Traumatic Spinal Cord Injury: Disorder and Assessment

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Condition: Traumatic spinal cord injury (SCI) means there is damage to spinal cord or nerves that run through the backbone (spine). Depending where the injury is and how severe it is, partial or complete loss of feeling and loss of control in just the legs (paraplegia) or both the arms and legs (tetraplegia) may be present.

Background: Over 12,000 SCIs occur each year, mostly from auto accidents. Other common causes of SCI include acts of violence, falls, and sports injuries.  Younger people are more likely to have an SCI from an auto accident while older people are more likely to get injured from falling.

Risk Factors: Men between the ages of 15 and 35 are most likely to have an SCI. The number of SCIs in persons over 65 years of age is increasing because of falls.

History and Symptoms: Details about how the injury occurred may help to determine injury severity and if there are other associated injuries.  The inability to use arms and or legs (paralysis) that follows an SCI is usually sudden. There may also be breathing, blood pressure problems, or problems controlling the bladder and bowel.  Sexual function is often affected but the ability to have children often remains after an injury.

Physical Exam: Physicians specializing in Physical Medicine and Rehabilitation (physiatrists) receive very thorough training in examining and treating people with SCI.  Your physician will perform a thorough examination including checking strength, reflexes, and sensation.   The initial examinations may help to predict long term recovery from SCI and will guide the treatment you receive.  Precautions may be taken to prevent movement of the spine during the evaluation.

Diagnostic Process: Imaging of the spine may include X-rays, CT scans and/or MRIs.  Blood tests are usually obtained to assess if bleeding, infection or chemical abnormalities are present.

Rehab Management: Rehabilitation is usually directed by a physiatrist who has specialized training in treating SCI.  The goal of rehab is to maintain as much mobility and activity as possible and prevent further injuries. Patients and caregivers need to be educated about safe ways to move and do exercises that will improve strength, balance, and endurance. Assistive devices, ramps, and other changes in the environment may also be helpful.     

Other Resources for Patients and Families: There are numerous associations that provide support and information for patients and families. The Paralyzed Veterans of America (PVA) provides support and other resources on their website for people with SCI and their caregivers. Your physician or care team may provide you with additional resources based on your needs.