Learn About Acute Spinal Cord Injury
The spinal cord contains the nerves that carry messages between the brain and the rest of the body. The spinal cord starts at the brain and extends down the neck and back inside the vertebrae.
Acute spinal cord injury (SCI) is a sudden traumatic injury that either results in a bruise, a partial injury or a complete injury to the spinal cord.
Partial Spinal Cord Injury—sometimes called an incomplete injury, the spinal cord is able to carry some messages to and from the brain to the rest of the body.
Complete Spinal Cord Injury—the spinal cord is unable to carry messages to and from the brain to the rest of the body, resulting in a near-total loss of motor and sensory function.
Causes of Acute Spinal Cord Injury
There are many causes of SCI, but most injuries occur when the area of the spine or neck is bent or compressed. The most common causes of SCI are:
- Motor vehicle accidents
- Violence (gunshots or stab wounds)
- Sports injuries
- Diving accidents
- Trampoline accidents
Incidence of Acute Spinal Cord Injury
- SCI is a common cause of permanent disability and death in children and adults
- Approximately 12,000 people in the United States sustain a spinal cord injury every year
- About 255,000 people in the United States are living with a spinal cord injury
- About 77 percent of all SCI are male
- Approximately 53 percent of all spinal cord injuries occur in patients between the ages of 16 and 30 years
Symptoms of an Acute Spinal Cord Injury
Symptoms of spinal cord injury depend on the severity and location of the injury. Usually, symptoms are more severe the higher up the spinal cord injury is. For example, an injury on the neck, at C1 or C2 (the first and second cervical vertebrae in the spinal column), affects the respiratory muscles and the ability to breathe. A lower injury, in the lumbar vertebrae, may affect the nerve and muscle control to the bladder, bowel and legs.
The following are the most common symptoms of acute spinal cord injuries. However, each individual may experience symptoms differently. Symptoms may include:
- muscle weakness
- loss of voluntary muscle movement in the chest, arms or legs
- breathing problems
- loss of feeling in the chest, arms or legs
- loss of bowel and bladder function
Types of Acute Spinal Cord Injury
SCI is classified according to the patient's type of loss of motor and sensory function. The following are the main classifications:
- Quadriplegia (tetraplegia)—involves loss of movement and sensation in all four limbs (arms and legs). Quadriplegia also affects the chest muscles and may require a mechanical breathing machine for the patient
- Paraplegia—involves loss of movement and sensation in the lower half of the body (right and left legs)
Different kinds of support braces called cervical orthoses are used to keep the spine immobilized while healing. Orthoses are usually used after an injury or after surgery to prevent secondary injuries to the spine.
There are four basic types of cervical orthoses:
Cervical collars (C-collars)—These collars are popular for treating different conditions of the cervical spine. The C-collars come in two forms:
- Soft C-collars generally do not restrict motion but provide comfort and warmth and serve as a reminder to patients to limit their motion.
- Rigid C-collars are made of plastic that consists of two pieces, a front and a back that are attached on the sides with Velcro® and provide support in the front under the chin and in the back at the base of the head. These orthoses (the Philadelphia, Aspen and Miami J) restrict cervical motion, particularly side-to-side and front-to-back flexion and extension of the head.
Poster Type—These types of orthoses are usually made of a combination of aluminum and plastic, and they consist of three parts (head, chin and chest) that support the spine and restrict movement of the (cervical) spine. Examples of poster type orthoses include:
- SOMI (sternoooccipital-mandibular immobilizer)
- Four-poster cervical orthosis
- Guilford two-poster orthosis
Cervical Thoracic Orthoses (CTO)—These types of orthoses extend from the chest to the chin and provide multilevel cervical immobilization that prevents motion between the cervical spine and thorax (chest).
Halo Orthoses—These are for patients who require the most cervical stability. The halo consists of a metal ring that is secured to the skull with pins and then fastened to two metal rods that attach to a thoracic vest. The patient's skull is held in position relative to their trunk, preventing all movement of the head and neck.
Thoracolumbosacral Orthosis (TLSO)—This type of orthosis is a rigid brace made from plastic and is often custom-made in one piece with a single opening or two pieces with openings on sides located under the arms. It spans from the thorax (chest) to the sacrum (tail bone) and supports the spinal column from the middle to lower back—from the sixth thoracic vertebrae (T6) to the sacrum. The TLSO will keep the middle to lower back immobile by limiting forward and backward movement and twisting from side-to-side.