Spinal trauma is an injury to the spinal column, which may also include the bones, blood vessels and tissue of the spine. It may cause injury directly to the spine, or it may injure the neck or other surrounding structures. Spinal trauma can lead to a fracture or dislocation of one or more of the vertebrae, as well as bleeding, swelling and inflammation within the spinal cord. It can occur as a result of numerous different factors, including a fall, motor vehicle accident, sports injury or violent encounter.
Even a minor injury can cause spinal trauma in some cases if there is a pre-existing spine issue such as osteoporosis or spinal stenosis. In otherwise healthy individuals, spinal trauma usually takes place when there is direct, damaging impact to the spine. The spinal cord may be affected if a fragment of bone protruding from a broken vertebrae or a piece of metal embedded after a car accident reaches it. The sharp edges may cut or damage the spinal cord. There is also danger to the spine when excessive pulling, pressing or compression take place in the course of an injury.
Spinal trauma most commonly occurs in boys and men between the ages of 15 and 35. The greatest risk factors are taking part in unsafe physical activities, failure to wear protective gear when it is warranted and diving into shallow bodies of water.
When a spinal trauma has taken place, the symptoms will vary depending on the exact location of the injury. Patients may experience pain, loss of movement, weakness, loss of sensation, exaggerated reflexes and difficulty breathing, depending on the type and severity of their condition.
If the injury is to the cervical (neck) area, the arms, legs and midsection of the body may be affected. The symptoms may include breathing difficulties, loss of bladder and bowel control, pain, weakness or paralysis, numbness and spasticity. These symptoms may be present on one or both sides of the body.
When the injury is thoracic (chest area), the symptoms predominantly affect the lower half of the body. Typical symptoms are numbness, weakness or paralysis, pain, loss of bladder and bowel control, spasticity, blood pressure difficulties, increased sweating and body temperature fluctuations.
In a lumbar (lower back) injury, one or both legs and sometimes the muscles controlling the bladder and bowel can be impacted. Common symptoms include pain, numbness, weakness or paralysis, spasticity and loss of bladder and bowel control.
To evaluate spinal trauma and obtain a more detailed view of the spine, your doctor will most likely perform a series of imaging exams, including x-rays, CT scans, MRI and myelography. Frequently, these will be done once immediately after the injury occurred and then repeated a few days later when any swelling has subsided.
A neurological exam may be performed as well to test muscle strength and sensation to both light touch and a pinprick. This can help the physician pinpoint the precise location of the injury. Motor function in each of the extremities will most likely be checked as well. Trauma to the spine is always a possibility when an injury involves the head or pelvis, in many automobile accidents, and in incidents where one has fallen from a height or was diving into water.
Treatment for a spinal trauma injury will vary depending on each patient's individual condition, but often includes medication to reduce nerve damage. Corticosteroids may be used to decrease swelling that can do damage to the spinal cord. Use of a brace for immobilization of the spine or bed rest may promote healing. Surgery is sometimes necessary to remove bone fragments, herniated disks or foreign objects. It can also be beneficial for removing any fluid or tissue around the spine that is putting pressure on the spinal cord or to fuse broken spinal bones.
Physical rehabilitation is highly recommended after a spinal trauma. Exercises to strengthen the muscles and also keep them flexible are essential. When paralysis is involved, therapy may involve learning to use assistive devices such as braces, a walker or a wheelchair to maximize mobility.
Both physical therapy and long-term medication use can help manage the effects and minimize complications associated with spinal trauma. While there is no way to reverse spinal cord damage, many patients can relieve symptoms and restore functionality through a personalized treatment plan.