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Spinal Cord Injury Causes and Symptoms

First and foremost, a spinal cord injury (SCI), refers to damage of the spinal cord or specific nerves located at the spinal canal’s end. The actual damage of the spinal cord or spinal canal can vary in severity depending on the cause, but it may often cause permanent changes in the individual’s strength and bodily sensations.

The spinal cord serves the function of carrying out messages from the brain to various parts of the body, and vice versa. These messages involve sensations, such as pain, and therefore allow us to perceive these sensations. These messages additionally control our ability to execute movements with our limbs. Damage to the spinal cord, therefore, can interrupt these messages and impulses and thereby result in mild to severe mobility impairments.

According to spinal cord injury statistics released by the World Health Organization (WHO), between 250,000 to 500,000 cases of spinal cord injuries are reported worldwide every year. In the United States alone, the annual incidence of SCIs is approximately 17,000 according to another report released in 2016.

What Can Cause a Spinal Cord Injury?

Spinal cord injuries are the result of damage done to either the spinal cord or the vertebrae, ligaments, and disks of the spinal column. An injury can involve the column either being bruised, stretched, compacted, or otherwise impacted by some type of trauma, which can then lead to damage of the spinal cord.

Spinal cord injuries are often the result of some type of trauma, including unexpected accidents and incidents of violence, but there are number of ways in which this can occur.

Spinal Cord Injury causes infographic

Causes and risk factors associated with Spinal Cord Injuries

Furthermore, the spinal cord can also be damaged through causes deemed non-traumatic such as diseases, infections, and other similar conditions that do not involve being impacted directly through a direct traumatic event. The differences between traumatic and non-traumatic spinal cord injuries are detailed in further depth below.

It is also important to note that additional damage can occur to the spinal cord following any sort of trauma through resulting secondary events. For instance, although the spinal cord or column may be damaged through an initial event or circumstance, the injury can also be further damaged in the subsequent hours and days before receiving or undergoing medical treatment.

Therefore, it is essential to seek medical and professional care following any incident of spinal cord trauma. The same is true for individuals who have may have sustained a SCI through other health conditions.

Types of Spinal Cord Injuries: Traumatic and Non-Traumatic

The World Health Organization (WHO) states that the majority of spinal cord injury incidents occur as a result of preventable causes such as car accidents, falls, and other situations of violence.

Spinal cord injury causes may be categorised as either traumatic or non-traumatic based on how the injury was caused. Identifying whether an individual has suffered a traumatic or non-traumatic spinal cord injury is important due to how it may impact the specific symptoms an individual may be expected to experience.

No matter the cause, however, all spinal cord injuries involve the damaging of nerve fibers and potentially muscles at and below the injured area.

Traumatic Spinal Cord Injuries

According to the World Health Organization, up to 90% of annual incidences of spinal cord injuries across the globe are due to traumatic causes. Within this context, traumatic refers to a violent or otherwise injurious event that can impact several parts of the body, including the spinal cord.

Common traumatic spinal cord injury causes:

  • Motor vehicle accidents
  • Sports-related injuries
  • Falls
  • Diving into shallow water
  • Domestic violence that results in injury to the spinal cord
  • Electrical accidents
  • Violent attacks involving sharp objects or the penetration of bullets

Traumatic spinal cord injuries can also be further categorised into five different types of injuries: flexion injuries, rotation injuries, penetrating injuries, compression injuries, and hyperextension injuries.

Flexion injuries involve damage to the cervical (neck) region of the spinal column, which can then impact the spinal cord. This frequently occurs when there is a sharp, forcible movement of the head or neck – e.g. whiplash.

Rotation injuries occur when there is a rotation of the spinal column, which may subsequently result in impact on the spinal cord. Rotation injuries often co-occur alongside flexion injuries, and frequently transpire in motor vehicle accidents when the vehicle is hit on the side. The rotation of the spinal column most commonly occurs in the lumbar, cervical, and lower thoracic regions of the body.

Penetrating injuries can occur at any level of the spinal column and may commonly occur when a sharp object such as a knife, or other objects such as bullets, penetrate the spinal cord.

Compression injuries occur when force is transmitted through an individual’s head, the base of the spine, or the lower limbs. These often occur in diving accidents, or falls from a steep height. The spinal cord is affected when the vertebrae fractures and protrudes into the spinal canal, leaving the fractured vertebrae displaced.

Hyperextension injuries often do not cause significant damage to the spinal column as much as the ligaments, which may then damage the spinal cord. In cases where a person’s neck is forcibly extended backward, thereby stretching the spinal column, stretching of the ligaments as well as an opening of the discs can occur. This type of injury is the most common way in which children damage their spinal cord, and is also prevalent among incidents of SCIs in older adults.

Non-Traumatic Spinal Cord Injuries

Although the majority of cases worldwide are categorised as resulting from traumatic causes, it appears that the proportion of incidences of spinal cord injury due to non-traumatic causes is on the rise.

Unlike traumatic injuries, non-traumatic spinal cord injuries can be caused by a variety of health problems and diseases. Some of these causes may pose a greater risk as individuals age – such as arthritis and degeneration of the spinal column – while others may occur at any time in an individual’s lifetime.

