Spinal cord injury

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Symptoms

By Mayo Clinic staff

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Illustration showing the area of the body affected by paraplegia and quadriplegia 
Spinal cord injuries

Your ability to control your limbs after spinal cord injury depends on two factors: the place of the injury along your spinal cord and the severity of injury to the spinal cord. The lowest normal part of your spinal cord is referred to as the neurological level of your injury. The severity of the injury is often called "the completeness" and is classified as either:

  • Complete. If almost all feeling (sensory) and all ability to control movement (motor function) are lost below the spinal cord injury, your injury is called complete.
  • Incomplete. If you have some motor or sensory function below the affected area, your injury is called incomplete. There are varying degrees of incomplete injury.

Additionally, paralysis from a spinal cord injury may be referred to as:

  • Tetraplegia or quadriplegia. This means your arms, hands, trunk, legs and pelvic organs are all affected by your spinal cord injury.
  • Paraplegia. This paralysis affects all or part of the trunk, legs and pelvic organs.

Your health care team will perform a series of tests to determine the neurological level and completeness of your injury.

Spinal cord injuries of any kind may result in one or more of the following signs and symptoms:

  • Loss of movement
  • Loss of sensation, including the ability to feel heat, cold and touch
  • Loss of bowel or bladder control
  • Exaggerated reflex activities or spasms
  • Changes in sexual function, sexual sensitivity and fertility
  • Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord
  • Difficulty breathing, coughing or clearing secretions from your lungs

Emergency signs and symptoms
Emergency signs and symptoms of spinal cord injury after an accident may include:

  • Extreme back pain or pressure in your neck, head or back
  • Weakness, incoordination or paralysis in any part of your body
  • Numbness, tingling or loss of sensation in your hands, fingers, feet or toes
  • Loss of bladder or bowel control
  • Difficulty with balance and walking
  • Impaired breathing after injury
  • An oddly positioned or twisted neck or back

When to see a doctor
Anyone who experiences significant trauma to his or her head or neck needs immediate medical evaluation for the possibility of a spinal injury. In fact, it's safest to assume that trauma victims have a spinal injury until proven otherwise because:

  • A serious spinal injury isn't always immediately obvious. If it isn't recognized, a more severe injury may occur.
  • Numbness or paralysis may result immediately or come on gradually as bleeding or swelling occurs in or around the spinal cord.
  • The time between injury and treatment can be critical in determining the extent of complications and the amount of recovery.

If you suspect that someone has a back or neck injury:

  • Don't move the injured person — permanent paralysis and other serious complications may result.
  • Call 911 or your local emergency medical assistance number.
  • Keep the person still.
  • Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving, until emergency care arrives.
  • Provide basic first aid, such as stopping any bleeding and making the person comfortable, without moving the head or neck.
References
  1. Spinal cord injury: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/sci/detail_sci.htm. Accessed June 28, 2011.
  2. Spinal trauma. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec21/ch311/ch311a.html. Accessed June 28, 2011.
  3. Spinal cord injury facts. American Association of Neurological Surgeons. http://www.aans.org/Patient%20Information/Fact%20Sheets.aspx. Accessed June 28, 2011.
  4. Hansebout RR, et al. Acute traumatic spinal cord injury. http://www.uptodate.com/home/index.html. Accessed June 21, 2011.
  5. Spinal cord injury (SCI): Prevention tips. Centers for Disease Control and Prevention. http://www.cdc.gov/ncipc/factsheets/sciprevention.htm. Accessed June 28, 2011.
  6. Spinal cord injury acts and figures at a glance. National Spinal Cord Injury Statistical Center. www.nscisc.uab.edu/public_content/pdf/Facts%202011%20Feb%20Final.pdf. Accessed June 28, 2011.
  7. Revel SMH. Symptom clusters in traumatic spinal cord injury: An exploratory literature review. Journal of Neuroscience Nursing. 2011;43:85.
  8. Abrams GM, et al. Chronic complications of spinal cord injury. http://www.uptodate.com/home/index.html. Accessed June 21, 2011.
  9. Fouad K, et al. Spinal cord injury and plasticity: Opportunities and challenges. Brain Research Bulletin. 2011;84:337.
  10. Van den Berg MEL, et al. Survival after spinal cord injury: A systematic review. Journal of Neurotrauma. 2010;27:1517.
  11. Marsh BC, et al. Movement rehabilitation after spinal cord injuries: Emerging concepts and future directions. Brain Research Bulletin. 2011;84:327.
  12. Fast facts: Spinal cord injury. ThinkFirst National Injury Prevention Foundation. http://www.thinkfirst.org/About/Facts.asp. Accessed July 1, 2011.
  13. Emken JL, et al. Feasibility of manual teach-and-replay and continuous impedance shaping for robotic locomotor training following spinal cord injury. Transactions on Biomedical Engineering. 2008;55:322.
DS00460 Oct. 22, 2011

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