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Spinal injury

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What is spinal injury?

Spinal injury can occur to the bones (vertebrae) that make up the spine, or to the spinal cord, which is the bundle of nerves running down the neck and spine that carries electrical signals between the brain and body. Spinal cord injury can disrupt these signals and is therefore extremely serious, because it can result in loss of movement (paralysis) below the point of injury. Damage to the vertebrae often occurs at the same time as damage to the spinal cord, but the spinal cord can also be damaged without any damage to the vertebrae.

Causes

There are many possible causes of spinal injury. Some common causes include:

Risk factors

Risk factors for spinal injury include:

  • Dangerous driving;
  • High-impact contact sports, and;
  • Risky behavior, such as diving into shallow water.

Signs and symptoms

Signs and symptoms of spinal injury can include:

Methods for diagnosis

To diagnose spinal injury, a doctor will perform a physical examination, during which they will perform a range of tests to check a person's ability to move and feel sensation. This involves the doctor touching various parts of the person's body to check they can still feel, as well as checking their muscle strength and reflexes.

After physical examination, X-rays, CT or MRI scans are done to check if there is any spinal injury and related damage, such as fractures.

Types of treatment

First aid

Immediate first aid for a spinal injury is required. If someone has experienced a spinal injury, call 911. A person with a spinal injury should not be moved unless it is absolutely necessary (such as if they are in a car that is on fire). Their head and neck are to be held in place until medical assistance arrives. Under no circumstances should their head or neck be straightened, or allowed to bend or twist.

If someone is unconscious as a result of their injury, it is also important to check their breathing and, if necessary, to perform cardiopulmonary resuscitation (CPR). If CPR has to be performed, then it is again important not to tilt the person's head back.

Surgery and medication

Steroid medications can help to slightly improve a person's condition if taken within eight hours of injury. Depending on the extent of the injury, surgery may also be required to remove bone fragments, foreign objects or herniated discs, as well as to stabilize the spine.

Rehabilitation

After the initial period of treatment, rehabilitation is generally recommended to aid a person's recovery. It requires the assistance of physiotherapists to help strengthen muscles, and occupational therapists to help the person learn new skills. Psychologists will also form part of the management team, as the difficulties experienced from having a spinal injury can be a cause of psychological distress.

Researchers are currently developing robotic exoskeletons and other technological solutions that will hopefully one day help people with total paralysis to walk again, but the technology is in the early stages of development and is not yet in wide use.

Potential complications

The main complication of spinal cord injury is loss of movement, which results from damage to the nerves that form the spinal cord. When people lose the use of their legs, this is termed paraplegia. When they lose the use of their body and all four limbs, it is termed quadriplegia or tetraplegia.

If the nerves are completely severed, then total paralysis occurs. If they are only partly severed, then some movement may remain.

Spinal injury can also lead to loss of bladder or bowel control. This can be very difficult to deal with; however, with appropriate treatment many people can live with these issues.

Prognosis

The vast majority of people with a spinal cord injury have a minor enough injury that they can remain fully independent. If the damage is moderate, there is a chance they will walk again. However, if the spinal cord injury is severe, chances of a full recovery are poor. If paralysis is still present three days after injury, there is likely to be some ongoing physical disability.

Very rarely, if the spinal injury is very high up in the neck, it can cause paralysis of the breathing muscles, leading to cessation of breathing. If first aid is not immediately given, death is a possibility.

