What is spinal injury?

Spinal injury can occur to the bones (vertebrae) that make up the spine, or to the spinal cord, which is the bundle of nerves running down the neck and spine that carries electrical signals between the brain and body. Spinal cord injury can disrupt these signals and is therefore extremely serious, because it can result in loss of movement (paralysis) below the point of injury. Damage to the vertebrae often occurs at the same time as damage to the spinal cord, but the spinal cord can also be damaged without any damage to the vertebrae.

Spinal cord

A bundle of nerve tissue that runs from the brain through the spinal column and connects the brain to the body, transmitting sensory and motor signals.

Causes

There are many possible causes of spinal injury. Some common causes include:

  • Motor vehicle accidents;
  • Any trauma to the head, neck, face, chest or back;
  • Falls;
  • Stab or bullet wounds;
  • Infection, inflammation and tumors, and;
  • Electric shock.

Infection

Entry into the body of microorganisms that can reproduce and cause disease.

Inflammation

A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.

Trauma

1. Physical injury to the body caused by force or a toxic substance. 2. Psychological damage caused by a severely disturbing experience.

Risk factors

Risk factors for spinal injury include:

  • Dangerous driving;
  • High-impact contact sports, and;
  • Risky behavior, such as diving into shallow water.

Signs and symptoms

Signs and symptoms of spinal injury can include:

  • Difficulty walking;
  • Loss of movement in the arms or legs;
  • Loss of control of the bladder or bowel;
  • A stiff neck or neck pain;
  • A numb or tingling feeling in the arms or legs, and;
  • Weakness.

Bladder

An organ in the lower abdomen that stores urine for excretion.

Methods for diagnosis

To diagnose spinal injury, a doctor will perform a physical examination, during which they will perform a range of tests to check a person's ability to move and feel sensation. This involves the doctor touching various parts of the person's body to check they can still feel, as well as checking their muscle strength and reflexes.

After physical examination, X-rays, CT or MRI scans are done to check if there is any spinal injury and related damage, such as fractures.

Person having an MRI scan. 

MRI

A type of imaging that uses a magnetic field and low-energy radio waves, instead of X-rays, to obtain images of organs.

Types of treatment

First aid

Immediate first aid for a spinal injury is required. If someone has experienced a spinal injury, call 911. A person with a spinal injury should not be moved unless it is absolutely necessary (such as if they are in a car that is on fire). Their head and neck are to be held in place until medical assistance arrives. Under no circumstances should their head or neck be straightened, or allowed to bend or twist.

If someone is unconscious as a result of their injury, it is also important to check their breathing and, if necessary, to perform cardiopulmonary resuscitation (CPR). If CPR has to be performed, then it is again important not to tilt the person's head back.

Surgery and medication

Steroid medications can help to slightly improve a person's condition if taken within eight hours of injury. Depending on the extent of the injury, surgery may also be required to remove bone fragments, foreign objects or herniated discs, as well as to stabilize the spine.

Rehabilitation

After the initial period of treatment, rehabilitation is generally recommended to aid a person's recovery. It requires the assistance of physiotherapists to help strengthen muscles, and occupational therapists to help the person learn new skills. Psychologists will also form part of the management team, as the difficulties experienced from having a spinal injury can be a cause of psychological distress.

Researchers are currently developing robotic exoskeletons and other technological solutions that will hopefully one day help people with total paralysis to walk again, but the technology is in the early stages of development and is not yet in wide use.

Physiotherapist helping patient to walk again. 

CPR

An emergency lifesaving procedure that involves manually pumping air into the lungs, and compressing the chest to circulate the blood. This first aid technique is used when someone's breathing or heartbeat has stopped.

Discs

Intervertebral discs - layers of cartilaginous material that act as cushions between the vertebrae and the joints in the spine, enabling the spine to bend and twist.

Occupational therapists

A healthcare professional trained to deliver occupational therapy, which involves teaching a person self care, work and play activities to promote independence and reduce disability.

Steroid

A class of chemical substances that have a certain complex of carbon particles. The body produces several types of steroids naturally and artificially-produced steroids are used as medications.

Psychologists

A professional specializing in mental development, diagnoses and management of mental health conditions.

Potential complications

The main complication of spinal cord injury is loss of movement, which results from damage to the nerves that form the spinal cord. When people lose the use of their legs, this is termed paraplegia. When they lose the use of their body and all four limbs, it is termed quadriplegia or tetraplegia.

If the nerves are completely severed, then total paralysis occurs. If they are only partly severed, then some movement may remain.

Spinal injury can also lead to loss of bladder or bowel control. This can be very difficult to deal with; however, with appropriate treatment many people can live with these issues.

Bladder

An organ in the lower abdomen that stores urine for excretion.

Spinal cord

A bundle of nerve tissue that runs from the brain through the spinal column and connects the brain to the body, transmitting sensory and motor signals.

Prognosis

The vast majority of people with a spinal cord injury have a minor enough injury that they can remain fully independent. If the damage is moderate, there is a chance they will walk again. However, if the spinal cord injury is severe, chances of a full recovery are poor. If paralysis is still present three days after injury, there is likely to be some ongoing physical disability.

Very rarely, if the spinal injury is very high up in the neck, it can cause paralysis of the breathing muscles, leading to cessation of breathing. If first aid is not immediately given, death is a possibility.

Spinal cord

A bundle of nerve tissue that runs from the brain through the spinal column and connects the brain to the body, transmitting sensory and motor signals.

Prevention

There are a number of different ways to reduce the risk of spinal injury in different situations, including:

  • Wearing a seatbelt when in a car;
  • Not drinking and driving;
  • Not diving into shallow pools or other bodies of water where the depth of the water cannot be seen, and;
  • Avoiding high-impact contact sports, or if they are played, by only tackling someone safely and not head-first.