Spinal Cord Trauma - Causes, Types, Symptoms, Diagnosis, and Treatment

Introduction

Spinal cord trauma or injury affects the communication or relay of messages between the brain and other parts of the body. The spinal cord is protected by the vertebral column and various layers of tissues (meninges). The injury to the spinal cord mainly occurs due to sudden trauma to these vertebrae. The broken vertebral bones further damage the spinal cord and the nerves attached to nerves. These fractured bones can cause partial or complete injury to the spinal cord.

Spinal cord trauma is an extremely severe physical injury that can significantly affect a person’s everyday life. These injuries can impact the person's life by making them partially or completely paralyzed. The condition or trauma to the spinal cord can be treated by surgical methods, medications, and physical therapies.

What Are the Causes of Spinal Cord Trauma?

Spinal cord trauma can occur due to various reasons, such as:

• Accidents from motor vehicles.

• Gunshot wounds.

• Falls.

• Surgical complications.

• Sports injury.

What Are the Types of Spinal Cord Trauma?

There are mainly two types of spinal cord injuries.

• Incomplete: This injury causes partial damage to the spinal cord, and some functions remain intact on one or both sides of the person’s body. The brain and body can still communicate with each other along certain pathways.

• Complete: This causes total loss of function or paralysis of the body below the levels of injury to the spinal cord. Complete injury can cause paralysis of the lower half of the body or paraplegia or to all four limbs (quadriplegia). Complete spinal cord injury affects both sides of the body.

What Are the Symptoms Caused by Spinal Cord Trauma?

The symptoms of spinal cord trauma usually depend on the location and type of injury. A person should consult the doctor immediately in the case the following symptoms are experienced:

• Loss of bowel or bladder control.

• Breathing difficulties.

• Weakness in the legs and arms.

• Lumps around the spinal cord region.

• Lack of sensation or decreased sensation in the legs and arms.

• Severe pressure or pain in the back or neck.

What Are the Effects of Spinal Cord Trauma on the Body?

Spinal cord trauma or injury can hamper essential body functions, and if the nerves get damaged, communication with the brain is also affected. The spinal cord injury can affect the following:

• Heart rate.

• Reflexes.

• Bowel and bladder function.

• Sensations.

• Breathing.

• Muscle movement.

• Body metabolism process.

What Should Be Done if Someone Gets a Spinal Cord Injury?

In case someone gets a spinal cord injury,

• Contact emergency help 119 to seek medical help immediately.

• Do not reposition or move a person unless it is necessary.

• Perform CPR (cardiopulmonary resuscitation) if a person is not breathing. Move the person’s jaw downwards, and do not tilt the head backward.

• Make the person stay still and ask him to restrict movement, even if they can walk or get up. Wait till the medical help arrives.

What Are the Methods to Diagnose Spinal Cord Trauma?

The patient with spinal cord injury is assessed by the doctor physically and neurologically. The doctor also checks for any breathing difficulties or heart rate in spinal cord trauma. Further, they make sure there is any injury to the nerves by assessing the motor functions to check if a person can move body parts and sensory functions to ensure they feel the touch. In addition, spinal cord trauma can also be diagnosed with various tests, such as:

• X-rays to detect dislocation and broken bones.

• CT (computed tomography) scans to see damaged blood vessels, blood clots, and broken bones.

• MRI (magnetic resonance imaging) for viewing soft tissues and the spinal cord.

How Is Spinal Cord Trauma Managed?

1. Immediate Treatment:

Emergency surgical treatment is required for spinal cord injury due to some trauma to other body parts. The surgical method also treats spinal cord trauma caused by damaged bones, tissues, or blood clots. In addition, spinal cord injuries can be managed with corticosteroids if given to a person within seven to eight hours of injury. Corticosteroids may improve blood flow, reduce inflammation, and preserve nerve function.

2. Long-term Treatment:

The goal of the long-term treatment of spinal cord trauma include

• Minimizing the risk of chronic health conditions of the patient.

• Enhancing the quality of life of a person.

• Resorting the nerve functions caused by partial damage to the spinal cord.

Spinal cord injury is treated by admitting a patient to the hospital's intensive care unit (ICU) or any regional spinal injury center.

3. Medications - Intravenous methylprednisolone is given to the person for treating acute spinal cord injury caused by trauma. The medicine may cause side effects more than benefits to a person, such as pneumonia and blood clots, as shown in some studies. Therefore, methylprednisolone is not recommended now for use after spinal cord trauma.

4. Immobilization - A person with spinal cord injury may need stabilization or alignment of the spine by traction.

5. Surgery- Surgical procedures may be needed to remove fractured bone fragments, fractured or herniated disks that might compress the spine, or other foreign objects. The doctor may also perform surgery to stabilize the spine to reduce the risk of any pain or discomfort, or deformity in the future.

6. Rehabilitation - This is recommended during the early recovery phase. The rehabilitation team comprises a physical and occupational therapist, rehabilitation psychologist, dietitian, recreation therapist, nurse, and a doctor specializing in spinal cord injuries. They work together to strengthen muscle function, enhance motor skills, and help to learn ways to perform daily tasks. Rehabilitation further helps a person to learn new skills by using various technologies and equipment to help a person become independent after a spinal cord injury.

What Are the Long-term Complications Associated With Spinal Cord Trauma?

The long-term complications include

• Persistent pain.

• Sexual dysfunction.

• Loss of bowel and bladder control.

• Inability to regulate body temperature or blood pressure.

• Joint contraction.

• Spasticity.

• Increased risk of lung or heart problems.

• Paralysis in the legs and arms.

Conclusion

Spinal cord trauma is a severe complication that can potentially impact a person’s daily life. Therefore, necessary precautions and safety measures should be taken to eliminate the causes leading to spinal injury. The condition can be treated depending on the type and location of the injury, and the recovery is based on these factors. The recovery can be seen in the initial six months, if it may occur, or in some cases, it may take years.