Prevention

There are a number of different ways to reduce the risk of spinal injury in different situations, including:

References

  1. Spinal Cord Injuries. Accessed 8 December 2014 from link here
  2. Spinal Cord Injuries: MedlinePlus. Accessed 8 December 2014 from link here
  3. Spinal Cord Injury. Accessed 8 December 2014 from link here
  4. Spinal injury: MedlinePlus Medical Encyclopedia. Accessed 8 December 2014 from link here
  5. Tests for Brain Spinal Cord and Nerve Disorders: Symptoms and Diagnosis of Brain Spinal Cord and Nerve Disorders: Merck Manual Home Edition. Accessed 8 December 2014 from link here

9 Most frequently asked questions (FAQs)

What is spinal injury?
Spinal injury is an injury that happens to the bones of the spine (vertebrae), and/or to the spinal cord, the bundle of nerves that runs down the middle of the spine.
What are the symptoms of spinal injury?
Symptoms of spinal injury include a loss of movement, numbness or tingling in the arms or legs, loss of bladder or bowel control, pain or stiffness in the neck and weakness or difficulty walking.
What causes spinal injury?
A common cause of spinal injury is motor vehicle accidents. Other causes include sports injuries, falls, or other accidents such as diving into shallow water.
How is spinal injury diagnosed?
Spinal injury is diagnosed by physical examination and a range of scans, including X-ray, CT or MRI.
How is spinal injury treated?
Immediate first aid for spinal injury is not to move the injured person at all unless absolutely necessary. How spinal injury is treated depends on how severe it is. If the spinal cord is completely severed (cut), then nothing can be done to return the person back to the way they were. If only moderate damage is done, then orthopedic surgery and physical rehabilitation can help. New technological solutions for enabling people affected by spinal injury to regain control over their limbs are currently being developed; the future may hold much progress in this area.
Can spinal injury be prevented?
A person can reduce their risk of spinal injury by wearing a seatbelt, driving safely, avoiding high-impact contact sports and, if playing such sports, only tackling an opponent safely.
Are there different types of spinal injury?
Spinal injury can include injury to the bones of the spine (vertebrae) or to the nerves that run down it (spinal cord). Injury to the spinal cord can result in loss of movement or paralysis, depending on how bad the injury is. If the nerves are severed, the person will lose sensation and motor control below the point of the injury. If this occurs to the body and all four limbs, this is called quadriplegia. If it occurs at the waist and the use of the legs is lost, this is paraplegia.
What is the outlook for spinal injury?
The outlook for spinal injury varies, depending on how severe the injury is. If the nerves have been completely severed, there is no way to repair the damage and paralysis will remain for life. If the nerves are not completely severed and movement remains, the person may only experience muscle weakness. Fortunately, most cases of spinal injury are minor and patients recover fully with surgery and rehabilitation and go on to live independent lives.
Is spinal injury serious?
Spinal injury should be treated as a medical emergency. Although most spinal injuries are minor and result in no long-term problems, minor injuries should be treated as severe until diagnosed by a doctor. In cases of severe injury, in which the nerves are completely severed (cut), total paralysis can occur below the point of the injury.

Related topics

Spinal stenosis

Spinal stenosis is an abnormal narrowing of the spinal canal that can cause varying symptoms, depending on the location and severity of the narrowing. Symptoms may include numbness, weakness or pain in the limbs, as well as bladder, bowel or sexual dysfunction. Treatment can include physical therapy, medication and surgery.

Cervical radiculopathy

In cervical radiculopathy, a nerve in your neck (the cervical spine) becomes pinched. This can affect nerves that travel to your arms, shoulder and hands, causing weakness, numbness, pins and needles or pain.

Spondylolisthesis

Spondylolisthesis is caused when one of the vertebrae of the spine shifts out of position. It can cause back pain and stiffness. It is different to a slipped disc, which occurs when a disc in between two vertebrae is damaged.

Ankylosing spondylitis

Ankylosing spondylitis is a form of arthritis in which the joints of the spine become inflamed, in particular where the spine attaches to the pelvis. It usually develops in young adults and causes pain and stiffness, especially in the lower back. Eventually, fusion of vertebrae in the spine can occur.

About this article

Title: Spinal injury

Author: Dr Idan Ben-Barak PhD, MSc, BSc (Med)

First Published: 14 Jul 2015

Last reviewed: 17 Jan 2022

Category: Information on Spinal injury

Average rating: 4.7 out of 5 (279 votes)

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