Accidents, falls, and certain diseases can injure the spinal cord. How a spinal cord injury affects a person depends on two factors: the area of the spinal cord where the injury occurred and the severity of the damage.
The spinal cord is a bundle of nerves that sends messages from the brain to other parts of the body. It is vital to a person’s ability to feel and control various body parts, such as the arms, legs, and bladder.
There is no cure for a spinal cord injury. However, rehabilitation and adaptive devices can help a person gain more independence and improve their quality of life.
Symptoms
The symptoms of a spinal cord injury vary from person to person.
A person should seek medical care if any of the following symptoms are present following an accident or injury:
- extreme pain in the head, neck, or back
- weakness or inability to walk
- trouble breathing
- difficulty with balance and coordination
- numbness or tingling in the extremities
- loss of bladder or bowel control
Having these symptoms does not necessarily mean that a person has a spinal cord injury. Sometimes, a broken backbone can put pressure on the spinal cord, causing symptoms that may go away after the bone heals.
However, the serious nature of spinal cord injuries means that it is always important to seek emergency medical care if these symptoms appear.
Anyone who is with a person who may have sustained a back injury should avoid trying to lift or move them, as this could significantly worsen any damage.
Long-term symptoms
People who have spinal cord injuries may have some or all of the following symptoms throughout their life:
- loss of movement of certain parts of the body
- loss of feeling or change in feeling
- loss of bowel or bladder control
- pain, which can range from mild to severe
- muscle spasms
- abnormal reflexes
- loss of sexual function
- infertility
- trouble walking or maintaining balance
- difficulty breathing or coughing
A person’s symptoms will depend on the severity of the injury and which part of the spinal cord it affected.
Causes
Spinal cord injuries have a variety of causes, including:
- hard impacts and collisions in sports
- automobile accidents
- falls
- hitting the head when diving
- injuries from violent acts, such as gunshot wounds
- certain types of cancer
- arthritis
- specific types of infections
- some medical conditions, such as spina bifida and polio
Risk factors
A spinal cord injury can happen to anyone at any age. However, certain factors do increase the chances of sustaining this type of injury.
According to the National Spinal Cord Injury Statistical Center:
- The average age at spinal cord injury is 43 years.
- Males account for 78% of new spinal cord injury cases.
- Vehicle crashes are responsible for nearly 40% of spinal cord injuries, with falls following closely behind.
The American Association of Neurological Surgeons state:
- Motor vehicle accidents are the leading cause of spinal cord injury in younger people.
- Falls are the leading cause of spinal cord injury in people over the age of 65 years.
- As many as 90% of all sports-related spinal cord injuries occur in males.
Types of spinal cord injuries
There are many different types of spinal cord injuries. Usually, doctors will categorize them into complete and incomplete spinal cord injuries.
A complete injury is one in which a person loses all feeling and control of the body below the spinal cord injury.
A person with an incomplete spinal cord injury may still have some feeling in or control of the affected areas.
The location of the injury also determines its type. There are four sections of the spinal cord:
- cervical spine (vertebrae C1 through C7, which contain a total of eight cervical nerve roots)
- thoracic spine (vertebrae T1 through T12)
- lumbar spine (vertebrae L1 through L5)
- sacral spine (vertebrae S1 through S5)
Each of the four sections controls different parts of the body. In most cases, a person will lose some or all control and feeling in the limbs that are below the spinal cord injury.
Learn more about spinal cord anatomy here.
Cervical spinal injury
The top portion of the spine, which includes the vertebrae in the neck, is the cervical spine. As cervical spine injuries are closest to the brain and may affect the largest portion of the body, they tend to be the most severe type.
An injury to the cervical spine often causes tetraplegia, also known as quadriplegia, which is full or partial paralysis of the four limbs and the torso.
Thoracic spinal injury
The thoracic spine includes the upper and middle part of the back.
A thoracic spine injury often affects the muscles in the abdomen, legs, and lower back. People with a thoracic spine injury may have paraplegia, which means that they have paralysis in parts of the trunk and legs. A person with paraplegia can still use their arms and hands.
