The spinal cord is a bundle of nerves that transmits messages between the brain and the rest of the body, including the muscles, organs, and peripheral nerves. Every function of your body depends on the health of your spinal cord. Following a spinal cord injury, these signals may become disrupted, resulting in a loss of motor control and sensation.
If you have suffered a traumatic event, your spinal column and spinal cord may have sustained significant damage. Results of a spinal cord injury can appear differently depending on the type and location of the injury. The most common is loss of motor, sensory and slowing of some of the body’s internal organs (autonomic nerve function) below the level of the injury. In general, the higher in the spinal cord an injury occurs, the more function, sensation and internal body functions will be affected.
To preserve as much function as possible and prevent the progression of secondary damage, spinal cord surgery may be necessary.
What is a Spinal Cord Injury?
The spinal cord relays messages between the brain and the rest of the body. Layers of tissue called meninges and a column of vertebrae (spinal bones) surround and protect the spinal cord. A spinal cord injury (SCI) is damage to the tight bundle of cells and nerves that sends and receives signals from the brain to and from the rest of the body. The spinal cord extends from the lower part of the brain down through the lower back.
Most spinal cord injuries come from a sudden, traumatic blow to the vertebrae. The fractured (broken) bones then damage the spinal cord and its nerves. In rare cases, an injury can completely sever, or split, the spinal cord. This damage can cause temporary or permanent changes in sensation, movement, strength, and body functions below the site of injury.
Anatomy of the Spine
Your spine is made of 26 bones called vertebrae (7 cervical, 12 thoracic, 5 lumbar, the sacrum and coccyx). Except for the top two neck vertebrae, each vertebra is separated by a disc. Each disc contains a soft, jelly-like center surrounded by a tough outer layer of fibers known as the annulus. Discs, bone, ligaments and strong muscles stabilize the spine. The muscles control movement. Inside the spine is called the spinal cord.
The spinal cord is composed of nerves leading to and from the brain. It controls and transmits all muscle movement and sensation for the arms, legs and trunk. Nerve roots come from the spinal cord and carry electrical impulses to and from muscles, organs and other structures. These nerve roots can become pinched or irritated by abnormal conditions.
A compression injury to your back can cause a disc to rupture. This can create spinal instability and/or nerve symptoms (numbness, tingling and changes in sensation).
Spinal curvatures called scoliosis can be due to degenerative changes, instability, or an unknown cause. These conditions can also be corrected by a spinal fusion.
Your doctor will choose the best instrumentation and procedure for your individual needs.
Types of Spinal Cord Injuries
Injuries to the spinal cord can vary, but the most common are these three types:
- Contusion: bruising of the spinal cord
- Compression: pressure on the spinal cord, often caused by the accumulation of blood, disc material, or fluid in the canal
- Central Cord Syndrome: specific damage to the cervical region of the spinal cord
Spinal cord injuries can be complete or incomplete (partial):
- Complete: A complete injury causes total paralysis (loss of function) below the level of the injury. It affects both sides of the body. A complete injury may cause paralysis of all four limbs (quadriplegia) or the lower half of the body (paraplegia).
- Incomplete: After an incomplete injury, some function remains on one or both sides of the body. The body and brain can still communicate along certain pathways.
Symptoms of a Spinal Cord Injury
Spinal cord injury symptoms depend on the type (complete or incomplete) and location of the damage. Get immediate medical attention if you notice any of the following issues after an injury:
- Loss of movement
- Weakness in the arms and or legs
- Decreased sensation in the arms and or legs
- Exaggerated reflex activities or spasms
- Loss of bladder or bowel control
- Severe pain or pressure in the neck or back
- Unusual lumps along the spine
- Difficulty breathing, coughing or clearing secretions from your lungs
How Does a Spinal Cord Injury Affect the Body?
