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The spinal cord is a bundle of nerves that carries messages between the brain and the rest of the body.
Acute spinal cord injury (SCI) is due to a traumatic injury that can either result in a bruise (also called a contusion), a partial tear, or a complete tear (called a transection) in the spinal cord. About 250,000 to 400,000 individuals in the US have a spinal cord injury. About 60 percent of these cases are 30 years old or younger.
SCI results in a decreased or absence of movement, sensation, and body organ function below the level of the injury. The most common sites of injury are the cervical and thoracic areas. SCI is a common cause of permanent disability and death in children and adults.
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Anatomy of the spine:
The spine consists of 33 vertebrae, including the following:
7 cervical (neck)
12 thoracic (upper back)
5 lumbar (lower back)
5 sacral* (sacrum - located within the pelvis)
4 coccygeal* (coccyx - located within the pelvis)
These vertebrae function to stabilize the spine and protect the spinal cord. In general, the higher in the spinal column the injury occurs, the more dysfunction a person will have.
Injury to the vertebrae does not always mean the spinal cord has been damaged. Likewise, damage to the spinal cord itself can occur without fractures or dislocations of the vertebrae.
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What are the types of SCI?
SCI can be divided into two main types of injury:
complete injury
Complete injury means that there is no function below the level of the injury - either sensation and movement - and both sides of the body are equally affected. Complete injuries can occur at any level of the spinal cord.
incomplete injury
Incomplete injury means that there is some function below the level of the injury - movement in one limb more than the other, feeling in parts of the body, or more function on one side of the body than the other. Incomplete injuries can occur at any level of the spinal cord.
What causes an acute spinal cord injury?
There are many causes of SCI. The more common injuries occur when the area of the spine or neck is bent or compressed, as in the following:
birth injuries, which usually affect the spinal cord in the neck area
falls
motor vehicle accidents (where the person is either riding as a passenger in the car or is struck as a pedestrian)
sports injuries
diving accidents
trampoline accidents
Penetrating injuries that pierce the cord, such as gunshots and stab wounds may also cause damage.
What are the symptoms of an acute spinal cord injury?
Symptoms vary depending on the severity and location of the SCI. At first, the patient may experience spinal shock, which causes loss of feeling, muscle movement, and reflexes below the level of injury. Spinal shock usually lasts from several hours to several weeks. As the period of shock subsides, other symptoms appear, depending on the location of the injury.
Generally, the higher up the level of the injury to the spinal cord, the more severe the symptoms. For example, an injury at C2 or C3 (the second and third vertebrae in the spinal column), affects the respiratory muscles and the ability to breathe. A lower injury, in the lumbar vertebrae, may affect nerve and muscle control to the bladder, bowel, and legs.
SCI is classified according to the person's type of loss of motor and sensory function.
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