Spinal Cord Injuries
What Is a Spinal Cord Injury?
A spinal cord injury is when the spinal cord gets cut, bruised, stretched, or poked. It can change the way the body moves, feels, and functions.
Right after an injury, doctors don’t always know what a person’s long-term outlook will be. Recovery can continue for up to 2 years after the injury. A trained medical team can help someone with a spinal cord injury get the medical care they need for their best recovery.
What Is the Spinal Cord?
The spinal cord is a cable that goes from the brain down to the lower back. It is made up of nerves. Nerves are cells that carry movement and feeling messages from the brain to the rest of the body and from the body back to the brain.
The spinal cord controls:
- how muscles move
- body functions such as breathing and going to the bathroom
- feelings (sensations) such as hot, cold, vibration, touch, and being aware of the body’s position and movement
What Can Cause a Spinal Cord Injury?
Spinal cord injuries can happen from things like car accidents, diving accidents, gunshot wounds, tumors, or spinal surgery.
What Problems Can Happen From a Spinal Cord Injury?
Different parts of the spinal cord control different body parts. From the top to the bottom, the nerves in the spinal cord are:
- 7 cervical nerves (C1-7), which control the muscles used to breathe and to move the arms and hands
- 12 thoracic nerves (T1-12), which control the muscles used to sit and balance and some muscles used to breathe
- 5 lumbar nerves (L1-5), which control the muscles used to move the hips, legs, and feet
- 5 sacral nerves (S1-5), which control the muscles used to go to the bathroom and have sex
When the spinal cord is injured, the nerves can’t carry messages like they usually do:
- An incomplete injury blocks only some nerve messages. Others might get carried to below the level of the injury.
- A complete injury blocks all nerve messages. None can go below the level of the injury.
Separate areas of the spinal cord control muscle movements and sensations. The front of the spinal cord controls movement, and the back and sides control sensations.
What Is Spinal Shock?
Spinal shock is swelling of the spinal cord after an injury. It can last for weeks to months. It can be hard to tell what long-term problems someone might have until the spinal shock goes away.
How Are Spinal Cord Injuries Diagnosed?
Right after the injury, doctors will do tests to look at the spinal cord, the spine (the bones that make up the backbone and protect the spinal cord), and the surrounding bones and tissues. They might order:
To check how the nerves are working, doctors do tests such as an electromyogram (EMG). An EMG stimulates muscles with electric pulses to see which muscles the nerves can reach.
How Are Spinal Cord Injuries Treated?
Treatment for a spinal cord injury depends on what muscles, sensations, and functions are involved. It also depends on whether the bones of the spine were damaged. Treatment can include:
- help with breathing
- help peeing with a catheter (a small straw-like tube)
- surgery on the spine to make it more stable or make sure it doesn’t press on the spinal cord
Long-term treatments include helping people live with changes caused by the injury. This is called rehabilitation (or rehab) and can include:
- Learning how to use a wheelchair or walk with crutches.
- Learning how to empty the bladder and bowel.
- Doing exercises to regain as much strength as possible.
- Help with ordering special equipment for home such as a commode or walker.
- Learning new ways to do enjoyable activities.
- Getting ready to go back to school and/or work.
- Finding ways to cope with feelings of frustration, fear, sadness, and anger.
Other treatments are being studied to see how they can help people with a spinal cord injury.
How Can Parents Help?
Everyone reacts differently after a serious injury. Your child may feel angry, sad, nervous, or not seem to be feeling anything at all. They may want to be left alone or might want you with them a lot. They may talk back or not listen. These reactions are normal and OK at first. Your child needs time to adjust to the injury.
To help your child:
- Reassure your child that they are safe now and you will make sure they get the medical care they need.
- Try to be calm and reassuring. Remind your child that the medical team has helped other kids with similar injuries and will help them too.
- Tell your child that no matter what they’re feeling, it’s OK. This lets them know that they can talk to you about all types of feelings.
- Let your child know that you’re there if they want to talk about what happened but if they aren’t ready to talk, that’s OK too.
- Consider having your child to talk to a mental health specialist to learn healthy ways to cope with how they feel about their injury.
- Involve your child in medical discussions in age-appropriate ways. Be honest with your child about the procedures, tests, and therapies they will need.
- Keep a routine as much as possible. It can help when your child knows what to expect.
- Increase time with family and friends so your child feels loved and supported.
- Help your child find relaxing and fun things to do. Read a book aloud together, watch an upbeat series, or follow a sports team together. If your child is able, do a craft together.
- During rehab, support your child by helping them set goals with their therapists, telling them how proud you are of their hard work, celebrating their progress, and accepting “off” days as a part of getting better.
- Take care of yourself. It is harder to care for your child when you are worried and upset. Make time to deal with your own feelings by talking to family, friends, clergy, your doctor, or a mental health specialist.
Most kids start to adjust a few weeks after a spinal cord injury. But some kids have stronger, longer-lasting feelings. Talk to someone on your care team, a counselor, psychologist, or social worker if your child doesn’t seem to be feeling better, is very sad, often talks about dying, or ever talks about self-harm.
What Else Should I Know?
When a child has a spinal cord injury, it affects everyone in the family. Find out about your child’s injury and about spinal cord injuries in general. Your care team can help with any questions you have.
You also can find more information and support online at:
- Limited Mobility Factsheet (for Schools)
- Compression Fracture of the Spine
- Spinal Fusion Surgery
- Magnetic Resonance Imaging (MRI): Cervical Spine
- Magnetic Resonance Imaging (MRI): Lumbar Spine
- X-Ray Exam: Cervical Spine
- Nervous System