The body loses many essential functions if an injury means nerves can’t communicate with the brain. A damaged spinal cord can affect:
- Bladder and bowel (intestinal) function
- Breathing
- Heart rate
- Metabolism, or the body’s process of converting food into energy
- Muscle movement
- Reflexes
- Sensations
Diagnosis
In the emergency room, a doctor may be able to rule out a spinal cord injury by examination, testing for sensory function and movement, and by asking some questions about the accident.
But if the injured person complains of neck pain, is not fully awake or has obvious signs of neurological injury, emergency diagnostic tests may be needed.
These tests can include:
- X-rays. X-rays can reveal vertebral (spinal column) problems, tumors, fractures or degenerative changes in the spine.
- CT scan. A CT scan can provide a clearer image of abnormalities seen on X-ray. This scan uses computers to form a series of cross-sectional images that can define bone, disk and other problems.
- MRI. MRI uses a strong magnetic field and radio waves to produce computer-generated images. This test is helpful for looking at the spinal cord and identifying herniated disks, blood clots or other masses that might compress the spinal cord.
Immediate Treatment for a Spinal Cord Injury
You may need emergency surgery for a spinal cord injury if there is trauma to another area of the body. Surgery can also address spinal cord damage from broken bones, blood clots or damaged tissue.
Some research suggests that a corticosteroid injection may help spinal cord injuries. The medication should be given within eight hours after the injury occurs. This treatment may improve blood flow, preserve nerve function and/or reduce inflammation.
Long-Term Treatment for a Spinal Cord Injury
Long-term goals of spinal cord injury treatment include:
- Enhancing independence and quality of life
- Reducing the risk of chronic (ongoing) health conditions
- Restoring some nerve function in partial injuries
Long-term complications of a spinal cord injury may include:
- Inability to regulate blood pressure or body temperature.
- Increased risk of heart or lung problems.
- Loss of bladder or bowel control.
- Paralysis in the arms or legs.
- Persistent pain.
- Spasticity, joint contracture.
- Sexual dysfunction.
Types of Spine Surgeries
Talk to your doctor and neurosurgeon about your options when it comes to spine surgery. Options for spine surgery may include:
- Spinal fusion: This procedure joins together two or more vertebrae to improve stability or correct a deformity.
- Laminectomy: Also known as decompression surgery, this procedure removes the lamina to relieve pressure on nerves and spinal cord.
- Foraminotomy: This procedure enlarges the area in the spine around compressed nerves to relieve pressure.
- Vertebroplasty: This procedure is used to treat spine fractures weakened by osteoporosis by injecting bone cement.
Making the Decision to Undergo Spinal Cord Injury Surgery
Deciding to undergo spinal cord injury surgery yourself or making the decision on behalf of a loved one who is a minor or is incapacitated is not something that should be taken lightly. There are many risks associated with surgery ranging from the procedure itself to the drugs that are used in the process.
Much of the decision about whether to undergo spinal cord surgery will depend on your age, overall health, the location of the injury, and how much your symptoms affect your day-to-day life. If you are experiencing weakness or numbness that makes it hard to walk, demonstrate hand function, or causes bladder, bowel, or sexual function issues, it may be time to consider spinal cord injury surgery. However, that is ultimately a decision that you will need to decide with your doctor.
Patients should understand that, in cases of traumatic injury (a fracture or loss of function due to spinal cord injury) and in situations where a patient is losing the ability to use an arm or a leg, surgery is often needed on an urgent (soon) or emergent (immediate) basis. However, most patients considering spinal surgery do so to treat their pain. Painful conditions sometimes improve over time even without surgery. On the other hand, delaying surgery months or years may result in worse outcomes and less recovery than when surgery is performed sooner.
How Can I Get Started?
The experienced and dedicated orthopedic surgeons at Ventura Orthopedics are here for you. If you need spinal or back surgery, it may be time to consult a medical professional. The experienced and dedicated orthopedic surgeons at Ventura Orthopedics are here for you. We are committed to helping you through any procedure until optimum health, strength and mobility are restored.
Call us today at 800-698-1280 to schedule an appointment.
