Spinal cord trauma

Email this page to a friendShare on facebookShare on twitterBookmark & SharePrinter-friendly version Spinal cord trauma is damage to the spinal cord. It may result from direct injury to the cord itself or indirectly from disease of the surrounding bones, tissues, or blood vessels. Causes Spinal cord trauma can be caused by a number of injuries to the spine, including:       Assault Falls Gunshot wounds Industrial accidents Motor vehicle accidents Sports injuries (particularly diving into shallow water)

A minor injury can cause spinal cord injury if the spine is weakened (such as from rheumatoid arthritis orosteoporosis) or if the spinal canal protecting the spinal cord has become too narrow (spinal stenosis) due to the normal aging process. Direct injury, such as cuts, can occur to the spinal cord, especially if the bones or the disks have been weakened. Fragments of bone (for example, from broken vertebrae, which are the spine bones) or fragments of metal (such as from a traffic accident or gunshot) can cut or damage the spinal cord. Direct damage can also occur if the spinal cord is pulled, pressed sideways, or compressed. This may occur if the head, neck, or back are twisted abnormally during an accident or intense chiropractic manipulation. Bleeding, fluid buildup, and swelling can occur inside or outside the spinal cord (but within the spinal canal). The buildup of blood or fluid can press on the spinal cord and damage it. Most spinal cord trauma happens to young, healthy individuals. Men ages 15 - 35 are most commonly affected. The death rate tends to be higher in young children with spinal injuries. Risk factors include:    Participating in risky physical activities Not wearing protective gear during work or play Diving into shallow water

Older people with weakened spines (from osteoporosis) may be more likely to have a spinal cord injury. Patients who have other medical problems (stroke or prostate cancer, for example) that make them more likely to fall may also be more susceptible. Symptoms Symptoms vary depending on the location of the injury. Spinal cord injury causes weakness and loss of feeling at, and below the injury. How severe symptoms are depends on whether the entire cord is severely injured (complete) or only partially injured (incomplete).

incontinence.injury to the nerve roots in this area. if the injury is high up in the neck. Injuries to the cervical or high thoracic spinal cord may also result in blood pressure problems. THORACIC (CHEST LEVEL) INJURIES When spinal injuries occur at chest level. Exams and Tests Spinal cord injury is a medical emergency that needs immediate medical attention. This type of spinal cord injury is a medical emergency and needs immediate surgery. Symptoms can also include breathing difficulties from paralysis of the breathing muscles. However. abnormal sweating. including a brain and nervous system (neurological) exam. as well as the muscles that control the bowels and bladder. Once swelling goes down. The following tests may be ordered:     CT scan or MRI of the spine Myelogram (an x-ray of the spine after injecting dye) Somatosensory evoked potential (SSEP) testing or magnetic stimulation Spine x-rays Treatment . paralysis CERVICAL (NECK) INJURIES When spinal cord injuries occur in the neck area. and middle of the body. The symptoms may occur on one or both sides of the body. some reflexes may slowly recover. LUMBAR SACRAL (LOWER BACK) INJURIES When spinal injuries occur at the lower back level.Injuries at and below the first lumbar vertebra do not cause spinal cord injury. Some of the reflexes may be abnormal or missing. they may cause "cauda equina syndrome" -. symptoms can affect the legs. bladder spasms) Numbness Sensory changes Pain Weakness. legs. The health care provider will perform a physical exam. and trouble maintaining normal body temperature. Injuries at any level can cause:       Increased muscle tone (spasticity) Loss of normal bowel and bladder control (may include constipation. symptoms can affect the arms. symptoms can affect one or both legs. if it is not already known. This will help identify the exact location of the injury.

