Spinal Cord Injury: Symptoms, Causes, Treatment

What are the symptoms of a spinal cord injury?

The symptoms of a spinal cord injury can vary widely depending on the location and severity of the injury. Common symptoms include:

Motor Symptoms

• Paralysis: Loss of movement in part or all of the body, which can affect the arms, legs, or trunk, depending on the injury’s level.
• Muscle Weakness: Difficulty with muscle control or reduced strength in specific areas.

Sensory Symptoms

• Loss of Sensation: Reduced or complete loss of feeling in areas below the level of the injury. This may include changes in touch, temperature, pain, and vibration.
• Abnormal Sensations: Tingling, burning, or numbness in parts of the body.

Autonomic Symptoms

• Changes in Blood Pressure: Low blood pressure (hypotension) or sudden drops when changing positions.
• Problems with Temperature Regulation: Difficulty regulating body temperature, leading to excessive sweating or feeling too hot or cold.
• Difficulty Breathing: In severe injuries, particularly in the cervical spine, breathing problems can occur if the muscles involved in respiration are affected.

Bowel and Bladder Symptoms

• Loss of Control: Inability to control bowel and bladder function, leading to incontinence or difficulty urinating.
• Retention: Difficulty emptying the bladder or bowel.

Sexual Function Symptoms

• Sexual Dysfunction: Problems with sexual arousal, function, or fertility.

Pain

• Neuropathic Pain: Pain resulting from nerve damage, which may be described as burning, shooting, or stabbing.
• Musculoskeletal Pain: Pain in the muscles or joints due to altered posture or stress.

Psychological Symptoms

• Depression and Anxiety: Emotional and psychological challenges, including depression, anxiety, or mood swings, often accompany spinal cord injuries.

The specific symptoms and their severity depend on the spinal cord injury’s level and extent. For example:

• Cervical Spine Injuries: Can affect the arms, legs, and torso, and may impair breathing.
• Thoracic Spine Injuries: Typically affect the trunk and legs but may spare the arms.
• Lumbar and Sacral Spine Injuries: Generally affect the legs and lower body.

Immediate medical evaluation and treatment are crucial to managing spinal cord injuries and minimizing long-term effects.

What are the causes of a spinal cord injury?

Spinal cord injuries (SCIs) can result from a variety of causes, broadly categorized into traumatic and non-traumatic origins. Here’s a detailed look at each:

Traumatic Causes

1. Motor Vehicle Accidents: Collisions involving cars, motorcycles, or bicycles are leading causes of spinal cord injuries.
2. Falls: Falls, especially from significant heights, can cause damage to the spinal cord.
3. Sports Injuries: Contact sports, such as football or wrestling, and activities like diving into shallow water can lead to spinal injuries.
4. Violence: Incidents such as gunshot wounds or stab wounds can damage the spinal cord.
5. Workplace Accidents: Injuries from industrial accidents or heavy lifting can cause spinal cord trauma.

Non-Traumatic Causes

1. Degenerative Diseases: Conditions like osteoarthritis or degenerative disc disease can lead to spinal cord compression over time.
2. Tumors: Spinal cord tumors, whether primary or metastatic, can cause injury by pressing on the spinal cord.
3. Infections: Infections like meningitis or abscesses can inflame or damage the spinal cord.
4. Autoimmune Disorders: Conditions such as multiple sclerosis or lupus can lead to inflammation or demyelination of the spinal cord.
5. Vascular Conditions: Disorders such as spinal cord infarction or arteriovenous malformations can disrupt blood flow to the spinal cord, leading to injury.

Other Contributing Factors

• Congenital Conditions: Birth defects or genetic conditions affecting the spine and spinal cord, such as spina bifida, can increase the risk of injury.
• Surgical Complications: Complications from spine surgery or other medical procedures can occasionally result in spinal cord damage.

In many cases, the exact cause of a spinal cord injury may involve a combination of these factors. Prompt medical attention is crucial for minimizing damage and improving outcomes.

What is the treatment for a spinal cord injury?

The treatment for a spinal cord injury (SCI) aims to stabilize the injury, prevent further damage, and optimize recovery. Initially, emergency care involves immobilizing the patient with a backboard and cervical collar to prevent additional injury. Stabilization efforts in the emergency setting focus on managing the patient’s airway, breathing, and circulation. In some cases, surgery may be required to relieve pressure on the spinal cord from bone fragments or herniated discs, and corticosteroids might be administered to reduce inflammation if given within the first 8 hours after the injury.

Once stabilized, treatment shifts to acute and ongoing management, which includes physical and occupational therapy to improve mobility, strength, and daily living skills. Managing pain and maintaining bladder and bowel function are crucial aspects of medical care. Preventing and treating pressure sores and other skin issues is also important. Psychological support through counseling and therapy helps patients cope with the emotional impact of an SCI. Assistive devices like wheelchairs and adaptive equipment may be needed to support mobility and independence.

Lifestyle adjustments, such as modifying the home environment for safety and accessibility, are often necessary. Regular follow-ups and continuous monitoring help address long-term needs and complications. Participation in research and clinical trials can provide access to new treatments and therapies. Treatment is typically multidisciplinary, involving a team of healthcare professionals who work together to meet the complex needs of each patient.