Common non-traumatic spinal cord injury causes:

  • Arthritis
  • Disk degeneration of the spinal column
  • Infections
  • Inflammation
  • Cancer
  • Osteoporosis
  • Blood-related or circulation problems
  • Diseases of the nervous system

Additional Risk Factors

Spinal cord injuries can happen to anyone, from celebrities to older adults and even infants.

However, there are some additional risk factors that can make a person more likely to experience a spinal cord injury.

Males, for instance, account for approximately 80% of all new incidences of spinal cord injuries annually within the United States.

Engaging in risky behaviour where incidents of violence may be more likely to occur can heighten an individual’s risk of sustaining a spinal cord injury. Risky behaviour also includes instances where those engaging in sports or recreational activities may reach beyond their limits or otherwise take unnecessary risks, as well as driving recklessly in a motor vehicle.

Age can count as a risk factor as well considering that injuries such as falls often occur with older adults over 65. Children and infants may also be vulnerable to incidents where reckless or otherwise naive behavior can result in serious injury to the spinal cord.

What Are the Symptoms of a Spinal Cord Injury?

Symptoms, or signs, of a spinal cord injury can range from mild to moderate to severe depending on the cause and severity of the injury itself.

However, no matter the case’s severity, individuals who have experienced an incident that may have caused a spinal cord injury should immediately consult medical professionals. Early intervention and assessment can potentially prevent symptoms from worsening, as well as help prevent further complications as a result of the untreated injury.

A competent medical professional will be able to diagnose the issue, provide details pertaining to the individual’s prognosis, and relay recommendations for treatment.

If you are unsure of whether you have a spinal cord injury, refer to the list of common and emergency symptoms shown below.

Spinal Cord Injury Symptoms:

  • Headaches
  • Having trouble walking
  • Feeling off-balance or dizzy
  • Changes in sexual function, sensitivity, or fertility
  • Uncontrollable and excessive muscle spasms

Emergency Symptoms:

  • Loss of control over your bowels or bladder
  • Weakness of limbs
  • Difficulty breathing
  • Inability to move your arms or legs (paralysis)
  • Numbing or tingling sensations in feet, hands, fingers, or toes

Serious cases of spinal cord injury may be initially overlooked, but failure to address symptoms early on can lead to another serious injury. Furthermore, the time between a patient sustaining their injury and receiving treatment for it may be critical in determining the progression of the symptoms as a result of the injury, as well as how long it may take to reach an expected state of potential recovery.

Complete and Incomplete Spinal Cord Injuries

Symptoms may also vary depending on the injury’s severity, and this level of severity may often be referred to as either “complete” or “incomplete”.  

The difference between these two categorisations lies in an individual’s sensory motion and ability to control limb movements following the injury. The location of the injury may additionally account for the damage that results, as the lower portion of the spinal cord, for instance, accounts for any neurological damage that may occur.

Complete refers to instances where all feeling, or sensation, and motor function are lost below the place of the injury on a person’s body.

On the other hand, incomplete or partial loss is viewed as a spectrum where there may be varying degrees of how much sensory and motor function have been lost below the injured area.

Types of Paralysis: Quadriplegia and Paraplegia 

Approximately 52% of individuals with a spinal cord injury are considered paraplegic, while 47% are categorised as quadriplegic.

Quadriplegia

Quadriplegia, also known as tetraplegia, refers to cases where the individual suffers paralysis in the arms, hands, and entire lower body – including the pelvic organs – as a result of their spinal injury.

Paraplegia

Paraplegia refers to cases where the individual suffers paralysis in their pelvic organs, legs, and behind.

Both quadriplegia and paraplegia are still categorised as either complete or incomplete based on the definitions provided above. Since 2010, approximately 45% of all new cases of spinal cord injuries have been categorised as incomplete tetra/quadriplegia, making it the most frequent neurological category. The least common category refers to less than 1% of cases where full neurological capacity has been restored by the time the individual has discharged from their initial hospitalisation. 

What to Expect with Spinal Cord Injury

Although incidences of spinal cord injury can vary in their levels of severity, most individuals who have experienced this type of injury can expect to experience chronic pain. Timelines for the recovery or rehabilitation period are determined on an individual basis by medical professionals that have been able to thoroughly assess the extent of the severity of the injury.

Additional Statistics & Facts 

Below are some interesting spinal cord statistics, facts and figures:

  • Mortality rates for new cases of SCI are highest during the first year following the injury, and then tend to reduce in subsequent years (NSCISC, 2016).
  • Survival rates for individuals with a SCI are worse in low and middle-income countries. The main cause of death in low-income countries remains complications due to secondary conditions (e.g. infections); however, this is no longer the case in middle and high-income countries (WHO, 2013).
  • Although the global prevalence of SCIs is not exactly known, incidence estimates have been placed at about 40 – 80 cases per million population (WHO).
  • The leading cause of re-hospitalisation following the initial assessment of the injury – more likely to occur within the first year rather than subsequent years – is diseases involving the genitourinary system (NSCISC, 2016).
  • The average age of injury as of 2016 is 42 years old. This has increased since the 1970s, when the average age of injury was 29 years old (NSCISC, 2016).
  • Males are most at risk for experiencing a spinal cord injury as young adults (20-29 years old) and as older adults (70+ years).
  • In contrast, females are most at risk for experiencing a spinal cord injury in adolescence (15-19 years old) and older age (60+ years).