Spinal Cord Injury (SCI)
UW Health Orthopedics and Rehabilitation in Madison, Wisconsin provides comprehensive treatment for spinal cord injury (SCI).
About Spinal Cord Injury
A spinal cord injury is damage to the spinal cord that results in loss of function. There is a disruption in the flow of communication transmitted by the nerves that control movement and sensation. This loss may include active movement, sensation and bowel or bladder function.
The spinal cord does not have to severed to cause loss of function. Trauma that results in bruising of the delicate spinal cord is most often the cause for the damage.
Anatomy of the Spinal Cord
The spinal cord is a column of many nerve cells and long nerve fibers that begin at the base of the brain and extend to the waist. The end of the spinal cord is called the conus medullaris. From this region, long nerve roots known as the cauda equina extend to the bottom of the sacrum.
Damage to the spinal cord or these nerve roots may result in loss of function. Spinal cord injuries may affect muscle control, sensation, bowel and bladder control and sexual functioning. Injuries in the first four cervical vertebrae may affect the ability to breathe. Some of the nerves transmit messages from brain down the spinal cord to the muscles of the body and control active movements of the trunk and extremities. Other nerves relay sensation from the areas of the body up to the brain and allow us to perceive touch, pressure, hot/cold, pain and the position of our body in space.
The spinal cord is protected by the vertebral column which consists of 33 vertebrae. The vertebrae are separated by intervertebral discs and are connected and stabilized by ligaments. The first seven vertebrae in our neck are called cervical vertebrae. The first one is named C1, and they consistently are named through C7. The next 12 vertebrae are called thoracic vertebrae, and a rib is attached to each one. They are named T1 through T12. There are five sacral vertebrae, which are fused, and then four coccygeal vertebrae (the tailbone). Spinal nerves that relay commands to the muscles and sensations from areas of the body enter and exit the spinal column between each vertebra.
Causes of Spinal Cord Injury
- Traumatic: The majority of spinal cord injuries are caused by trauma, resulting in fractures, dislocation or crushing of one or more vertebrae. These bones then press on the spinal cord and result in damage. Trauma may also cause damage to the ligaments, blood supply and the spinal nerves. Causes of trauma include automobile and motor cycle accidents, falls, sports and recreation injuries, and assaults.
- Nontraumatic: Nontraumatic causes of spinal cord injury include spinal cord tumors, degenerative spinal diseases, arthritis, bleeding within the spinal cord, ischemia (loss of blood supply), spondylosis (narrowing of the spinal canal), congenital conditions (spina bifida), radiation therapy, inflammations and infections.
Symptoms of Spinal Cord Injury
Symptoms of spinal cord injury include neck or back pain, loss of active movement or sensation, numbness or tingling, loss of bowel and/or bladder control, difficulty breathing or clearing secretions, or an oddly-positioned head or back. These symptoms, however minor, should be a red flag for a possible spinal cord injury.
Two major factors influence the extent of the injury:
- Location: The location or spinal level of the injury determines which muscles may be weakened or paralyzed and which sensory deficits are noted. This establishes the neurological level, or the lowest functioning segment of the spinal cord. Injuries in the cervical spine (neck region) may result in impairments in the arms and legs and the trunk. This is known as tetraplegia, formally called quadriplegia. Injuries in the thoracic, lumbar or sacral spine (back region) may result in loss of function in the trunk and legs. This is known as paraplegia.
- Severity: The severity of the injury determines if the injury is complete or incomplete. In a complete injury, nerve damage is severe enough that there is a complete disruption of nerve conduction, resulting in no voluntary movement or appreciation of sensation below the level of the injury. In an incomplete injury there is still some ability to transmit nerve signals. This provides some sensation and possibly muscle activity below the level of injury.
- National Spinal Cord Injury Association (NSCIA)
- The Spinal Cord Injury Information Network
- Paralyzed Veterans of America (PVA)
- The Christopher Reeve Paralysis Foundation (CRPF)
- Madison SCI Group