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Spinal Cord Injury

Overview

A Spinal Cord Injury (SCI) is a serious medical condition that results from damage to the spinal cord, leading to temporary or permanent changes in its function. These injuries can affect motor control, sensation, and autonomic function below the level of the injury, and the impact varies depending on the severity and location of the injury.

Anatomy of the Spinal Cord

The spinal cord is a cylindrical structure of nerve tissue encased within the vertebral column (spine). It extends from the brainstem down to the lower back and is divided into four regions :

Cervical (C1–C8) – neck
Thoracic (T1–T12) – upper/mid back
Lumbar (L1–L5) – lower back
Sacral (S1–S5) – pelvis
Coccygeal – tailbone region (minor involvement)

Classification of Spinal Cord Injury

By Severity

Complete SCI : Total loss of motor and sensory function below the level of injury.

Incomplete SCI : Partial preservation of sensory and/or motor function below the level of injury.

By Level of Injury

Cervical SCI : May cause quadriplegia (tetraplegia) – paralysis of all four limbs.

Thoracic SCI : May cause paraplegia – paralysis of the lower body and legs.

Lumbar/Sacral SCI : Can affect legs, bladder, bowel, and sexual function.

Causes of Spinal Cord Injury

Traumatic Causes
  • Motor vehicle accidents.
  • Falls.
  • Sports injuries.
  • Acts of violence (e.g., gunshot wounds).
  • Diving accidents.
Non-Traumatic Causes
  • Tumors.
  • Infections (e.g., spinal abscess, meningitis).
  • Degenerative diseases (e.g., spinal stenosis).
  • Autoimmune conditions (e.g., multiple sclerosis).
  • Ischemia (loss of blood flow to spinal cord).

Treatment of SCI

Emergency Management
  • Immobilization to prevent further injury.
  • Airway and breathing support if cervical spine involved.
  • Steroids (like methylprednisolone) – sometimes used early to reduce inflammation.
Surgical Treatment
  • Decompression of spinal cord.
  • Stabilization with rods, plates, or screws.
Rehabilitation
  • Physical therapy (to strengthen muscles, prevent atrophy).
  • Occupational therapy (to improve independence).
  • Assistive devices (wheelchairs, braces).
  • Psychological support.

Long-Term Management

  • Prevention of complications: pressure sores, UTIs, blood clots.
  • Bowel/bladder management programs.
  • Management of spasticity or chronic pain.
  • Social and vocational rehabilitation.

Prevention of SCI

  • Use seatbelts and child safety seats.
  • Wear helmets during high-risk activities (sports, biking).
  • Fall prevention strategies (especially for elderly).
  • Safe diving practices.
  • Violence prevention and community safety initiatives.