Fact: There is no way to reverse damage to the spinal cord.
What Is a Spinal Cord Injury (SCI)?
A spinal cord injury is damage to the spinal cord. It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.
The spinal cord is a bundle of nerves and other tissue that the vertebrae of the spine contains and protects. The vertebrae are the bones stacked on top of each other that make up the spine. The spine contains many nerves, and extends from the brain’s base down the back, ending close to the buttocks.
The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We are able to perceive pain and move our limbs because of messages sent through the spinal cord.
If the spinal cord sustains an injury, some or all of these impulses may not be able to “get through.”
The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.
There are about 12,000 new cases of SCI each year. In the U.S., there are over 250,000 people living with a spinal cord injury.
What are the types of SCI?
SCI can be divided into two main types of injury:
- Complete injury. Complete injury means that there is no function below the level of the injury—neither sensation or movement—and both sides of the body are equally affected. Complete injuries can happen at any level of the spinal cord.
- Incomplete injury. Incomplete injury means that there is some function below the level of the injury—movement in one limb more than the other, feeling in parts of the body, or more function on one side of the body than the other. Incomplete injuries can happen at any level of the spinal cord.
Common causes of spinal cord injury
- The most common causes of spinal cord injuries in the United States are:
- Motor vehicle accidents. Auto and motorcycle accidents are the leading cause of spinal cord injuries, accounting for more than 35 percent of new spinal cord injuries each year.
- Falls. Spinal cord injury after age 65 is most often caused by a fall. Overall, falls cause more than one-quarter of spinal cord injuries.
- Acts of violence. Around 15 percent of spinal cord injuries result from violent encounters, often involving gunshot and knife wounds, according to the National Spinal Cord Injury Statistical Center.
- Sports and recreation injuries. Athletic activities, such as impact sports and diving in shallow water, cause about 9 percent of spinal cord injuries.
- Alcohol. Alcohol use is a factor in about 1 out of every 4 spinal cord injuries.
- Diseases. Cancer, arthritis, osteoporosis and inflammation of the spinal cord also can cause spinal cord injuries.
Spinal cord injuries of any kind may result in one or more of the following signs and symptoms:
- Loss of movement
- Loss of sensation, including the ability to feel heat, cold and touch
- Loss of bowel or bladder control
- Emergency signs and symptomsEmergency signs and symptoms of spinal cord injury after an accident may include:
- 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
- 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 your spinal cord
- Difficulty breathing, coughing or clearing secretions from your lungs
Tests and diagnosis
In the emergency room, a doctor may be able to rule out a spinal cord injury by careful inspection, testing for sensory function and movement and asking some questions about the accident.
But if the injured person complains of neck pain, isn't fully awake or has obvious signs of weakness or neurological injury, emergency diagnostic tests may be needed.
These tests may include:
- Computerized tomography (CT) scan. A CT scan may provide a better look at abnormalities seen on an X-ray. This scan uses computers to form a series of cross-sectional images that can define bone, disk and other problems.
- X-rays. Medical personnel typically order these tests on people who are suspected of having a spinal cord injury after trauma. X-rays can reveal vertebral (spinal column) problems, tumors, fractures or degenerative changes in the spine.
- Magnetic resonance imaging (MRI). MRI uses a strong magnetic field and radio waves to produce computer-generated images. This test is very helpful for looking at the spinal cord and identifying herniated disks, blood clots or other masses that may be compressing the spinal cord.
SCI is classified according to the person's type of loss of motor and sensory function. The following are the main types of classifications:
- Quadriplegia (quad means four). This involves loss of movement and sensation in all four limbs (arms and legs). It usually happens as a result of injury at T1 or above. Quadriplegia also affects the chest muscles and injuries at C4 or above require a mechanical breathing machine (ventilator).
- Paraplegia (para means two like parts). This involves loss of movement and sensation in the lower half of the body (right and left legs). It usually happens as a result of injuries at T1 or below.
- Triplegia (tri means three). This involves the loss of movement and sensation in one arm and both legs and usually results from incomplete SCI.
Treatments and drugs
Unfortunately, there's no way to reverse damage to the spinal cord. But researchers are continually working on new treatments, including prostheses and medications that may promote nerve cell regeneration or improve the function of the nerves that remain after a spinal cord injury.
In the meantime, spinal cord injury treatment focuses on preventing further injury and empowering people with a spinal cord injury to return to an active and productive life.
Early (acute) stages of treatmentIn the emergency room, doctors focus on:
- Maintaining your ability to breathe
- Preventing shock
- Immobilizing your neck to prevent further spinal cord damage
- Avoiding possible complications, such as stool or urine retention, respiratory or cardiovascular difficulty and formation of deep vein blood clots in the extremities
- Medications. Intravenous (IV) methylprednisolone (A-Methapred, Solu-Medrol) is a treatment option for an acute spinal cord injury. If methylprednisolone is given within eight hours of injury, some people experience mild improvement.
It appears to work by reducing damage to nerve cells and decreasing inflammation near the site of injury. However, it's not a cure for a spinal cord injury.
- Immobilization. You may need traction to stabilize your spine, to bring the spine into proper alignment or both. In some cases, a rigid neck collar may work. A special bed also may help immobilize your body.
- Surgery. Often surgery is necessary to remove fragments of bones, foreign objects, herniated disks or fractured vertebrae that appear to be compressing the spine. Surgery may also be needed to stabilize the spine to prevent future pain or deformity.
- Experimental treatments. Scientists are trying to figure out ways to stop cell death, control inflammation and promote nerve regeneration. Ask your doctor about the availability of such treatments.
Want to learn more?
The following are organizations and/or websites dedicated to providing information and education surrounding Spinal Cord Injury. These organizations are dedicated to research, education, awareness, and/or support. They are listed in Alphabetical order without any preference or prejudice. Listing these organizations is not a recommendation or referral in any regard for seeking treatment or consultation or support for treatment.
Center for Neuro Recovery
John Hopkins Medicine
United Spinal Association