SPINAL CORD INJURY

What is the spinal cord?

The spinal cord is a collection of nerves that

travels from the bottom of the brain down
your back. There are 31 pairs of nerves that
leave the spinal cord and go to arms, legs,
chest and abdomen. These nerves allow your
brain to give commands to your muscles and
cause movements of your arms and legs.
The spinal cord is
very sensitive to
injury. Unlike other
parts of your body,
the spinal cord
does not have the
ability to repair
itself if it is
damaged
 What is spinal cord injury?
• A spinal cord injury (SCI) refers to any injury
to the spinal cord that is caused
by trauma instead of disease.  Depending on
where the spinal cord and nerve roots are
damaged, the symptoms can vary widely, from
pain to paralysis to incontinence.
 Spinal cord injuries are described as either
complete or incomplete.
• In a complete spinal cord injury there is
complete loss of sensation and muscle
function in the body below the level of the
injury.
• In an incomplete spinal cord injury there is
some remaining function below the level of
the injury. In most cases both sides of the
body are affected equally.
Spinal cord trauma
is damage to the
spinal cord. It may
result from direct
injury to the cord
itself or indirectly
from disease of the
surrounding bones,
tissues, or blood
vessels
 Causes and risk factors
Spinal cord injury can be caused by a number of injuries
to the spine, including:
• Assault
• Falls
• Gunshot wounds
• Industrial accidents
• Motor vehicle accidents
• Sports injuries (particularly diving into shallow water)
• A minor injury can cause spinal cord injury if the spine is
weakened, such as from rheumatoid arthritis or
osteoporosis if the spinal canal protecting the spinal cord
has become too narrow (spinal stenosis) due to the
normal aging process.
Causes of spinal cord injury
• An injury to the upper portion of the spinal
cord in the neck can cause quadriplegia-
paralysis of both arms and both legs. If the
injury to the spinal cord occurs lower in the
back it can cause paraplegia-paralysis of both
legs .
CERVICAL (NECK) INJURIES
• When spinal cord injuries occur in the neck area,
symptoms can affect the arms, legs, and middle of the
body. The symptoms may occur on one or both sides of
the body. Symptoms can also include breathing
difficulties from paralysis of the breathing muscles, if
the injury is high up in the neck.
THORACIC (CHEST LEVEL) INJURIES
• When spinal injuries occur at chest level, symptoms
can affect the legs. Injuries to the cervical or high
thoracic spinal cord may also result in blood pressure
problems, abnormal sweating, and trouble maintaining
normal body temperature.
LUMBAR SACRAL (LOWER BACK) INJURIES
• When spinal injuries occur at the lower back
level, symptoms can affect one or both legs, as
well as the muscles that control the bowels
and bladder. 
 Symptoms

• Injuries at any level can cause:

• Increased muscle tone (spasticity)
• Loss of normal bowel and bladder control (may
include constipation, incontinence, bladder
spasms)
• Numbness
• Sensory changes
• Pain
• Weakness, paralysis
 Diagnostic test to confirm SCI
• In the emergency room, a doctor may be able
to rule out a spinal cord injury by careful
inspection, testing for sensory function and
movement, and asking some questions about
the accident. But if the injured person
complains of neck pain, isn't fully awake, or
has obvious signs of weakness or neurological
injury, emergency diagnostic tests may be
needed.
• Spinal cord injury is a medical emergency that
needs immediate medical attention.
• The health care provider will perform a
physical exam, including a brain and nervous
system (neurological) exam..
The following tests may be ordered
X-rays.
  Medical personnel typically order these tests
on people who are suspected of having a
spinal cord injury after trauma. X-rays can
reveal vertebral (spinal column) problems,
tumors, fractures or degenerative changes in
the spine.
 Computerized tomography (CT) scan.
 A CT scan may provide a better look at
abnormalities seen on an X-ray. This scan uses
computers to form a series of cross-sectional
images that can define bone, disk and other
problems.
• Magnetic resonance imaging (MRI).
 MRI uses a strong magnetic field and radio
waves to produce computer-generated
images. This test is very helpful for looking at
the spinal cord and identifying herniated disks,
blood clots or other masses that may be
compressing the spinal cord.
Medical and surgical management
• Unfortunately, there's no way to reverse
damage to the spinal cord. But, researchers
are continually working on new treatments,
including prostheses and medications that
may promote nerve cell regeneration or
improve the function of the nerves that
remain after a spinal cord injury.
 Early (acute) stages of treatment
In the emergency room, doctors focus on:
• Maintaining your ability to breathe
• Preventing shock
• Immobilizing your neck to prevent further
spinal cord damage
• Avoiding possible complications, such as stool
or urine retention, respiratory or
cardiovascular difficulty, and formation of
deep vein blood clots in the extremities
• Medications. 
Methylprednisolone (Medrol) is a treatment
option for an acute spinal cord injury. If
methylprednisolone is given within eight hours
of injury, some people experience mild
improvement. It appears to work by reducing
damage to nerve cells and decreasing
inflammation near the site of injury. However,
it's not a cure for a spinal cord injury.
• Immobilization.
 You may need traction to stabilize your spine,
to bring the spine into proper alignment or
both. Sometimes, traction is accomplished by
securing metal braces, attached to weights or
a body harness, to your skull to keep your
head from moving. In some cases, a rigid neck
collar may work. A special bed also may help
immobilize your body.
• Surgery. 
Often, surgery is necessary to remove
fragments of bones, foreign objects, herniated
disks or fractured vertebrae that appear to be
compressing the spine. Surgery may also be
needed to stabilize the spine to prevent future
pain or deformity.
• Experimental treatments. 
Scientists are trying to figure out ways to stop
cell death, control inflammation and promote
nerve regeneration.
THANK YOU