The vertebrae (spine) that protects the spinal cord is separated by elastic cartilage discs. The discs allow us to bend and curl back to some extent.
A nervous bundle that form the spinal cord transmit nervous impulses from the brain to the body and vice versa. This allows us to control movements and feel, for example, touch or warmth. If the spinal cord is damaged (in an accident), part or parts of the body below the site of the injury may also be affected. This damage can be temporary, although some cases end with permanent disability.
The affected area of the body depends on the site of the spinal cord injury. Possible symptoms include numbness, weakness or paralysis of all the muscles below the site of injury, including muscle paralysis that control bowel and bladder functions. Muscles are rarely affected on only one side of the body. Spinal cord injury does not have to be accompanied by pain, but the consequent injury to the adjacent nerve often causes very severe pain – in sciatica, for example.
Unlike the symptoms of some types of brain injury that may occur only after a long time, symptoms of spinal cord injury occur almost immediately after the injury.
Spinal cord injuries are considerably less frequent than brain injuries. However, our medical records indicate that injuries to the spinal column and spinal cord amount to 1-4% of all injuries.
Most spinal cord injuries are the result of falls or traffic accidents; one of the major causes are permanent injuries after the sudden stopping of a car, where sudden head shaking damages the spinal cord in the neck.
The injury of the spinal cord in the neck may be deadly if the nerves that control breathing are damaged; it can also lead to complete paralysis of the arms and legs, as well as general numbness from the neck below. Injuries to other parts of the spinal cord are usually not fatal, but can cause permanent, severe disability. Paralysis of the bladder often leads to frequent urinary tract infections; paralysed body partes are particularly vulnerable to injury. In addition, immobile patients have problems with wounds from sitting and lying. Spinal cord injuries can also affect sex life, e.g. making it difficult to ejaculate in men.
What to do?
Serious spinal cord injury obviously requires urgent hospital care. If a person who has experienced an accident cannot move with his feet or he/she complains about anxiety, seek professional help immediately. Do not move the injured person – the wrong movement can hurt the nerves even more. Emergency aid kits are equipped with special bearers for transferring severely injured persons. It is best to be with the injured person and to calm him/her down by telling that the help is on the way.
The spine is scanned as early as possible; X-ray will determine the location and extent of the damage. Physicians will probably examine whether the lower parts of the body are numb, usually by simply touching them with the needle. In some cases, a myelogram is also done to determine if the spinal cord is just swollen – in which case there are good prospects for recovery without special treatment – or seriously damaged.
Self-help: spinal cord injury with permanent consequences inevitably means a drastic change in lifestyle. If you experience such an injury, you may have to stay in hospital for several months. With the help of various medical specialists, you will learn new ways of moving and solving everyday life problems. You may need to make some changes in the house – you probably won’t be able to use the strairs – but you would have to make the most effort to continue with your previous habits. If this is not possible, ask your doctor or social worker for information on courses and disability associations.
Professional help: treatment of possible spinal cord injury begins immediately after the injury. If the spinal cord is heavily damaged a surgical procedure may be needed, although resting in bed is sometimes enough for recovery. However, heavily damaged nervous bundles do not heal by themselves, and cannot be treated with drugs or surgical procedures. At first, the patient must lie mostly immobile and under constant observation in order to detect an improvement in condition. If the neck is hurt, the head on both sides is supported to prevent any unnecessary movements. During the observation, the patient also requires intensive care – feeding, regular rotation to prevent the development of decubitus wounds, as well as around the urination and the stool. This stage of treatment may take several weeks; if the patient stays immobile after that, a team of doctors, nurses, physiotherapists, and work therapists will then start with rehabilitation. The goal of rehabilitation is to utilize the remaining muscle strength. There are a number of mechanical and electrical aids that develop the physical skills of the disabled. If the lower part of the back is injured, and therefore the hands are not affected, the patient will not depend on other people so much even though he/she will probably have to use the wheelchair. The goals and types of treatment obviously depend on the degree of injury. But, if you become disabled, you do not have to be ashamed to seek advice and help solving – for example – sexual problems.
It is important that the patient and his/hers family do not lose their patience. Sometimes it may take up to three or four months before assessing the degree of disability and recovery. In this long and difficult period courage, determination and good will can play a significant role in healing.