Lumbar spinal injury
The lumbar spine is the lowest major portion of the spine. The vertebrae in this section are larger because they support more weight than those in other areas of the spine.
A person with a lumbar spine injury may lose some function in the hips and legs, but they usually retain control of their upper body. Some people with a lumbar spine injury may be able to walk with braces or use a wheelchair.
Sacral spinal injury
The sacral spine is the area just above the tailbone. The nerves arising from this part of the spinal cord control the area of the hips, groin, and backs of the thighs.
An injury to the sacral spine can cause some loss of function in the hips and legs. It may also affect bladder and bowel control. However, people with a sacral spine injury can often still walk.
Complications
A spinal cord injury can cause complications and changes to daily functioning. These may include:
- Loss of bladder control, bowel control, or both: People with spinal cord injuries may need to learn how to empty their bladder and bowels when they cannot feel the urge to go.
- Loss of muscle tone: If a person is unable to move and use their arms or legs, the muscles may shrink (atrophy) and become weak. The person’s physical fitness may also decrease.
- Muscle spasms: Sometimes, a spinal cord injury can cause muscles to contract, leading to uncontrolled movements and spasticity.
- Nerve pain: Research suggests that more than two-thirds of people who have spinal cord injuries experience long-term nerve pain. The pain may occur in parts of the body that still have feeling, or they may affect areas that have little to no sensation.
- Skin sores and injuries: If a person cannot feel certain parts of their body, they may not be aware of any sores, cuts, or burns that they sustain in this area. They will need to do frequent skin and nail checks to look for injuries to help prevent infections and other complications.
- Lung problems: If a person cannot cough or breathe well after a spinal cord injury, they may not be able to clear their lungs well. This difficulty puts them at a higher risk of getting pneumonia.
- Blood clots: Some people may have blood pressure that is too low, which raises the risk of blood clots and swelling.
- Stroke and cardiac arrest: With some spinal cord injuries, there is a risk of the blood pressure suddenly going dangerously high. Doctors refer to this as autonomic dysreflexia, and it can lead to seizures, heart attack, and stroke.
- Risk of obesity: If a person cannot walk or move as they once did, they may spend more time being sedentary. This lifestyle change can lead to a person having overweight or obesity and developing associated conditions, such as type 2 diabetes and heart disease.
- Changes in sexual function: Spinal cord injuries can reduce or remove the ability to obtain an erection or become sexually aroused. They can also make it difficult or impossible to have an orgasm.
- Infertility: Women with spinal cord injuries may have difficulty getting pregnant, and these injuries can sometimes prevent ejaculation in males.
- Mental health conditions: A spinal cord injury can cause a decline in mental health. Study findingsTrusted Source suggest that depression is “highly prevalent” among people who have a spinal cord injury.
A spinal cord injury can cause challenging, lifelong complications. People can manage many of these complications with the help of medical providers, including rehabilitation therapists and doctors.
Treatment and recovery
Treatment and recovery time depend on the type of spinal cord injury that a person sustains. A medical team will assess the person’s case and develop a suitable treatment plan and recovery time frame. They will take into account the type and extent of the injury to manage and prevent complications.
Surgery is a standard treatment for spinal cord injuries. Usually, surgery is the first response where there is a risk of further damage. The type of surgery will depend on the injury.
In many cases, occupational therapy, physical therapy, and rehabilitation play an essential role in improving and maintaining long-term quality of life. For some people, this will involve ongoing therapy sessions to maintain physical strength and mobility.
Counseling and psychotherapy may help with emotional trauma after sustaining a spinal cord injury. Reaching out to friends and family for emotional support and day-to-day help will also make recovery easier.
People who have spinal cord injuries should see their doctors and medical providers regularly. These professionals can help manage complications, recommend adaptive equipment, and improve a person’s quality of life.
Outlook
A spinal cord injury can be life-changing, and coping with it can be difficult. However, with support from a medical team, friends, and family, people with spinal cord injuries can participate in activities that they enjoy and lead a full, rewarding life.