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Spinal Cord Injury

Back & Spine Treatments

A spinal cord injury is devastating; however, many people with spinal cord injuries lead independent, fulfilling lives. The right treatment and rehabilitation are key to ensuring the best outcome after a spinal cord injury. Our hospital’s Back & Spine Center is staffed with a renowned, interdisciplinary team of board-certified neurologists, neurosurgeons, and specialists who stay at the forefront of medical advances in spinal care to ensure our patients are given world-class treatment for spinal cord injuries.

While in the emergency room, the patient is evaluated to diagnose the underlying cause of their injury and uncover any neurologic defects resulting from it. Once a spinal cord injury is diagnosed, the patient is then admitted to our spine injury center, where our team of neurosurgeons, spinal cord medicine specialists, nurses, therapists, and others work collaboratively to give you the best treatment.

Looking for expert spinal cord injury treatment and care, or need a second opinion regarding treatment? Contact us at the Back & Spine Center of RWJBarnabas Health today.

What Is a Spinal Cord Injury?

Spinal cord injuries are the result of damage to the spinal cord, which is a bundle of nerves running down the middle of the back, carrying messages from the brain to the rest of the body. According to the National Spinal Cord Injury Statistical Center (NSCISC), there are over 17,000 new cases of spinal cord injury every year in the United States, not including those who die at the time of the accident that caused their injury. According to NSCISC, at least 291,000 individuals nationwide are currently living with a spinal cord injury, but the National Spinal Cord Injury Association estimates that the number may be as high as 450,000 individuals.

Anatomy of the Spine

To understand its function, it helps to have basic knowledge of the anatomy of the spine and surrounding structures. The spinal column is about 18 inches long, and consists of 33 bones called vertebrae. These bones cover and protect the spinal cord, which runs through the spinal column, including the brain and spinal cord. The brain relays messages through the spinal cord to the rest of the body, dictating both voluntary and involuntary functions.

The spine itself has four sections, not including the tailbone. The sections of the spine include:

  • Cervical vertebrae (C1-7): Located in the neck

  • Thoracic vertebrae (T1-12): Located in the upper back and attached to the ribcage

  • Lumbar vertebrae (L1-5): Located in the lower back

  • Sacral vertebrae (S1-5): Located in the pelvis

What Causes Spinal Cord Injuries?

Most spinal cord injuries are preventable. Some of the most common causes of spinal cord injuries include:

  • Motor vehicle accidents (almost 40% of spinal cord injuries are caused by vehicular crashes)

  • Falls (almost one-third of spinal cord injuries result from falls)

  • Sport injuries, such as diving accidents

  • Violence

  • Birth injuries

Symptoms of Spinal Cord Injuries

Depending on its location, a spinal cord injury can disrupt the signals traveling from the brain through the spinal cord, which can impact countless areas of our bodies. The most telling sign of a spinal cord injury is the inability to move or control the legs and/or arms. An individual’s ability to move their limbs after a spinal cord injury depends on the severity of the injury, as well its location along the spinal cord.

A spinal cord injury may be either complete or incomplete, depending on whether there is motor or sensory function below the injured area. If all feeling and motor function (ability to move) is lost below the spinal cord injury, it is “complete.” An injury is called “incomplete” if there is still some motor or sensory function below the affected area.

Spinal cord injuries may either be tetraplegic or paraplegic. “Tetraplegia,” which is also known as quadriplegia, paralyzes the arms, hands, trunk, legs, and pelvic organs. Paraplegia is the paralysis of all or part of the trunk, legs, and pelvic organs.

Any kind of spinal cord injury will result in one or more of the following symptoms:

  • Loss of movement

  • Extreme pain or pressure in the neck, head, or back

  • Altered or lost sensation, including the ability to sense heat, cold, and touch

  • Tingling of the hands, fingers, feet, or toes

  • Loss of bowel or bladder control

  • Changes in sexual function, sensitivity, and fertility

  • Pain or intense tingling caused by nerve damage to the spinal cord

  • Difficulty breathing or coughing

  • Difficulty or inability to walk

  • Unusual lumps on the head or spine

Cervical Spinal Cord Injury Symptoms

The vertebrae in the neck make up the “cervical” spinal cord, which includes bones C1-7. Because this part of the spine is closer to the brain and affects a larger portion of the body, these injuries are the most severe types of spinal cord injury. Injuries to the cervical spine result in tetraplegia or quadriplegia, meaning there is limited or no sensation or movement below the neck. Paralysis is permanent and requires lifelong medical care; patients will need assistance completing some basic daily functions. Many of these patients are unable to speak, or speaking ability will be impaired.

Immediate treatment for a cervical spinal cord injury involves stabilizing the injured area and administering anti-inflammatory drugs such as methylprednisolone to help reduce swelling. Once the patient is stable, rehabilitation can start, which focuses on learning to use the non-paralyzed portions of the body and regaining as much independence as possible.

Most individuals who sustain cervical spinal cord injuries are totally dependent for all care, and usually need breathing assistance with the help of a respirator or other support. Individuals who injure C2 or C3 often sustain terminal injuries, because of an inability to breathe.

