Spinal cord trauma

Alternative names

Spinal cord compression or injury; Compression of spinal cord

Definition

Spinal cord trauma is damage to the spinal cord that results from direct injury to the cord itself, or from indirect injury from damage to the bones, soft tissues, and blood vessels surrounding the spinal cord.

Causes, incidence, and risk factors

Spinal cord trauma can be caused by any number of injuries to the spine. They can result from motor vehicle accidents, falls, sports injuries (particularly diving into shallow water), industrial accidents, gunshot wounds, assault, and others.

A seemingly minor injury can cause spinal cord trauma if the spine is weakened (such as from rheumatoid arthritis or osteoporosis) 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, particularly if the bones or the discs have been damaged. Fragments of bone (from fractured vertebrae, for example) or fragments of metal (such as from a traffic accident) 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 injury.

Bleeding, fluid accumulation, and swelling can occur inside the spinal cord or outside the spinal cord (but within the spinal canal). The accumulation of blood or fluid can compress the spinal cord and damage it.

Spinal cord injuries occur in approximately 12,000-15,000 people per year in the U.S. About 10,000 of these people are permanently paralyzed, and many of the rest die as a result of their injuries. Most spinal cord trauma occurs to young, healthy individuals. Males between ages 15 and 35 are most commonly affected.

Only about 5% of spinal cord injuries occur in children. The fatality rate is higher with pediatric spine injuries.

Risk factors include participating in risky physical activities, not wearing protective gear during work or play, or 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 that make them prone to falling from weakness or clumsiness (from stroke, for example) may also be more susceptible.

Symptoms

Symptoms vary somewhat depending on the location of the injury. Spinal cord injury results in varying degress of weakness and sensory loss at and below the injury. The pattern depends on whether the entire cord is injured (complete) or only partially (incomplete).