness or neurological injury, further diagnostic tests may be needed. These tests may include X-rays, CT scans, and MRIs. For a spinal cord injury, some basic questions to ask the doctor include the prognosis, available treatments, and whether surgery might help.
Management and Treatment
Complications
Potential complications of spinal cord injury include circulatory problems such as low blood pressure, swelling of extremities, and increased risk of blood clots. Other complications include respiratory problems, bone density loss, muscle tone issues, weight loss and muscle atrophy, sexual health changes, pain, and depression. These complications can be addressed through rehabilitation, therapy, medications, and consultations with specialists. Preventive measures to reduce the risk of spinal cord injury include driving safely, wearing seat belts, and being cautious when swimming or diving.
Prevention
Spinal cord injuries can sometimes be prevented by taking certain precautions. Some preventive measures include driving safely, wearing seat belts, ensuring children wear seat belts or appropriate child safety seats, and checking water depth before diving. By following these guidelines, you can reduce your risk of experiencing a spinal cord injury due to car accidents, drowning, or other accidents. However, some spinal cord injuries may still occur despite preventive measures, as they can also be caused by diseases or acts of violence.
Treatment
Treatments for spinal cord injuries focus on managing symptoms, promoting rehabilitation, and improving overall quality of life. Some of the treatments include:
- Medications: Pain management is a crucial aspect of spinal cord injury treatment. Doctors may prescribe pain medications, muscle relaxants, or antidepressants to help manage pain and alleviate muscle spasms.
- Rehabilitation: Physical, occupational, and speech therapy are essential components of rehabilitation. Therapists work with patients to improve mobility, strength, coordination, and communication skills.
- Assistive technologies: Various assistive technologies, such as wheelchairs, braces, and adaptive devices, can help individuals with spinal cord injuries perform daily activities more independently.
- Surgery: In some cases, surgery might be necessary to stabilize the spine, relieve pressure on the spinal cord, or address complications such as spinal cord compression or herniated discs.
- Mental health support: Dealing with a spinal cord injury can be emotionally challenging. Psychological support, counseling, and support groups can help individuals and their families cope with the emotional aspects of the injury.
- Preventing complications: Regular monitoring and management of circulatory, respiratory, and bone health issues, such as orthostatic hypotension, autonomic dysreflexia, and osteoporosis, are essential for preventing complications associated with spinal cord injuries. It's important to note that the effectiveness of treatments varies depending on the severity and location of the injury. Regular follow-up with healthcare professionals is crucial for managing spinal cord injuries and maximizing recovery.
Preparing for medical consultation
To prepare for an appointment for a spinal cord injury, you can:
- Be aware of any pre-appointment restrictions and ask about them when scheduling the appointment.
- Write down any symptoms you've been experiencing and for how long, as well as your medical history, including all conditions and medications.
- Bring a family member or friend along to help remember important information and provide support.
- Prepare a list of questions to ask the doctor, such as inquiries about the prognosis, available treatments, and potential benefits and risks of surgery.
- Be prepared to discuss the circumstances of the injury and any relevant details, and be open to the input and recommendations of the medical professionals involved in your care. Remember that the appointment might be brief, so it's important to be well-prepared and gather all necessary information beforehand.