A spinal trauma is a condition which causes damage to different parts of the spinal cord which may include the spinal canal, spinal nerves, spinal vertebrae, etc. Spinal trauma may result in impaired sensory and motor control below the injury level. These traumas are the most devastating neurological conditions with a huge socioeconomic and psychological impact on the patients, care givers and the healthcare systems. Current advancements in the medical field have improved stability and survival rate of individuals affected by them.
Causes and risk factors of Spinal Trauma
Some of the most common causes of spinal trauma include:
- Road accidents
- A traumatic fall
- Violence (gunshots, stabbing etc.)
- Sports-related injuries
- Older individuals with degenerative bone disorders.
Signs and symptoms of Spinal Trauma
There are mainly two forms of spinal trauma: complete spinal cord injury (SCI) and incomplete spinal cord injury.
Complete SCI: This form of spinal trauma leads to complete loss of motor and sensory function below the injury level. Both right and left sides of the body are affected in complete SCI. This occurs due to disruption of blood supply to the spinal cord and uncontrolled bleeding causing neurogenic shock.
Incomplete SCI: This form of SCI allows for some movement below the level of injury, unlike in complete SCI. An individual affected with incomplete SCI may show better movement of one arm/leg than the other or better functioning of one side of the body when compared with the opposite side.
Sports injuries generally cause spinal concussions which exhibit symptoms such as numbness, tingling, burning or electric-shock sensation.
When to seek emergency medical care after a traumatic injury?
Individuals experiencing any of the following signs after an injury must seek emergency care:
- High intensity pain and pressure in the neck, head or back
- Tingling, numbness or reduced sensation in the arms or legs
- Loss of control and coordination of any body part
- Difficulty in breathing
- Bowel or bladder issues
- Any lumps observed on the head or spine
- Disrupted positioning of the neck or spine.
Diagnosis of Spinal Trauma
Spinal traumas are diagnosed based on physical examination and diagnostic imaging scans.
Physical examination: The first step in physical examination for spinal trauma includes evaluation of all vital parameters including blood pressure, pulse rate, airway and breathing pattern. This is followed by assessment of neurological function. The doctor examines the strength, sensations and reflexes in the arms and legs.
Diagnostic imaging scans: X-rays, CT-scan or MRI may be recommended based on the requirement. CT scan is used to detect any bony fragments, abnormalities or fractures. MRI may produce a more detailed visual of the spinal cord along with surrounding soft tissues to identify any factors causing compression of the spinal cord and spinal nerves.
Treatment of Spinal Trauma
Treatment methods of spinal traumas generally focus on preventing further damage and improving nerve function. Treatment begins with emergency immobilization by a medical personnel even before the patient is admitted to the hospital. Then, the individual is transferred to an intensive care unit where doctors closely monitor vital functions such as cardiac functioning, lung functioning, breathing and provide prompt treatment for any infections/complications. Traction is usually indicated to stabilize the spine in most cases.
Surgery is considered in conditions where trauma leads to spine compression as a result of bony fragments, vertebral fractures, herniated discs, clots or any other lesions. Though surgery cannot reverse the existing damage to the spinal cord, spine stabilization procedures may be necessary to prevent deformities, worsening of neurological symptoms and pain in later stages.
