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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 results in a bruise (also called a contusion), a partial tear, or a complete tear (called a transection) in the spinal cord. SCI is a common cause of permanent disability and death in children and adults.
There are many causes of 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. More than half of all SCIs occur among young people between the ages of 16 and 30 years. The majority of people who suffer SCI are male. African Americans are at higher risk for SCI than whites.
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.
Immediately after a spinal cord injury, your spine may be in shock, which causes loss or decrease in feeling, muscle movement, and reflexes. But, as swelling subsides, 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.
The following are the most common symptoms of acute spinal cord injuries. However, each person may experience symptoms differently. Symptoms may include:
The symptoms of SCI may resemble other medical conditions or problems.
Acute SCI is a medical emergency. Anytime there is a suspicion of injury to the spinal cord, emergency medical evaluation is necessary.
The effects of an SCI may not be clear at first. A comprehensive medical evaluation and diagnostic testing are needed. The diagnosis of SCI begins with a physical exam and diagnostic tests. During the exam, the health care 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. Occasionally, surgery is necessary 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 difficult 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, though researchers are actively seeking means of stimulating spinal cord regeneration. The severity of the SCI and the location determines if the SCI is mild, severe, or fatal.
Surgery is sometimes necessary 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 health care 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 the following:
Recovery from a SCI often requires long-term hospitalization and rehabilitation. An interdisciplinary team of health care providers, including nurses, therapists (physical, occupational, or speech), and other specialists work to your pain, monitor your heart function, blood pressure, body temperature, nutritional status, bladder and bowel function, and attempt to control involuntary muscle shaking (spasticity).
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 health care 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 diagnostic testing following 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 health care provider may recommend that you see a mental health professional. Antidepressant medications 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 health care provider about when you would need to call them.
Your health care 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 health care 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 health care provider:
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.