Acute Spinal Cord Injury

What is an acute spinal cord injury?

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 either results in a bruise (also called a contusion), a partial tear, or a complete tear (called a transection) in the spinal cord. SCI is a common cause of permanent disability and death in children and adults.

About 12,000 people a year sustain a spinal cord injury. As many as 229,000 to 306,000 people in the US are living with a spinal cord injury, according to the Spinal Cord Injury Information Network. More than half of all SCIs occur among young people between the ages of 16 and 30 years. The majority of SCI victims (80.9 percent) are male.

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 typically 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
• violence (gun shots or stab wounds)

Treatment of an acute spinal cord injury:

Specific treatment for an acute spinal cord injury will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the SCI
• type of SCI
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the SCI
• your opinion or preference

SCI requires emergency medical attention on the scene of the accident or injury. This is accomplished by immobilizing the head and neck areas to prevent the patient from moving. This may be very difficult since the victim and/or bystanders may be very frightened after the traumatic incident.

There is currently no way to repair a damaged or bruised spinal cord, though researchers are actively seeking means of stimulating spinal cord regeneration. The severity of the SCI and the location determines if the SCI is mild, severe, or fatal.

Surgery is sometimes necessary to evaluate the injured cord, stabilize fractured back bones, decompress (or release) the pressure from the injured area, and to manage any other injuries that may have been a result of the accident. Treatment is individualized, depending on the extent of the condition and the presence of other injuries.

Treatment may include:

• observation and medical management in the intensive care unit (ICU)
• medications, such as corticosteroids (to help decrease the swelling in the spinal cord)
• mechanical ventilator, a breathing machine (to help the patient breathe)
• Foley catheter – a tube that is placed into the bladder that helps to drain the urine into a collection bag.
• feeding tube (placed through the nostril to the stomach, or directly through the abdomen into the stomach, to provide extra nutrition and calories)

Recovery from a SCI requires long-term hospitalization and rehabilitation. An interdisciplinary team of physicians, nurses, therapists (physical, occupational, or speech), and other specialists work to medically manage the patient to control pain, to monitor the heart function, blood pressure, body temperature, nutritional status, bladder and bowel function, and attempt to control involuntary muscle shaking (spasticity). Rehabilitation focuses on preventing muscle wasting and contractures, and works to retrain the patient to use other muscles to aid in mobility and movement.