Spinal-Cord Trauma

What Is It?

The spinal cord carries nerve signals from the brain to the rest of the body. Trauma to the spinal cord can result from a number of injuries, most commonly from motor-vehicle accidents, falls and violence. More than 80 percent of cases of spinal-cord trauma occur in people between the ages of 15 and 35, and approximately 80 percent of those affected are male. Most spinal-cord injuries occur in the area of the neck called the cervical region. Trauma can result from bruising to the spinal cord itself, loss of blood flow to the cord or cuts in the cord. Cuts or a complete severing of the spinal cord are quite rare. Spinal-cord injuries are serious and can cause diminished strength, coordination and sensation as well as other functions, such as bladder control.

Symptoms

The symptoms of spinal-cord trauma vary, and depend on the location and severity of the injury. Complete spinal-cord trauma — trauma that results in a total loss of sensation or the ability to move — occurs at about the same level as the injury. For example, a person injured in the middle of the neck will lack feeling and be unable to move below the middle of the neck. Almost one-half of all spinal-cord injuries are complete. Complete injuries that take place in the upper neck can compromise breathing ability and require the person to use a mechanical ventilator.

Other signs that can accompany spinal-cord injury include neck, head or back pain or pressure, or significant bruising and swelling of the skin over the injured area.

Injuries to a specific side of the spinal cord or its center will produce characteristic patterns of symptoms, such as weakness or paralysis of arms or legs, or one side of the body. In an injured person who is unconscious, the degree of neurological injury may be much harder assess, so doctors must have a high degree of suspicion that a spinal-cord injury has taken place and take steps to protect the spinal cord. This usually is done by using a cervical collar to immobilize the neck or by strapping the person to a stiff backboard for transport.

Diagnosis

The possibility of spinal-cord trauma should be considered in anyone who has been in a severe automobile accident or who has experienced significant injury to the head or neck. If you are conscious, you will be asked about neck pain and whether you can feel and move your arms and legs. You also will be assessed for recent use of drugs or alcohol, for whether you have other painful injuries that may be diverting attention from a neck injury, and for the presence of other signs of spinal-cord injury. X-rays, computed tomography (CT) scans and magnetic resonance imaging (MRI) also may be used to evaluate your spine and the spinal cord.