The spine is like a control tower for your bones and muscles. For example, when you want to scroll down reading this blog post, your brain sends a message down your spinal cord to the nerves that control your arm and fingers. Then, you know exactly how to position and move your fingers.
That’s why spinal cord injuries can instantly change lives forever.
The damage makes it challenging—or impossible—for the spinal cord to transmit and receive messages from the brain and body. This can make it difficult—or impossible—to move.
In the general population, according to the American Association of Neurological Surgeons (AANS), the leading causes of spinal cord injury are:
- Car accidents
- Falls
- Gunshots
Spinal cord injuries affect thousands of lives
Some 450,000 people in the US have a spinal cord injury, according to the AANS. And an estimated 11,000 additional spinal cord injuries occur every year, mostly in people between ages 16 and 30.
Jessica Berry, MD, Director of Spinal Cord Injury Services and Assistant Professor of Clinical Physical Medicine and Rehabilitation at Penn Medicine, often works with patients after a spinal cord injury.
Dr. Berry says when someone has a sudden, acute injury to the spinal cord, the person might experience:
- Weakness in arms, legs, or trunk
- Change in sensation or numbness at points below the injury
- Changes in urinary or bowel movements
- Difficulty breathing
- Extreme pain or pressure in the neck, head, or back
- Partial or complete loss of control over parts of the body
- Trouble balancing or walking
This happens as bone fragments or disc material tear into the spinal cord tissue, or ligaments become bruised, according to the National Institute of Neurological Disorders and Stroke.
“I develop a relationship with the person after they been stabilized,” Dr. Berry says. “They come to inpatient rehab after hospitalization, and we work on promoting recovery of lost functions and teaching skills to the person’s new level of function.”
While males are more likely to experience a spinal cord injury—80% vs. 20% in females, according to Dr. Berry—she says that doesn’t mean they have an inherent risk. “It tends to do more with regard to the types of behaviors they’re engaged in that put them at risk,” she explains.
If An Accident Happens
Emergency medicine technicians who respond to potential spinal cord injury calls will immobilize the spine at the scene, according to the AANS. This means they stop the person from moving to avoid further trauma. They will use a backboard, stretcher, or cervical collar to decrease movement until physicians can evaluate the person in a hospital.
“It’s definitely very scary,” Dr. Berry says. “Symptoms occur quickly.”
In some cases, the patient requires emergency surgery if a herniated disc or blood clot is compressing the spinal cord. Surgery might also be used to stabilize the spine and prevent pain or deformity, says the American Association of Neurological Surgeons.
Road To Recovery
Recovery after a spinal cord injury varies from person to person.
For example, Dr. Berry says that if a person is paraplegic, he might not have use of their legs or trunk muscles. A rehab physician and physical therapist will work with the person to teach them how to use a wheelchair, dress, bathe, and care for themselves.
Sometimes, the work requires help from caregivers. Other times, the patient has the physical capacity to do more for themselves. It all depends on the degree of the injury.
Another piece of recovery involves managing medications. Following a spinal cord injury, Dr. Berry says medications might help control:
- Bowel and bladder dysfunctions
- Pain
- Muscle spasticity
- Blood pressure
- Other health issues
Physical medicine and rehabilitation physicians work with patients to manage all of those issues, in addition to the injury itself.
Once the patient completes the inpatient rehab phase, the person is discharged, Dr. Berry says. “Then, they will follow up with a physical medicine physician for the remainder of their life to manage any issues.”