Thoracic Spinal Cord Injury Symptoms

This part of the spine is built for stability, and helps keep the spine upright. The thoracic part of the spine includes the 12 vertebrae located in the upper and middle part of the back. These bones are numbered T-1 to T-12, and each number corresponds with the nerves in that area of the spinal cord. Nerves T-1 through T-5 help control the muscles that help with breathing. Nerves T-6 through T-12 are important for balance and posture, as they affect the abdominal and back muscles.

Injuring the thoracic spine typically results in paraplegia, or paralysis below the waist. Patients with thoracic spinal cord injuries can often move their arms, hands, and upper bodies normally, and get around with a manual or electric wheelchair. Many can learn to drive a modified car, and may be able to stand in a standing frame or even walk with braces. Most are able to live independently, work a full-time job, and practice good self-care without assistance.

Lumbar Spinal Cord Injury Symptoms

The lowest major portion of the spinal cord includes the five lumbar vertebrae in the mid- to lower back, above the minor sacral spine section. The lumbar spine carries most of the weight of any section of the spine, and has larger vertebrae than the thoracic or cervical sections. Lumbar spinal cord injuries often result in a degree of function loss in the hips and legs, but not the functionality of the upper body. People who suffer from lumbar spinal cord injuries have little or no voluntary control of their bowel or bladder. Most need a manual or electric wheelchair for movement, although some may be able to walk with special braces. The length of recovery for a person with this type of spinal cord injury varies, and depends on which nerves were affected. Most people who have injured their lumbar spinal cord are able to regain their independence and mobility with the assistance of a wheelchair.

Sacral Spinal Cord Injury Symptoms

The sacral spine, or sacrum, is one bone, located above the tailbone, in the pelvis. Sacral spinal cord injuries are rare, and usually only occur from a fall or direct trauma to the area. The sacrum is comprised of 5 bones which fuse in childhood. The bones are numbered S-1 to S-5, and their numbers correspond with the nerves in that section of the spinal cord. Injuries to the sacral nerves can result in some loss of function to the hips and legs, as well as lack of voluntary bowel or bladder control. Most people with sacrum injuries are still able to walk.

Spinal Cord Injury Diagnosis

Diagnosis of a spinal cord injury is usually straightforward. The patient must be assessed quickly and accurately to find the cause of the injury. In the emergency room, a doctor can check for a spinal cord injury by testing sensory function and movement, if the patient is conscious. For patients who aren’t fully conscious, emergency diagnostic tests may be needed.

Emergency tests for a spinal cord injury may include:

  • X-rays: This is typically the first imaging test done, and the entire spine may be x-rayed. This imaging test can reveal spinal column problems, tumors, fractures, or degenerative conditions of the spine.

  • Computerized tomography (CT) scan: A CT scan can provide a more detailed look than an x-ray image. These scans form a series of cross-sectional images that can identify problems of the bones or disks.

  • Magnetic resonance imaging (MRI) scan: This imaging test is very useful to look at the spinal cord and identify any herniated disks, blood clots, or other masses that could be compressing the spinal cord.

Spinal Cord Injury Treatment

Treatment for a spinal cord injury is divided into four categories: pre-hospital care, emergency room treatment, operative/hospital care, and rehabilitation. Urgent medical attention is vital after a spinal cord injury. Pre-hospital care focuses on safely removing the patient from the accident and taking precautions to stabilize the neck in a collar and the spine on a backboard to avoid further injury. In the early stages of treatment, your medical team at the emergency room will focus on maintaining your ability to breathe, preventing shock, and avoiding possible complications such as a deep vein blood clot in the legs.

Once a spinal cord injury is confirmed, the patient will usually be admitted to an intensive care unit to stabilize blood pressure, monitor breathing and cardiovascular function, and minimize any complications from the injury.

Surgery for Spinal Cord Injuries

In some cases, the patient may need immediate surgery, particularly if the spinal cord appears to be compressed by some other lesion. While surgery cannot reverse damage inflicted to the spinal cord, it can stabilize the spine to prevent any future pain or deformity.

Unfortunately, there is no way to reverse the damage done by a spinal cord injury, but continuous new research is being performed to investigate the possibility of promoting nerve cell regeneration after a spinal cord injury.

Rehabilitation After a Spinal Cord Injury

After suffering a spinal cord injury, life will change, and you will have to physically and emotionally adapt to the changes. As your condition improves, intensive rehabilitation can begin. The success of your program depends on a variety of factors, including the level and severity of the injury, the type and degree of resulting disabilities, your overall health, and support from family/friends in your recovery efforts. Rehabilitation will focus on maximizing your capabilities while helping promote your independence, so you can move on with life feeling comfortable physically, emotionally, and socially.

Rehabilitation may include:

  • Self-care skills

  • Physical care

  • Mobility skills

  • Respiratory care

  • Communication skills

  • Socialization skills

  • Vocational training

  • Psychological counseling

  • Family therapy

  • Continuing education

Request an appointment online now or call 833-656-3876.