Spinal cord trauma

Alternative names:

compression of spinal cord; spinal cord compression; spinal cord injury

Symptoms:

Symptoms vary somewhat depending on the location of the injury.

Lumbar injuries:

• weakness, loss of muscle control, or paralysis
• discrete transition below which sensation is impaired
• loss of bladder control
• loss of bowel control
• loss of sexual functioning (male impotence)

Note: It affects all muscles below the injury, usually from the chest down (paraplegia).

Cervical injuries:

• all the symptoms of lumbar injury, plus
• weakness, paralysis, numbness includes the arms and hands (quadriplegia)
• breathing difficulties (from paralysis of the breathing muscles)

Partial injuries are uncommon. If only one side of the spinal cord is injured, paralysis may occur on only one side of the body although sensation changes may occur on either or both sides.

Additional symptoms that may be associated with this disease:

• urinary hesitancy
• urinary frequency/urgency, increased
• penis pain
• muscle spasms (cramps)
• constipation
• breathing, absent temporarily
• abnormal lack of sweating
• positive Babinski's reflex

Signs and tests:

Symptoms may have developed immediately after injury or may occur gradually because of fluid accumulation around the spinal cord. Spinal-cord injury is a medical emergency requiring immediate attention to minimize the long-term effects.

A neurologic examination indicates the level of the spinal-cord injury if the location is not immediately evident. The reflexes may be abnormal or may be absent in affected areas of the body. There may be some recovery of reflexes after swelling has subsided. Muscle spasticity is common.

• Spine X-rays will show fracture or damage to the bones of the spine.
• A CT scan or MRI of the spine may pinpoint the location and extent of spinal-cord trauma.
• A myelogram (an X-ray of the spine after injection of dye) may be recommended.

This disease may also alter the results of the following tests:

• a lumbosacral spine MRI
• a CPK