Dr. Aida Abaz Quka
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have some questions I would like answered on cervical spinal cord injuries, please.
If a person only had a partial transection of the cervical spinal cord would their final outcome still be a complete cervical spinal cord injury, where they no mobility or sensory function? Or is it possible their final outcome could be an incomplete cervical spinal cord injury where they have some mobility and sensory function?
Can a person with a neck fracture die from their cervical spinal cord being compressed because of bleeding and swelling from the fracture compressing against the cord?
Can a person with an incomplete cervical spinal cord injury, caused by a traumatic accident, die four days after the accident because of the cervical spinal cord failure to control blood pressure and heart rate, or respiratory failure because of damage done to the cord? Or would they have to have a complete cervical spinal cord injury to die four days after the accident because of the same reason stated above?
And lastly, would it be possible for a elderly male, aged 80, who has had a fall, and has either a partially severed his cervical spinal cord, or his cervical spinal cord been injured by being compressed from bleeding and swelling as result of a neck fracture, be physically able to walk roughly 50 meters with someone assisting him? If it is possible, what would their balance be like, for example, if the person assisting the injured man was holding him with one their arms holding him at the waist would be able to walk in a straight line, or would his walking be staggered, unbalanced and uncoordinated?
Hello,
Welcome to icliniq.com.
I read carefully your question and would explain that the cervical spinal cord is a very delicate part of the spinal cord because in its beginning are located the most important centers which control the heart rate, the pulmonary function, and the blood pressure values.
It is true that just after a trauma a man can walk, with or without assistance for 50 meters and this can sound strange. In fact, this can be related to the lack of damage to the spinal cord in that moment (there is only the fracture of the vertebral column, while the central nervous system is intact). While walking, the instability of the damaged vertebral column causes further damage to the spinal cord and the person gets paralyzed.
Regarding the partial and complete damage of the spinal cord, it is difficult to judge. All the damages begin as partial, but because of the spinal cord instability, the lack of right immobilization and the bleeding and swelling, the damage may become complete in the next days. The swelling and bleeding tend to spread and the spinal cord is trapped within the vertebral column, and can not expand further, so the swelling and bleeding cause further damage to the spinal cord. It is difficult to judge in the first days of trauma.
But, because of the swelling in the first days after the trauma (first week), the person may die because of acute cardio-respiratory arrest, due to the dysfunction of the heart and respiratory function. The swelling tends to spread in the upper cord and the paralysis becomes complete, affecting also the respiration and the heart rhythm.
I hope this helps.
Patient's Query
Thank you doctor,
I just need a bit more understanding and some more answers on the walking question.
I understand a person can walk after fracturing their neck but I want to know the answers to the following questions, please:
Can a person walk with a cervical spinal cord that has been completely severed after the initial trauma? Surely, it would be physically impossible, how would the legs receive the message from the brain?
Could an 80-year-old man walk with a partially severed cervical spinal cord 20 minutes to 1 hour after the initial trauma? If it is possible, I want to know whether it is because his cervical spinal cord has only been mildly damaged, or is still possible for an 80-year-old man to walk, 20 minutes to 1 hour after the initial trauma, with a cervical spinal cord that has been severely damaged?
Lastly, I want to know if the 80-year-old man could walk, would his balance be seriously affected 20 minutes to 1 hour after initial trauma, for example, whether he would be able to walk unassisted and in a straight line, or would his balance be so bad he would struggle to walk in a straight line and need the assistance of someone else to help him to walk and to prevent him from falling over?
Hello,
Welcome back to icliniq.com.
Here are my answers to your questions:
A person can not walk with severe damage to the spinal cord, as the signal does not reach the legs.
A person with mild damage to the spinal cord can walk for 20-60 minutes.
A person can walk only when there is a fracture of the vertebral column without damage to the spinal cord or with mild damage to the spinal cord. Later, because of the instability of the vertebral column, the spinal cord gets damaged further because it is not protected by the bones and it gets compressed (trapped) in the spinal canal which is broken and not stable.
Usually, the walking is not stable and needs assistance in cases of mild damage to the cervical spinal cord. This does not happen when there is just bone fracture but not damage to the spinal cord. In such cases, walking may be just with slight imbalance, but later the patient can not move his legs because of further damage to the spinal cord due to the instability of the cervical vertebral column.
I hope you will find this answer helpful.
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