Injuries to the spinal column and/or spinal cord are caused by trauma (including car accident, gunshot and falls) or disease (such as polio, spina bifida, Friedreich’s Ataxia). The trauma fractures or dislocates vertebrae, the fragments of which bruise or tear into the spinal cord tissue. Most injuries to the spinal cord do not completely sever it, but the fractures and compression of the vertebrae crush and destroy axons—parts of the nerve cells that carry messages along the spinal cord. These axons provide the communication link between the brain and the rest of the body, and the extent of the injury will determine the patient’s prognosis. Some patients are able to recover completely, while in other cases, the result is permanent, complete paralysis.
Spinal cord injuries are generally classified as either complete or incomplete. An incomplete injury means that the spinal cord has retained at least some of its ability to convey messages to and/or from the brain. These patients usually have some motor and/or sensory function below the site of the injury. A complete spinal cord injury means a total lack of sensory and motor function below the level of injury. The level of injury is a determining factor in which parts of the body will be affected by paralysis and loss of function.
For most spinal cord injury patients, other medical complications often result. These may include chronic pain, bladder/bowel dysfunction, sexual dysfunction and an increased susceptibility to respiratory and/or heart problems. These chronic conditions must be maintained on a daily basis.
In the United States, there are approximately 450,000 people living with spinal cord injuries, with about 100,000 new cases occurring each year. More than 80% of new patients are males, ages 16-30. Quadriplegia (paralysis of all four limbs or of the entire body below the neck) is slightly more common than paraplegia (impairment in motor and/or sensory function of the lower extremities).
Immediate care combined with aggressive treatment and rehabilitation can improve possible outcomes for many people with spinal cord injuries. In many cases, quality emergency care can minimize nervous system damage and may restore some abilities. Medications, surgeries and physical therapy may be successful with spinal cord injuries, depending on the location of the vertebrae involved and the severity of damage to the spinal cord. In approximately one-third of patients with vertebrae damage in the neck area, assistance with breathing will be required. Skill-building activities can be a vital part of physical and occupational therapies, and counseling may provide social and emotional support.
While there is currently no cure, improvements to functioning may be regained days, weeks, and in very rare cases years, after the injury occurs. The swelling of the spinal cord that typically occurs with a spinal cord injury usually abates after some passage of time and may allow a patient to recover some functioning that was initially lost at the time of the injury. Only a very small number of people who suffer a spinal cord injury recover all lost functioning.