Spinal Cord Injury

What’s a spinal cord injury?

A spinal cord injury (SCI) involves damage to the spinal cord, a critical structure responsible for transmitting messages between the brain and the rest of the body. This type of injury is severe and often has a profound impact on daily life. The spinal cord, housed within the spine’s vertebrae, is a bundle of nerves and tissues that facilitate communication between the brain and the body. The spinal cord enables us to perceive sensations, such as pain, and to move our limbs. When the spinal cord is injured, it disrupts the transmission of these vital messages.

This disruption can result in a partial or complete loss of sensation and mobility below the injury site. Typically, an injury higher up on the spinal cord, closer to the neck, can lead to paralysis affecting a larger portion of the body than an injury in the lower back.

How do spinal cord injuries usually occur?

A spinal cord injury (SCI) often stems from unpredictable accidents or violent events. Common causes of SCIs include:

• Violent attacks, such as stabbings or gunshots
• Diving into shallow water and hitting the bottom
• Trauma from car accidents, especially to the face, head, neck, back, or chest
• Falling from significant heights, such as from a building or tree
• Head or spinal injuries sustained during sporting events
• Electrical accidents
• Severe twisting of the middle torso

What are the symptoms of a spinal cord injury?

Some symptoms of a spinal cord injury can include:

• Problems walking: Difficulty or inability to walk, stand, or move limbs.
• Loss of control of the bladder or bowels: Inability to control urination or bowel movements.
• Inability to move the arms or legs: Paralysis or loss of sensation and movement in limbs.
• Feelings of spreading numbness or tingling in the extremities: Sensory changes like numbness, tingling, or loss of sensation spreading from the point of injury.
• Unconsciousness: Loss of consciousness or altered level of consciousness following a traumatic event.
• Headache: Persistent or severe headache, which can be a sign of trauma to the head or neck.
• Pain, pressure, and stiffness in the back or neck area: Pain or discomfort in the spinal region, potentially with stiffness or pressure.
• Signs of shock: Pale skin, rapid pulse, shallow breathing, and confusion, indicating shock due to severe injury.
• Unnatural head positioning: The head is positioned in an unnatural or abnormal angle or alignment.

If you suspect a spinal cord injury based on these symptoms, it’s crucial to seek immediate medical attention and avoid moving the person unless necessary to prevent further injury.

What should I do if I suspect a spinal cord injury?

If you believe you or someone else has a spinal cord injury, follow these steps:

• Call for help immediately. The quicker medical assistance arrives, the better.
• Avoid moving or disturbing the person unless absolutely necessary. This includes not repositioning their head or attempting to remove a helmet.
• Encourage the person to remain as still as possible, even if they can get up and walk.
• If the person isn’t breathing, perform CPR. Avoid tilting the head back; instead, gently move the jaw forward.

Upon arrival at the hospital, doctors will conduct a thorough physical and neurological exam to determine if there is a spinal cord injury and its location. Diagnostic tools that may be used include:

• CT scans
• MRIs
• X-rays of the spine
• Evoked potential testing, which measures how quickly nerve signals reach the brain

How can I prevent spinal cord injuries?

Reducing the risk of spinal cord injuries involves taking certain precautions:

• Always wearing a seatbelt while in a car: Seatbelts help prevent ejection during accidents, reducing the risk of spinal injuries caused by impacts.
• Wearing proper protective gear while playing sports: Helmets, padding, and other protective equipment can cushion blows to the head and spine during athletic activities, reducing the risk of spinal injuries.
• Never dive into water unless you’ve examined it first: Always ensure the water is deep enough and free of obstacles like rocks or shallow areas. Diving into shallow water can lead to severe spinal cord injuries.

These measures can significantly decrease the chances of sustaining a spinal cord injury in situations where accidents are more likely to occur.

What’s the long-term outlook?

A spinal cord injury can have profound effects on an individual’s life, and while some people can lead fulfilling lives after such an injury, there are significant challenges to overcome:

• Loss of Mobility: Many individuals with spinal cord injuries require assistive devices such as wheelchairs, walkers, or other mobility aids to move around. Depending on the level and severity of the injury, some individuals may experience complete paralysis from the neck down (quadriplegia) or from the waist down (paraplegia).
• Assistance with Daily Living: Tasks that were once routine may now require assistance or adaptation. This includes activities such as dressing, bathing, and preparing meals. Learning new techniques and utilising assistive technology can help regain independence in daily activities.
• Health Complications: Common complications associated with spinal cord injuries include pressure sores (bedsores) due to prolonged sitting or lying down and urinary tract infections due to difficulties with bladder control. Managing these complications requires ongoing attention and care.
• Rehabilitation: Intensive rehabilitation is essential for individuals with spinal cord injuries. This involves physical therapy to maintain muscle strength and mobility, occupational therapy to learn adaptive techniques for daily tasks, and psychological support to cope with the emotional impact of the injury.
• Quality of Life Adjustments: Adapting to life after a spinal cord injury often involves adjusting living arrangements, work environments, and social activities. Accessibility modifications to homes and workplaces may be necessary to accommodate mobility aids and ensure safety and comfort.