Acute Spinal Cord Injury

What is an acute spinal cord injury?

The spinal cord is a bundle of nerves that carries messages between the brain and the rest of the body.

Acute spinal cord injury (SCI) is due to a traumatic injury that either 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.

About 12,000 people a year sustain a spinal cord injury. As many as 231,000 to 311,000 people in the US are living with a spinal cord injury, according to the Spinal Cord Injury Information Network. More than half of all SCIs occur among young people between the ages of 16 and 30 years. The majority of SCI victims (80.9 percent) are male.

What causes an acute spinal cord injury?

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:

  • Birth injuries, which typically affect the spinal cord in the neck area

  • Falls

  • Motor vehicle accidents (automobiles, motorcycles, and being struck as a pedestrian)

  • Sports injuries

  • Diving accidents

  • Trampoline accidents

  • Violence (gun shot or stab wounds)

  • Infections that form an abscess on the spinal cord

What are the symptoms of an acute spinal cord injury?

After a traumatic event, a person may have varying degrees of symptoms associated with the severity and location of the SCI. The location of the injury on the spinal cord will determine how severe the injury will be. For example, an injury that damages the cervical spine (in the neck area) can cause loss of muscle function or strength in all four extremities (arms and legs). This is referred to as tetraplegia (formerly called quadriplegia). An injury of this type often requires mechanical breathing assistance, as with a ventilator, as the chest muscles may also be weakened. An injury to a lower part of the spinal cord that causes paralysis and loss of function in the legs and lower body is called paraplegia.

The extent of the damage to the spinal cord determines whether the injury is complete or incomplete. A complete injury means that there is no movement or feeling below the level of the injury. An incomplete injury means that there is still some degree of feeling or movement below the level of the injury.

Initially after a spinal cord injury, the patient may experience spinal shock, which causes loss or decrease in feeling, muscle movement, and reflexes. 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, at C1 or C2 (the first and second vertebrae in the spinal column), and especially in the mid-cervical vertebrae of 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.

The following are the most common symptoms of acute spinal cord injuries. However, each individual may experience symptoms differently. Symptoms may include:

  • Muscle weakness

  • Loss of voluntary muscle movement in the chest, arms, or legs

  • Breathing problems

  • Loss of feeling in the chest, arms, or legs

  • Loss of bowel and bladder function

The symptoms of SCI may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How are acute spinal cord injuries diagnosed?

The full extent of the SCI may not be completely understood immediately after the injury, but may be revealed with a comprehensive medical evaluation and diagnostic testing. Acute SCI is a medical emergency. Anytime there is a suspicion of injury to the spinal cord, emergent medical attention is absolutely necessary. The diagnosis of SCI is made with a physical examination and diagnostic tests. During the examination, the physician obtains a complete medical history and inquires as to how the injury occurred. Trauma to the spinal cord can cause neurological problems and requires further medical follow-up. Occasionally, surgery is necessary to stabilize the spinal cord after acute SCI.