The spinal cord is one long, thin bundle of nerves that spans the length of the back carrying nervous impulses to and from various parts of the body to the brain.

Injury to the spinal cord is a serious and potentially debilitating event that occurs in around 5 per 100,000 people in the Western world, mostly as a result of road traffic accidents.

Common causes

Some of the major causes of spinal cord injury include:

• Road traffic accidents or vehicular accidents
• Falls
• Acts of violence
• Sports injuries

Symptoms

One of the most common features of spinal cord injury is paralysis. The severity of the injury is often referred to in terms of “completeness”. In cases where all feeling and control of movement is lost below the site of injury, the injury is termed complete. If some sensation and voluntary control is present, the injury is termed incomplete. Incomplete injuries vary in severity.

The injury may also be referred to in terms of the limbs involved and divided into the following:

• Tetraplegia or quadriplegia is paralysis that involves the hands, arms, trunk, legs and pelvic organs.
• Paraplegia is paralysis that involves the lower limbs, trunk and pelvic organs.

Spinal cord injury can lead to serious disability and have severe impacts on a person’s quality of life.

Pathology

The spinal cord injury may be caused in several ways. For example –

• The cord may be disrupted or torn
• The cord may be compressed due to a blood clot or a fracture of the vertebral bones
• Compression of blood vessels that supply the cord may prevent blood from reaching parts of the spinal cord tissue

Diagnosis and management

A careful evaluation of the injury and testing of sensory reflexes may be sufficient for a physician to rule out a spinal cord injury, but if the patient seems weak, confused or complains of neck pain, for example, the following emergency tests may be arranged.

X-ray – An X-ray can reveal vertebral abnormalities, tumors, fractures or degeneration of the spine.

Computed tomography (CT) scan – A CT scan generates cross-sectional images to provide a more detailed view of the problem areas detected using X-ray.

Magnetic resonance imaging (MRI) scan – This type of scan uses magnetic fields and radio waves to create images of the spine and is particularly useful for detecting herniated discs and masses that may be compressing the spine.