What Is a Spinal Cord Injury?

A spinal cord injury consists of damage to any part of the spinal cord, or the nerves at the end of the spinal canal. This damage often causes a permanent loss of function or/and sensation below the site of the injury.

The most common spinal cord injury causes are traumatic accidents such as falls, traffic collisions, and sports injuries. After the initial trauma, additional damage frequently occurs due to swelling, inflammation and fluid building up around the spinal cord.

Non-traumatic spinal cord injuries are much less common but do also occur. A spinal cord tumor, multiple sclerosis, spinal stenosis, spinal cord compression, infection, loss of blood and osteoarthritis are all possible causes of non-traumatic spinal cord injuries.

Spinal cord injuries can be divided into two levels of severity:

• Complete spinal cord injury — This type of injury to the spinal cord results in a complete loss of function below the level of the injury. All sensation and voluntary movement are lost on both sides of the body. A complete spinal cord injury might take the form of a severed spinal cord, or the spinal cord might remain in one piece but sustain severe damage.
• Incomplete spinal cord injury — When some level of function remains below the site of the injury, it is categorized as incomplete. People with incomplete spinal cord injuries may be able to move one limb more than another, have better function on one side of the body, or retain sensation in parts of the body that cannot be moved.

Paralysis from a spinal cord injury may be referred to as tetraplegia or paraplegia. Tetraplegia, also known as quadriplegia, means paralysis of the arms, hands, trunk, legs, and pelvic organs. Paraplegia means paralysis of the legs, pelvic organs and all or part of the trunk, with function remaining in the arms.

If a traumatic accident results in any signs of a spinal cord injury, the survivor should seek an emergency medical evaluation immediately. These signs include:

• Extreme pain or pressure in the neck, head or back
• Weakness, loss of coordination, or signs of paralysis in any part of the body
• Numbness, tingling, or loss of sensation in the hands, fingers, feet, or toes
• Loss of bladder or bowel control
• Difficulty with balance and walking
• Impaired breathing after injury
• An oddly positioned or twisted neck or back

Spinal cord injury symptoms vary in form and duration depending on the severity of the injury, but many people experience:

• Loss of movement
• Lost or altered sensation, including the ability to feel heat, cold and touch
• Loss of bowel or bladder control
• Exaggerated reflexes or spasms
• Changes in sexual function, sexual sensitivity and fertility
• Pain, including an intense stinging sensation caused by damage to the nerve fibers in the spinal cord
• Difficulty breathing, coughing, or clearing secretions from the lungs

Though anyone can suffer a spinal cord injury, there are several risk factors associated with both complete and incomplete spinal cord injuries, including:

• Being male
• Being between the ages of 16 and 30
• Being older than 65
• Engaging in risky behavior
• Having a bone or joint disorder

Often, a spinal cord injury causes permanent damage, but a small fraction of recovering individuals regain all function post-injury. It’s possible to regain some function as late as 18 months after the injury, so both short- and long-term rehabilitation efforts are critical.

Spinal Cord Injury Complications

Because the spinal cord carries messages between the brain and the rest of the body, spinal cord injuries can cause serious complications related to multiple bodily functions.

Common areas that are affected are:

• Bladder control — Loss of bladder control is common with spinal cord injuries, because the spinal cord may no longer be able to send a message to the brain that the bladder is full. Loss of bladder control can also increase the risk of urinary tract infections and kidney or bladder stones.
• Bowel control — Similar to bladder control, bowel control becomes more difficult after a spinal cord injury because of the interrupted flow of information from the bowels to the brain.
• Skin sensation — Below the site of the injury, a person may lose all sensation in their skin. This makes them more susceptible to skin injuries like burns and pressure ulcers.
• Circulation — Circulatory problems like low blood pressure, high blood pressure, and swelling in the extremities are common with spinal cord injuries.
• Respiratory system — If a spinal cord injury causes paralysis that affects the abdominal and chest muscles, it may be hard to breathe and cough, which can lead to lung problems and pneumonia.
• Muscle tone — Some people who experience spinal cord injuries suffer from spastic paralysis, which causes the muscles to stiffen or move uncontrollably, or flaccid paralysis, which leaves the muscles limp and unable to contract.
• Fitness and wellness — Spinal cord injuries lead to muscle atrophy and limited mobility, which may create the risk of obesity, cardiovascular disease and diabetes.
• Sexual health — Spinal cord injuries may affect sexuality, fertility and sexual function for both men and women.
• Pain — Persistent nerve pain is a common complication, especially in the case of incomplete spinal cord injuries.
• Depression — Spinal cord injury symptoms are life-altering, and it can be difficult for a person to adjust to the loss of independence/function and lifestyle changes.

