Spinal cord trauma

Spinal cord injury; Compression of spinal cord

Symptoms vary somewhat depending on the location of the injury. Spinal cord injury results in varying degrees of weakness and sensory loss at and below the injury. The pattern depends on whether the entire cord is injured (complete) or only partially (incomplete).

The spinal cord doesn't go below the 1st lumbar vertebra, so injuries at and below this level do not cause spinal cord injury. However, they may cause "cauda equina syndrome" -- injury to the nerve roots in this area.

CERVICAL (NEAR THE NECK) INJURIES

When spinal cord injuries occur near the neck, varying degrees of symptoms can affect both the arms and the legs:

• Weakness, paralysis
• Breathing difficulties (from paralysis of the breathing muscles)
• Spasticity (increased muscle tone)
• Sensory changes
• Numbness
• Pain
• Loss of normal bowel and bladder control (such as constipation, incontinence, bladder spasms)

THORACIC (CHEST-LEVEL) INJURIES

When spinal injuries occur at chest level, varying degrees of symptoms can affect the legs:

• Weakness, paralysis
• Breathing difficulties (from paralysis of the breathing muscles)
• Spasticity (increased muscle tone)
• Sensory changes
• Numbness
• Pain
• Loss of normal bowel and bladder control (such as constipation, incontinence, bladder spasms)

Injuries to the cervical or high thoracic cord may also result in blood pressure problems, abnormal sweating, and trouble maintaining regular body temperature.

Spinal cord injury is a medical emergency requiring immediate attention.

The health care provider will perform a physical exam, including a neurological exam. This will help identify the exact location of the injury, if it is not already known. Some of the person's reflexes may be abnormal or absent. Once swelling goes down, some reflexes may slowly recover.

The following tests may be ordered:

• Spine x-rays may show fracture or damage to the bones of the spine.
• A CT scan or MRI of the spine may show the location and extent of the damage and reveal problems such as blood clots (hematomas).
• Myelogram (an x-ray of the spine after injection of dye) may be necessary in rare cases.
• Somatosensory evoked potential (SSEP) testing or magnetic stimulation may show if nerve signals can pass through the spinal cord.