Rehabilitation will help you cope with the disability from your spinal cord injury. This includes total paralysis or numbness. You may need to wear the spine braces for a long time. especially if there is paralysis of the breathing muscles. and other rehabilitation therapies after the injury has healed. such as dexamethasone or methylprednisolone. Surgery may be needed to:    Remove fluid or tissue that presses on the spinal cord (decompression laminectomy) Remove bone fragments. occupational therapy. The health care team will also provide information on muscle spasms. Muscle spasticity can be relieved with medications taken by mouth or injected into the spinal canal. disk fragments. If spinal cord pressure is caused by a growth that can be removed or reduced before your spinal nerves are completely destroyed. or foreign objects Fuse broken spinal bones or place spinal braces Bedrest may be needed to allow the bones of the spine to heal. This can help keep the spine from moving. Injuries near the top of the spine lead to more disability than injuries low in the spine. Paralysis and loss of sensation of part of the body are common. and bowel and bladder dysfunction. Ideally. Death is possible. You will probably need physical therapy. paralysis may improve. See also:      Autonomic hyperreflexia Bowel retraining Neurogenic bladder Pressure ulcer Urinary catheter Support Groups For organizations that provide support and additional information. Your skin will be protected against pressure sores. and physical therapy are used to help control pain. see spinal injury resources. Outlook (Prognosis) How well a person does depends on the level of injury. Corticosteroids. corticosteroids should begin as soon as possible after the injury. care of the skin. are used to reduce swelling that may damage the spinal cord. Spinal traction may be recommended. Botox injections into the muscles may also be helpful. . muscle relaxers. The skull may be held in place with tongs (metal braces placed in the skull and attached to traction weights or to a harness on the body). and loss of movement and feeling.A spinal cord injury is a medical emergency that needs to be treated right away. The time between the injury and treatment can affect the outcome. Painkillers (analgesics).

Call 911 if you lose movement or feeling. Routine bowel care often takes one hour or more each day. Maintain routine health visits with their doctor. When to Contact a Medical Professional Call your health care provider if you have a back or neck injury. Keep immunizations up to date. The home will usually need to be modified.A person who recovers some movement or feeling within 1 week usually has a good chance of recovering more function. Follow all instructions for routine wound care to avoid pressure sores. Possible Complications The following are possible complications of a spinal cord injury:    Blood pressure changes . Most people with a spinal cord injury are in a wheelchair. . or need assistive devices to get around. although this may take 6 months or more. quadriplegia) Pressure sores Shock             People living at home with spinal cord injury should do the following to prevent complications:      Get lung (pulmonary) care each day (if they need it). Trained paramedics immobilize the injured spine to prevent further nervous system damage. Losses that remain after 6 months are more likely to be permanent.can be extreme (autonomic hyperreflexia) Chronic kidney disease Complications of immobility: o Deep vein thrombosis o Lung infections o Skin breakdown o Muscle contractures Increased risk of injury to numb areas of the body Increased risk of urinary tract infections Loss of bladder control Loss of bowel control Loss of feeling Loss of sexual function (male impotence) Muscle spasticity Pain Paralysis of breathing muscles Paralysis (paraplegia. This is a medical emergency! Managing a spinal cord injury begins at the site of an accident. Most people with spinal cord injury must perform bladder catheterization regularly. Follow all instructions for bladder care to avoid infections and damage to the kidneys.

Skeletal Trauma. 6th ed. Jupiter JB. Ling GSF. In: Goldman L. Cord compression References Gupta MC. Benson DR. and look for rocks or other possible objects in the way. Fenichel GM. Compression of spinal cord.Someone who may have a spinal cord injury should NOT be moved unless he or she is in immediate danger. A new age for rehabilitation. Falls while climbing at work or during recreation can cause spinal cord injuries. Football and sledding can often involve sharp blows or abnormal twisting and bending of the back or neck. 2008:chap 25. Krettek C. Cecil Medicine. SCI. Use caution when sledding and inspect the area for obstacles. Schafer AI. Update Date: 5/14/2012 . Use appropriate techniques and equipment when playing football or other contact sports. Initial evaluation and emergency treatment of the spine-injured patient. eds. eds. Trauma of the nervous system: spinal cord trauma. Jankovic I. Traumatic brain injury and spinal cord injury. 2012. Keenen TL. Pa: Saunders Elsevier. PA: Saunders Elsevier. Shih P. 4th ed. Defensive driving and wearing seat belts greatly reduces the risk of serious injury if there is an automobile accident. Philadelphia. In: Browner BD.  Alternative Names Spinal cord injury.   Diving into shallow water is a major cause of spinal cord trauma. Mazziotta JC. Bradley's Neurology in Clinical Practice. Trafton PG. Roy RR. Eur J Phys Rehabil Med. which can cause spinal cord injury. 2011:chap 406. In: Daroff RB. Pa: Saunders Elsevier. 2012:chap 50C. eds.48(1):99-109. 24th ed. Prevention Proper safety practices during work and recreation can prevent many spinal cord injuries. Check the depth of water before diving. Philadelphia. Levine AM. Philadelphia. Edgerton VR. Fessler RG. Use proper protective equipment for any activity in which an injury is possible.

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