Spinal Cord Injury FAQ

How Do Spinal Cord Injuries Occur?

Spinal cord injuries are often some of the most devastating a person can suffer. The majority of your nervous system is located in your spine, and severe damage can leave you paralyzed for life — or worse. There are many ways you could fall victim to such an injury. Here are the top 6, according to Mayo Clinic:

Car accidents: Over 35 percent of all new spinal cord injuries annually happen due to motor vehicle accidents. This includes cars, trucks and motorcycles. Whether you hit another vehicle or a stationary object, you could suffer from a spinal cord injury.

Falls: If you are over 65 years old, a spinal cord injury is more likely to happen from a fall than any other cause. It also affects industrial and construction workers. In all, a quarter of spinal cord injuries come from falling.

Violence: Unfortunately, violence is a common occurrence in the United States. Gunshot and stab wounds account for 15 percent of all spinal cord injuries. Often, violent acts sever nerves, causing severe damage.

Sports injuries: Whether you play for the pros or play in the backyard, you can suffer from sports injuries playing sports.Similarly, taking dives in the shallow end of the pool can cause injury. Altogether, sports and recreation account for about 9 percent of spinal cord injuries.

Alcohol use: Do you make the smartest decisions when you drink? Whether you text your ex or try death-defying maneuvers, the answer is probably “no.” Unfortunately, alcohol plays a factor in a fourth of all spinal cord injuries.

Disease: Not every spinal cord injury is a result of trauma. Osteoporosis, arthritis, cancer and other diseases and conditions can cause your spinal cord to deteriorate. This is one of the main causes of injury in older individuals.

Can Whiplash Cause Spinal Cord Injury?

The most common injury from a car accident is whiplash. It’s most likely to happen if you get rear ended, as your head snaps back then suddenly forward. This causes strain on your neck muscles, tendons and ligaments. It can even cause your tendons and ligaments to tear. Depending on the severity of the injury, you could suffer from a stiff neck, headaches, dizziness and even problems with concentrating.

Fortunately, these symptoms generally go away within a few weeks. However, it some cases, more serious injuries occur. Your spinal cord runs from the base of your skull to the very bottom of your spine. As such, whiplash can cause damage to the top of your spinal cord, known as the cervical vertebrae. This area of the spine is responsible for arm movement, breathing, head movement and other vital functions. Though it is very rare, whiplash could cause these vertebrae to become damaged or misaligned.

Though it is not likely to be an issue, every instance of whiplash should be treated as a spinal cord injury until you are told otherwise. That means you need to visit your doctor and allow them to conduct tests, including x-rays, to make sure everything is as it should be. Never ignore prolonged neck pain after a car accident or other instance of whiplash; doing so could result in permanent damage.

How Long Will I Be in the Hospital for a Spinal Cord Injury?

Because spinal cord injuries can have such a major impact on your life, it’s vital to seek immediate medical attention. You will be under close observation for the first 24 hours of your hospital stay, during which doctors will be monitoring your condition, conducting tests and formulating a treatment regimen. On average, you can expect to spend 8 to 13 days in the hospital for a spinal cord injury.

During this time, doctors will be watching for quite a few different things. They will monitor your vitals, including your heart rate, temperature and blood pressure. They will also check for range of movement and feeling in the extremities, as needed. They will also administer any number of tests, from x-rays to MRIs to CT scans. Your doctors will also check for neurological issues by checking pupil reflexes, balance, strength and other indicators.

From there, there are many different kinds of treatment you may receive. If the injury is not severe, you may just be given painkillers and anti-inflammatory medication. If needed, you may also be given a back brace. In severe cases, surgery may be needed to repair the spine. Note that the 8 to 13 days in the hospital does not include any rehabilitation or occupational therapy you may need.

How Is a Spinal Cord Injury Diagnosed?

