Spinal Cord Injuries and Paralysis

Spinal cord injuries and paralysis can occur because of a direct spinal cord injury. However, these spinal injuries can also be indirectly caused by damage to surrounding bones, tissues or blood vessels, leading to compression of the spinal cord.

Most spinal cord injury cases appear in young, healthy adults. According to the National Spinal Cord Injury Association, men between the ages of 16 and 30 are at highest risk for suffering from these spinal injuries due to their involvement in sports, high-risk activities and violent acts. However, there are other factors that can lead to spinal injuries, including:

• Arthritis
• Cancer
• Inflammation or infections
• Spinal disc degeneration.

People who have weakened spines due to osteoporosis or other medical conditions also have a higher risk of spinal cord injury.

Effects of Spinal Cord Injury

A spinal cord injury isn't always obvious. So if you experience significant head or neck trauma, get an immediate medical evaluation for the possibility of injury. Numbness or paralysis may gradually develop as bleeding or swelling occurs in or around the spinal cord. Excessive bleeding can lead to severe consequences, including death.

Some signs and symptoms of spinal cord injury include:

• Changes in sexual function, sexual sensitivity and fertility
• Difficulty breathing, coughing or clearing your lungs
• Exaggerated reflex activities or spasms
• Loss of bowel or bladder control
• Loss of movement
• Loss of sensation, including the ability to feel heat, cold and touch
• Pain or an intense stinging sensation.

Damage to the spinal cord affects the nerve fibers running through the injured area. After a spinal cord injury, some or all of the corresponding muscles and nerves below the location of the injury no longer function. The lowest segment of the spinal cord that is functioning normally is called the "neurological level" of the injury. In addition, specific portions of the spinal cord can be affected, resulting in patterns of sensory and/or motor deficit.

In cases of complete spinal injuries, all function below the neurological level is lost. If only partial function is lost below this threshold, the spinal cord injury is categorized as incomplete. A full neurological exam should be able to pinpoint the site and extent of injury.

Spinal cord injuries and paralysis that affect the arms, torso, legs and pelvic organs are called tetraplegia or quadriplegia. In contrast, paraplegia affects all or part of the:

• Legs
• Pelvic organs
• Torso.

Complications of Spinal Cord Injury

Spinal cord injury can lead to numerous complications, including:

• Changes in sexual health
• Difficulty breathing
• Impaired circulation (this may cause low blood pressure when you rise, and swelling of legs or arms and blood clots)
• Loss of bladder or bowel control
• Lost or reduced skin sensation, leading to injury due to prolonged pressure, heat or cold
• Muscle tone problems (this may cause spasticity, or uncontrolled tension or motion in the muscles, as well as flaccid, untoned muscles)
• Pain (this may arise from overusing specific muscle groups. Nerve pain, also known as neuropathic or central pain, may occur)
• Weight loss and muscle atrophy.

Treatment for Spinal Injuries

Spinal injuries may initially call for any of the following treatments:

• Immobilization, or using traction to stabilize the spinal cord or align it properly
• Medications (using methylprednisolone within eight hours of acute spinal injuries helps some people improve mildly)
• Surgery, which is sometimes necessary to bone fragments, foreign objects, herniated disks or fractured vertebrae that are compressing the spinal cord.).

After spinal injuries stabilize, doctors typically focus on preventing secondary problems. Medications help manage the effects of injury, and extensive rehabilitation will help the spinal cord injury patient to regain as much function as possible.

Resources

Mayo Clinic Staff. (n.d.). Spinal cord injury. Retrieved March 19, 2010, from http://www.mayoclinic.com/health/spinal-cord-injury/DS00460

Medline Plus Staff. (n.d.). Spinal cord trauma. Retrieved March 19, 2010, from http://www.nlm.nih.gov/medlineplus/ency/article/001066.htm

National Spinal Cord Injury Association Staff. (2007). Fact sheets. Retrieved April 1, 2010, from http://www.spinalcord.org/news.php?dep=17