Your spine is made of many bones called vertebrae. Your spinal cord runs downward through a canal in the center of these bones. The spinal cord is a bundle of nerves that carries messages between the brain and the rest of the body for movement and sensation.
Acute spinal cord injury (SCI) is due to a traumatic injury that bruises, partially tears, or completely tears the spinal cord. SCI is a common cause of permanent disability and death in children and adults.
Many things can cause SCI. The more common injuries occur when the area of the spine or neck is bent or compressed, as in the following:
Some people are at higher risk for SCI than others. Average age at the time of injury has increased over the past few decades and is currently 42 years. Most people who suffer SCIs are male. Non-Hispanic whites are at higher risk for SCI than any other ethnic group.
Symptoms of an acute SCI can vary widely. The location of the injury on the spinal cord determines what part of the body is affected and how severe the symptoms are.
Right after a spinal cord injury, your spine may be in shock. This causes loss or decrease in feeling, muscle movement, and reflexes. But, as swelling eases, other symptoms may appear depending on the location of the injury.
Generally, the higher up the level of the injury is to the spinal cord, the more severe the symptoms. For example, an injury to the neck, the first and second vertebrae in the spinal column (C1, C2), or the mid-cervical vertebrae (C3, C4, and C5) affects the respiratory muscles and the ability to breathe. A lower injury, in the lumbar vertebrae, may affect nerve and muscle control to the bladder, bowel, and legs, and sexual function.
The extent of the damage to the spinal cord determines whether the injury is complete or incomplete.
These are the most common symptoms of acute spinal cord injuries:
The symptoms of SCI may look like other medical conditions or problems.
Acute SCI is a medical emergency. Emergency evaluation is needed anytime there is a suspected injury to the spinal cord.
The effects of an SCI may not be clear at first. A full medical evaluation and testing are needed. The diagnosis of SCI starts with a physical exam and diagnostic tests. During the exam, the healthcare provider will ask about your medical history and how the injury occurred. A spinal cord injury can cause ongoing neurological problems that require further medical follow-up. Sometimes, surgery is needed to stabilize the spinal cord after acute SCI.
Diagnostic tests may include:
SCI requires emergency medical attention on the scene of the accident or injury. After an injury, your head and neck will be immobilized to prevent movement. This may be very hard when you are frightened after a serious accident.
Specific treatment for an acute spinal cord injury is based on:
There is currently no way to repair a damaged or bruised spinal cord. But, researchers are actively seeking ways to stimulate spinal cord regeneration. The severity of the SCI and the location determines if the SCI is mild, severe, or fatal.
Surgery is sometimes needed to evaluate the injured spinal cord, stabilize fractured backbones, release the pressure from the injured area, and to manage any other injuries that may have been a result of the accident. Your treatment may include:
Recovery from a SCI often requires long-term hospitalization and rehabilitation. An interdisciplinary team of healthcare providers, including nurses, therapists (physical, occupational, or speech), and other specialists work to control your pain and to monitor your heart function, blood pressure, body temperature, nutritional status, bladder and bowel function, and attempt to control involuntary muscle shaking (spasticity).
There is no sure way to prevent SCI, but there are many steps you can take that might lower your risk, including:
Recovery from a SCI often requires long-term hospitalization and rehabilitation. Physical therapy will likely be a very important part of your rehabilitation. In this treatment, specialists will work with you to prevent muscle wasting and contractures, and to help you retrain other muscles to aid in mobility and movement. Another type of therapy is occupational therapy, which helps you learn new ways of doing everyday tasks in spite of your new physical limitations.
A traumatic event that results in a SCI is devastating to both you and your family. The healthcare team will help educate your family after hospitalization and rehabilitation on how to help care for you at home and understand the specific problems that require immediate medical attention.
You will need frequent medical evaluations and testing after hospitalization and rehabilitation to monitor your progress.
It’s important to focus on maximizing your capabilities at home and in the community.
You may feel sad or depressed after your injury. If this happens to you or a loved one, your healthcare provider may recommend that you see a mental health professional. Antidepressants and psychotherapy, or “talk therapy,” are both available to help treat depression.
Depending on the severity of the injury, some people might recover some of their lost function, but others might continue to have long-term problems. Be sure to talk with your healthcare provider about when you would need to call them.
Your healthcare provider will likely advise you to call them if any problems you are having become worse, including weakness, numbness or other changes in sensation, or changes in bladder or bowel control.
People who have serious long-term effects from a spinal cord injury can also develop a number of other complications. Your healthcare provider might advise you to call them if you have problems such as:
Tips to help you get the most from a visit to your healthcare provider:
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