A spinal injury happens when damage or trauma to your spinal cord leads to the loss of movement, function or sensation below the site of the injury.
- The spinal cord runs through the centre of your spine. It is like a system of telephone wires that conduct messages from your brain, through your nerves, to all parts of your body. This means damage to it can affect a number of body functions.
- The amount of function lost tends to relate to the level in your spinal cord where the damage takes place.
- Damage to your spinal cord can be caused by trauma, such as car accidents or sporting injuries. There are also non-traumatic causes, such as transverse myelitis, multiple sclerosis, cervical myelopathy, infections, tumours, disturbance to the blood supply and motor neurone disease.
- Severance (complete cutting) of the spinal cord does permanent damage. However, given the right sort of equipment and adaptations to buildings, people with spinal cord injury can do most things that the rest of the community can and live fulfilling lives with all levels of spinal injury.
- Leading a healthy lifestyle can help to avoid or minimise health issues that can arise from long-term immobility, such as pressure sores or urinary tract infections.
What causes spinal cord injuries?
The spinal cord contains the nerves that carry messages between your brain and the rest of the body. The cord passes through your neck and back. Damage to your spinal cord can occur when its blood and oxygen supply is disrupted and/or pressure is applied to it.
Frequent causes of damage are traumatic accidents such as motor vehicle incidents, falls, violence and sports activities. There are also many diseases that can cause spinal cord injury such as transverse myelitis, multiple sclerosis, cervical myelopathy, infections, tumours, disturbance to the blood supply and motor neurone disease.
What are the symptoms of a spinal cord injury?
The symptoms experienced are different for everyone and depend on the level at which the spinal cord is damaged. They can include:
- loss of feeling or numbness
- loss of mobility (motor function)
- loss of bowel or bladder control
- loss of temperature control
- severe pain in your neck, head or back
- paralysis or difficulty with balance or walking
- stinging sensations
- oddly positioned or twisted neck or back
- difficulty breathing at higher levels near your neck.
How are spinal cord injuries diagnosed?
A physical examination is often the first test that is performed. The doctor may assess your muscle tone, strength, reflexes and your ability to sense touch and pin-prick. Other common tests doctors may use to assist diagnosis include:
Spinal injuries can be diagnosed as:
Complete – When your spinal cord is completely damaged and there is total loss of feeling and the ability to control movement below the injury.
Incomplete – When there is some movement and/or sensation below the injury. Types of incomplete spinal cord injury include conditions such as brown sequard syndrome, central cord syndrome, posterior cord syndrome and anterior cord syndrome.
When a spinal injury causes paralysis, paraplegia refers to the loss of function in 2 limbs, usually your legs. Quadriplegia and tetrapleglegia refer to functional loss of your arms and legs and usually includes your trunk (main body area).
What is the treatment for spinal cord injuries?
Treatment for spinal cord injuries has 3 key phases.
- Minimising further injury to your spinal cord
- If you suspect a spinal injury and need to perform first aid, do not move the injured person as permanent complications can result. Call 111 for emergency medical assistance.
- Keep the person's head, neck and back aligned and prevent unnecessary movement.
- Provide as much first aid as possible without moving the person's head or neck.
- If the person is wearing a helmet, don't remove it.
- In hospital, further steps will be taken to stabilise the spine. This can include traction or braces.
- Sometimes surgery is needed and any other injuries need to be treated.
- This involves a combination of physical therapies and occupational therapy tailored to each person's needs.
- This phase also usually includes counselling for both the person and their loved ones to help the adjustment and recovery process.
- Preventing and managing long-term complications
Health issues that may arise for people with spinal cord injuries include:
- lung infections
- urinary tract infections (UTI)
- kidney stones
- muscle spasm
- pressure sores
- fluctuations in body temperature
- chronic pain
- erectile dysfunction in men and reduced sexual responses in women
- depression and other mental health problems.
Talk to your doctor about the best way to prevent and manage these conditions.
What self-care can I do if I have a spinal injury?
If you get a spinal injury, it is likely you and your whānau/family will experience a period of grief. Grief is a healthy and important part of recovery. It can be helpful to talk about your disability and educate yourself about spinal injuries and technologies that can assist you. In the links below you will find support networks and learning resources.
Other self-care includes:
- learning about how to avoid pressure injuries
- learning about how to avoid urinary tract injuries
- setting goals for your future.
How can I prevent spinal cord injury?
Spinal injuries can happen to anyone, but you may be at greater risk if you are male, a young adult, drink alcohol, engage in risky behaviour or have an existing condition like osteoporosis. To reduce your risk:
- drive safely, and never drink and drive
- check water depth before diving
- wear the recommended safety gear when playing sports
- avoid leading with your head in sports, eg, don't slide head-first in rugby.
Support for spinal cord injuries
New Zealand Spinal Trust Information, resources and support for people living with spinal cord injuries and their families
Kaleidoscope Vocational rehabilitation programme
Back on track Spinal injury rehabilitation handbook
Parafed Auckland Sporting and recreational opportunities
Spinal Support A non-profit organisation assisting the rehabilitation of spinal patients
Information for carers Carers NZ
It's accessible Opportunities to learn more skills
Auckland Spinal Rehabilitation Unit Healthpoint
Spinal cord injury information SCI Info Pages
Staying healthy after a spinal cord injury University of Washington, US
Spinal cord resource centre United Spinal Association, US
Resources Spinal Cord Injury, Australia
- Kirshblum,SC. Stephen P. Burns, SP. et al. International standards for neurological classification of spinal cord injury (Revised 2011) J Spinal Cord Med. Nov 2011; 34(6): 535–546.
- Spinal cord injury – paraplegia Better Health Channel, Australia
|Jeremy Steinberg is a GP with special interests in musculoskeletal medicine, evidence-based medicine and use of ultrasound. He's been reviewing topics for Health Navigator since 2017 and in his spare time loves programming. You can see some of the tools he's developed on his website.|