Spinal Cord Injuries

Symptoms and Diagnosis

Symptoms in patients with SCI depend on severity and location of the injury. Complete injuries cause more paralysis, as do injuries higher in the spinal cord. Symptoms include intense pain in the back or neck, loss of movement, tingling or loss of sensation, balance problems, amplified reflexes and muscle spasms, bladder and bowel control problems, and changes in sexual function. Loss of consciousness and breathing difficulties may also indicate severe spinal damage.

Emergency cases are diagnosed using X-rays and computerized tomography (CT) to check for bone and disc degenerative changes. Magnetic resonance imaging (MRI) and myelography also illustrate spinal nerves, blood clots, and masses more accurately. Patients should be followed each month with repeated neurological examinations and spine imaging to forestall further complications.

Complications

SCI can lead to chronic pain, urinary and fecal incontinence, sexual dysfunction, infertility, kidney infections, and muscle spasticity. Lying for long periods in bed can cause painful pressure sores and puts the patient at risk for deep vein thrombosis or lethal blood clots that can travel to the lungs. Weak respiratory muscles cause breathing difficulties and recurrent pneumonia. Another phenomenon known as autonomic dysreflexia can result in seizures or strokes. SCI patients undergo muscle atrophy and later gain weight because of lifestyle changes. The psychological stress caused by SCI can also lead to depression and alcohol abuse.

Treatment

SCI can be prevented by driving safely, avoiding falls, and wearing proper protection during athletic activities. The goals of treating SCI are to allow patients to enjoy an active, fruitful life and to prevent complications [Page 1595]from further injury. Emergency medical personnel first respond to acute injuries by immobilizing the spine with a rigid board and neck collar. A steroid drug that reduces tissue inflammation, methylprednisolone, can prevent further nerve damage in some patients if given within eight hours of injury. Although emergency surgery is controversial, some surgeons may remove bone fragments and herniated discs endangering the spinal cord.

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