Injury to the Spinal Cord can occur due to trauma to any part of the spine from the cranium to the upper lumbar region where the spinal cord terminates. Trauma to the spinal cord is commonly associated with damage to the spine itself. Often, a fracture of the spine occurs in relation to the injured central nervous system tissue. The area where the spinal cord is injured dictates the level of function, as dysfunction develops below that specific level. Spinal cord injuries are classified as either incomplete or complete. Incomplete injuries show preservation of some function below the injured level. Complete injuries are characterized by a total lack of both motor and sensory function in motor-sensory and electrical modalities below the level of the injury.
Symptoms: Spinal cord injury presents with severe pain, limited mobility, or paralysis after a specific accident or trauma to the spine.
Diagnosis: Patients with spinal cord injury need to be thoroughly examined on admission to assess any preservation of function, including peri-anal and rectal examinations and testing of all reflexes and motor and sensory functions. Sematosensory evoked potentials (SSEP) are also a possible adjunctive test. They examine the ability of the spinal cord to transmit impulses by stimulating an area of the leg or arm with a weak electrical current, and determining whether or not this stimulus can be detected over the corresponding part of the brain. Wherever possible, radiographic studies (x-rays, CT scan) need to be performed in a timely manner. An MRI is indicated wherever possible to identify the injured spinal cord and any foreign tissues in the spinal canal, such as a fragment of bone or disc material.
Treatment: Surgery to correct a spinal deformity that narrows the spinal canal is often performed but is unlikely to reverse any major spinal cord dysfunction; however, removing bone or disc material from the spinal canal in a timely basis can promote the recovery of an incompletely injured cord. Patients with cervical spinal fractures are often placed in traction to try to realign the spinal canal to relieve any ongoing pressure on the spinal cord. Some spinal injuries that result in spinal cord trauma are stable and do not require surgery. In the cervical spine, fractures are sometimes treated with immobilization devices such as a halo external fixation device. Unstable fractures in the thoraco-lumbar region may require instrumented fusion.
For more information about spine related conditions and treatments, visit the UCLA Spine Center at at spinecenter.ucla.edu.