Spinal Injury

Overview

A spinal injury is any damage to the structures of the spine, which include the bones (vertebrae), the cushioning discs between them, the supporting ligaments and muscles, and the spinal cord that runs through the center. Injuries range widely in severity, from a mild muscle strain or a stable fracture to damage of the spinal cord itself, which can cause permanent loss of movement and sensation below the level of injury.

Spinal cord injury is the most serious form because the cord carries the signals between the brain and the rest of the body. Because the consequences can be severe, any suspected spinal injury after a significant accident is treated as an emergency, and the person should not be moved unless absolutely necessary. Many spinal injuries, however, involve the bones and soft tissues without cord damage and recover well.

Symptoms

Symptoms depend on where the injury is and whether the spinal cord is involved. Warning signs that the spinal cord may be affected include:

• Weakness, numbness, or paralysis in the arms or legs
• Tingling or loss of sensation
• Loss of bladder or bowel control
• Difficulty walking or maintaining balance
• Problems breathing, with high neck injuries

Injuries to the bones and soft tissues may cause:

• Back or neck pain, sometimes severe
• Stiffness and muscle spasm
• Tenderness over the spine

Any back or neck injury accompanied by weakness, numbness, or loss of bladder or bowel control is an emergency.

Causes

Spinal injuries usually result from a sudden force to the spine:

• Falls: A leading cause, especially in older adults.
• Motor vehicle and motorcycle crashes: A major cause of spinal cord injuries.
• Sports and recreation: Diving into shallow water, contact sports, and high-impact activities.
• Violence: Including gunshot and stab wounds.
• Disease and weak bones: Osteoporosis, tumors, or infection can weaken the spine and lead to fractures with little force.

Risk Factors

• Engaging in high-risk sports or activities
• Older age and conditions that increase falls
• Osteoporosis or other bone-weakening conditions
• Not using seat belts or protective equipment
• Alcohol or drug use that impairs coordination and judgment
• Existing spine disorders such as arthritis

Diagnosis

In an emergency, doctors first stabilize the spine and assess movement, sensation, and reflexes. Imaging then defines the injury:

• CT scan: Quickly shows fractures and bone injury.
• MRI: The best test to assess the spinal cord, discs, ligaments, and soft tissues.
• X-rays: Used to look at alignment and detect some fractures.

A detailed neurological examination determines the level and completeness of any spinal cord injury, which guides treatment and prognosis.

Treatment

Treatment depends on the type and severity of the injury:

• Immobilization and stabilization: A collar or brace protects the spine; emergency teams keep the spine still during transport.
• Conservative care: Rest, pain control, and physical therapy for many strains and stable fractures.
• Surgery: To stabilize unstable fractures, relieve pressure on the spinal cord or nerves, or repair damage.
• Rehabilitation: Physical and occupational therapy are central to recovery, especially after spinal cord injury.

For serious spinal cord injuries, care focuses on preventing further damage, managing complications, and maximizing independence through rehabilitation and supportive devices.

Prevention

• Always wear seat belts and use appropriate child safety seats
• Use proper protective gear in sports and check water depth before diving
• Reduce fall hazards at home, especially for older adults
• Keep bones strong with adequate calcium, vitamin D, and exercise
• Avoid driving or operating equipment under the influence of alcohol or drugs

When to See a Doctor

Call emergency services immediately and do not move the person if a back or neck injury is suspected and there is:

• Weakness, numbness, paralysis, or tingling in the limbs
• Loss of bladder or bowel control
• Severe back or neck pain after trauma
• Difficulty breathing or a head injury with neck pain

Keep the person still until help arrives. Seek medical care for any back or neck injury that causes persistent pain, even if these emergency signs are absent.

Related Topics

Frequently Asked Questions

References

1. Mayo Clinic. Spinal cord injury — Symptoms and causes.
2. National Institute of Neurological Disorders and Stroke (NINDS). Spinal cord injury.
3. MedlinePlus, U.S. National Library of Medicine. Spinal cord injuries.
4. American Association of Neurological Surgeons (AANS). Spinal cord injury.