Though severe, a spinal cord injury is not always easily diagnosable. They share similar symptoms as brain injuries or simple whiplash. As such, a battery of tests are generally administered to diagnose a spinal cord injury. These include:

X-rays: These are used to see if there is any damage to the vertebrae, such as cracks or fractures.
Myelogram: This is similar to an x-ray. However, a special dye is injected into the spine that highlights nerves and other non-bone tissue elements can be seen, using a special x-ray called fluoroscopy.
Computed tomography (CT) scan: During a CT or “cat” scan, a computer takes a series of cross-sectional images to check for issues such as blood clots. Often, this will be done soon after a myelogram to take advantage of the dye still in the spine.
Magnetic resonance imaging (MRI): An MRI uses strong magnets and radio waves to take a picture of the affected area. Often, these will be used to check for herniated disks and other issues, including swollen cartilage between the vertebrae.
Somatosensory evoked potential (SSEP) testing: Also called magnetic stimulation, SSEP is used to test how well the nerves themselves are operating. This test causes a nerve signal to be sent, which is tracked to make sure it can still pass through the spinal cord.

How Does a Spinal Cord Injury Affect the Nervous System?

Your spinal cord is the messenger system for the nervous system. Signals from the brain are directed down the spine, which then carries these signals throughout the body. As such, an injury can have devastating effects on the nervous system. There are many different parts of the nervous system, all connected to other systems in the body, and they can each be affected uniquely, depending on the location of the injury.

One of the most important factors in a spinal cord injury is the “completeness.” If there is no movement or feeling below the injury, it’s considered a complete injury. That’s because there is no signal going past that part of the spine, and therefore the brain cannot connect with the intended body part. If there is movement or feeling, it is an incomplete injury.

Here’s a quick rundown of the different sections of your spinal cord:

Cervical curve: Base of the skull to the shoulder, controls head and neck, diaphragm, biceps and wrists
Thoracic curve: From the shoulders to the bottom of the ribs, controls the chest muscles, hands, triceps and abdominal muscles
Lumbar curve: Bottom of the ribs to “tailbone,” Controls leg muscles
Sacral curve: Referred to as the “tailbone,” controls bowels, bladder and sexual function

Different parts of the spinal cord are also in charge of the skin and autonomic functions like breathing, internal temperature control and heartbeat.

Will I Walk Again After a Spinal Cord Injury?

A spinal cord injury could potentially devastate your life. Whether you’ve been in a car accident, a victim of violence in some other way been hurt, your first question will likely be, “Will I be able to walk again?” The answer to that is an unsatisfying “maybe.” There are a few factors to consider.

First, there’s the determination of whether your injury is complete or incomplete. A complete injury means no nerve signals are passing through the injured part of your spinal cord, leaving you immobile. Often, that is a result of a nerve tear or other inoperable obstruction. An incomplete injury means some nerve signals are coming through, and there is mobility/feeling below the injury. Your doctor will conduct a somatosensory evoked potential (SSEP) test to stimulate nerve signals and determine how far they travel.

Overcoming incomplete injuries may be possible with rehabilitation. However, complete injuries will leave you completely unable to walk — at least for now. New technology called exoskeletons has made its way onto the scene. These tools attach to the legs and use small motors to help those who are paralyzed walk again, or at least simulate the action. Though exoskeletons are pricey right now, the price should drop (and possibly be covered by insurance) in the coming years.

Do Spinal Cord Injuries Often Result in Paralysis?

Because the spinal cord is the Grand Central Station of the nervous system, injuring it can be terrifying. Each section of the spine controls a different part of your body, meaning an injury to any section could leave you partially paralyzed. While paralysis is often associated with legs and arms, it could also mean your urinary tract or respiratory system is unable to function properly.

The likelihood of paralysis is highest in “complete” injuries. This means signals from the nerves are not received past the point of the injury. For neck injuries, that could result in tetraplegia, meaning you are unable to move your arms or legs. A lower injury could result in paraplegia, meaning the legs are paralyzed. These often result from a lack of blood flow or other obstruction that kills the nerves.

