Spinal Trauma

Your ability to control your limbs after a spinal cord injury depends on where the injury occurred and the severity of the damage.

Dr Shiva will perform a series of tests to determine the neurological level and completeness of your injury.

Spinal cord injuries can cause one or more of the following signs and symptoms:

• Loss of movement
• Altered sensation, including the ability to feel heat, cold and touch
• Loss of bowel or bladder control
• Exaggerated reflex activities or spasms
• Changes in sexual function, sexual sensitivity and fertility
• Pain or an intense stinging sensation caused by damage to the nerve fibres in your spinal cord
• Difficulty breathing, coughing or clearing your lungs

Emergency signs and symptoms of spinal trauma
Emergency signs and symptoms of a spinal cord injury after an accident include:

• Extreme back pain or pressure in your neck, head or back
• Weakness or paralysis in any part of your body
• Numbness, tingling or loss of sensation in your hands, fingers, feet or toes
• Loss of bladder or bowel control
• Impaired balance and walking
• Difficulty breathing
• An oddly positioned or twisted neck or back

Anyone with significant head or neck trauma requires immediate medical evaluation for a spinal injury. It is safest to assume that trauma victims have spinal injuries until proven otherwise.

Spinal cord injuries can result from damage to the vertebrae, ligaments or discs of the spinal column or to the spinal cord itself.

A spinal cord injury can stem from a sudden, traumatic blow to your spine that fractures, dislocates, crushes or compresses one or more of your vertebrae.

Additional damage usually occurs over days or weeks because of bleeding, swelling, inflammation and fluid accumulation in and around your spinal cord.

A nontraumatic spinal cord injury can be caused by arthritis, cancer, inflammation, infections or disc degeneration of the spine.

In the emergency room, a doctor may be able to rule out a spinal cord injury by examination, testing for sensory function and movement, and by asking some questions about the accident.

Emergency diagnostic tests may be needed, such as an x-ray, CT or MRI scan if:

• The injured person complains of neck pain
• Is not fully awake
• Or has apparent signs of weakness or neurological injury.

A few days after injury, when some of the swelling may have subsided, Dr Shiva will conduct a more comprehensive neurological exam. This involves testing your muscle strength and ability to sense light touch and pinprick sensations to determine the level and completeness of your injury.

Unfortunately, there is no way to reverse damage to the spinal cord. Spinal cord injury treatment focuses on preventing further injury and empowering people with a spinal cord injury to return to an active and productive life.

Urgent medical attention is critical to minimise the effects of head or neck trauma. Treatment for a spinal cord injury often begins at the accident scene.

Emergency personnel typically immobilise the spine as gently and quickly as possible using a rigid neck collar and a rigid carrying board, which they use during transport to the hospital.

Early (acute) stages of treatment
In the emergency room, doctors focus on the following:

• Preserving your ability to breathe
• Preventing shock
• Immobilising your neck to prevent further spinal cord damage
• Avoiding possible complications, such as stool or urine retention, respiratory or cardiovascular difficulty, and formation of deep vein blood clots

Often surgery is necessary to remove fragments of bones, foreign objects, herniated discs or fractured vertebrae that may be compressing the spine. Surgery might also be needed to stabilise the spine to prevent future pain or deformity.

Dr Shiva might not be able to give you a prognosis right away. Recovery, if it occurs, usually relates to the severity and level of the injury. The fastest recovery rate is often seen in the first six months, but some people make minor improvements for up to two years.

Postoperative care

• No lifting more than 5kg, no bending or twisting for six weeks
• No driving for two weeks
• Keep the wound dry for five days. You can get wet in the shower, but pat the area dry rather than rub.
• GP review postoperatively for wound review on day seven
• Monitor for any wound redness, discharge or fevers
• Monitor for new symptoms, including worsening back or neck pain, arm or leg pain, pins and needles or numbness
• Six-week review with Dr Shiva