Spinal cord injuries also make people more susceptible to certain complications, known as secondary conditions, that can be dangerous and sometimes even life-threatening.

These secondary conditions include:

• Fractures
• Osteopenia or osteoporosis
• Deep vein thrombosis and pulmonary embolism
• Orthostatic hypotension
• Autonomic dysreflexia
• Septicemia
• Pneumonia
• Bladder and kidney stones

Spinal Cord Injury Recovery

A spinal cord injury causes irreversible damage to a person’s body, often affecting the function of multiple organs and extremities. However, comprehensive post-trauma care can help prevent complications, and focused rehabilitation programs help those with both complete and incomplete spinal cord injuries return to an active and productive lifestyle.

At Kindred Hospitals, our interdisciplinary care teams create customized treatment plans for people at all stages of spinal cord injury recovery. Often, post-trauma care is focused on preventing secondary issues that may arise, such as bowel and bladder issues, respiratory infections, pressure ulcers, blood clots, deconditioning and muscle contractures. Post-trauma care plans for spinal cord injuries may also include pain management, surgical wound care, respiratory therapy and cardiac monitoring.

In addition to post-trauma care, Kindred takes an interdisciplinary approach to spinal cord injury rehabilitation. Our team of physical, occupational and speech therapists create treatment plans designed to help each individual patient regain function, strengthen muscles and, in some cases, create strategies to adapt to paralysis or partial paralysis.

If you’ve suffered a complete or incomplete spinal cord injury, you may benefit from a rehabilitation program that includes:

• Physical therapy
  
  • Endurance training
  • Gait training
  • Strengthening programs
  • Range of motion exercises
  • Upright posture orientation
• Occupational therapy
  
  • Relearning how to perform daily activities
• Speech therapy
  
  • Cognition enhancement
  • Communication
  • Swallow assessment/training
  • Video swallows
  • Passy-Muir valve training
  • Adaptive equipment
  • Group and individual therapy sessions

“Damage to any part of the spinal cord will almost always change a person’s life forever,” says Dr. Dean French, Chief Medical Officer. “Whether they experience a complete or incomplete spinal cord injury, or suffer from a disabling medical condition like multiple sclerosis or a spinal cord tumor, patients must receive comprehensive treatment and rehabilitation to achieve the highest level of function. Without support from physicians and rehabilitation specialists, it can be extremely difficult to adapt to the limitations of full or partial paralysis. The interdisciplinary team at Kindred specializes in developing treatment plans that help spinal cord injury patients regain independence and function.”

Success Spotlight: Brooke’s Story

On the road to recovery after a traumatic accident

Brooke was riding on a motorcycle when she suffered a serious accident and had to be rushed to the hospital where she was treated for a traumatic brain and spinal injury. She had to have delicate brain surgery to relieve the pressure inside her skull and had to have a ventilator placed to support her breathing. She remained at the facility in intensive care and was able to be taken off the ventilator before being transferred to Kindred Hospital to receive ongoing medical care and begin rehabilitation.

When she was first admitted, Brooke was completely dependent on her caregivers for all her needs and mobility. Although her mental faculties were still in the early stages of recovery and she was confused and disoriented and unable to communicate, her team of caregivers began to work with her to help increase her strength, mobility and comprehension. With help from her speech therapist, Brooke regained the ability to swallow and received dedicated help with vocalizing and improving her cognitive abilities. She was able to begin drinking and eating a normal diet once again and made excellent progress with her physical and occupational therapists who helped her go from being bedbound to standing up and walking with the aid of a walker. Brooke also improved in the areas of comprehension and speech and by the time she was discharged to continue with specialized rehab, she had made significant gains in all areas of her recovery and was looking forward to the next stage in her journey to recovery.