An incomplete injury, on the other hand, means the injury does not totally block nerve signals. While these injuries can result in paralysis, it is often able to be overcome with rehabilitation and medical treatment. Things get tricky with “open” injuries, such as from a gunshot. The bullet may not immediately cause paralysis, but operation to remove it could damage nerves. Often in these cases, the bullet may be left in, while the patient is forced to be immobile so the spine can heal around it.

Are Spinal Cord Injuries Permanent?

The job of your spinal cord is to deliver messages from the brain to the rest of the body. It’s filled with thousands of nerves, transmitting rapid signals every second of the day. These nerves are very delicate and, unlike most other cells, are irreparable if they become damaged or torn. Luckily, they are protected by the vertebrae in your spine. It usually takes a lot of impact or trauma to completely break through these bones and make it to your nerves. At most, an impact usually causes bruising, swelling and/or small fractures.

These injuries can cause temporary paralysis and other issues, but with proper treatment and rehabilitation, you could be back on your feet in a few weeks to a few months. But in more severe cases, your injuries could become permanent. The likelihood of a nerve being severed or otherwise directly damaged is low, thanks to the aforementioned vertebrae. But, if swelling or other side effects of trauma go untreated, it could cause a loss of blood flow to the nerves. That causes nerve death, which (at least for now) is permanent.

New research is constantly being conducted to remedy these kinds of injuries. Stem cells have been thought to be a solution for spinal cord injuries. However, due to funding and moral reasons, research has been slow. For now, “complete” spinal cord injuries, or ones in which the nerves are completely damaged, are permanent.

Why Do Car Accidents Cause Spinal Cord Injuries?

Motor vehicle accidents account for 40 percent of all spinal cord injuries. While your spine may be strong enough to protect your nerves from everyday bumps and poor sleeping positions, it’s simply not made to resist major trauma. Luckily, your vertebrae are strong and durable enough to not easily break. However, there are many other parts of the spinal cord that make it a fairly delicate structure.

The most common injuries to the spinal cord are from strains and tears to muscles, ligaments and tendons. This can cause severe swelling, bruising and other fairly serious injuries. Perhaps the most well-known of these kinds of injuries is whiplash. This is when the neck jolts back then suddenly forward, putting massive strain on the upper portion of the spinal cord, or cervical curve.

You may also suffer from spinal fractures in the middle to lower back. In a car accident, your upper body will move forward due to the sudden stop. However, your torso remains in place, if your seatbelt is working properly. This can result in your vertebrae being pulled apart, causing fractures, herniated disks and other injuries to the soft tissue and cartilage.  If not treated quickly, such injuries could result in permanent disability and other lifelong issues.

How Do I Administer First Aid for a Spinal Cord Injury?

The most important thing to remember if you suspect someone has suffered from a spinal cord injury is to NEVER MOVE THEM. The exception is if they are in an otherwise life-threatening situation, such as being stuck in a burning car or choking on blood. Otherwise, moving them could only make a bad situation worse. You could cause further injury by jarring bones cartilage disks that are already in a precariously disjointed position.

Here are a few more steps to keep in mind:

Call 911: Medical professionals are best able to deal with these kinds of emergency situations. They know what signs to look for in a possible spinal cord injury and how to move the victim.
Keep the victim stationary: With adrenaline after an accident, it’s natural for a person to try to get up and do a self-examination. Make sure they don’t move, either purposefully or otherwise, and keep their neck still.
Perform modified CPR: If the victim isn’t breathing, conduct CPR. Remember to pump the chest at about 100 beats per minute; that’s the tempo of “Stayin’ Alive” by the Bee Gees and “Sweet Home Alabama” by Lynyrd Skynyrd. Do not tilt their head back for mouth-to-mouth; instead, gently lower their jaw.
Don’t remove any gear: If you are on the construction site, don’t remove any safety gear from the victim. This includes helmets. Doing so could jar the spine and cause further damage.
Know when and how to roll: As mentioned before, one of the only times you should move a victim is if they are choking on blood or vomit. If this is the case, work with at least one other person to gently roll the victim on their side, keeping their back, neck and head aligned.