Have you ever seen someone unable to walk or lose a limb after an accident? The main cause of such severe conditions can be damage to the spinal cord, which is the main nerve cord that runs through our spine. This is a condition that many people fear, and it is also a very serious one. So today we will talk about this very simply, in a way that you can understand.
What exactly is Spinal Cord Injury?
Simply put, a spinal cord injury (SCI) is any damage to the spinal cord, the main nerve cord inside our spine. This nerve cord carries and transmits messages from our brain to almost every other part of our body. This damage can range from minor, manageable levels to very severe, lifelong levels.
Think of our nervous system as an expressway. The two main parts of this highway are the brain and the spinal cord. This highway has roads for vehicles (messages) coming from the brain, and separate roads for vehicles (messages) going to the brain.
The nerves that branch out from the spinal cord are like the on- and off-ramps on this highway. Messages travel to all parts of the body through these off-ramps.
Now, spinal cord injury is like a highway road closure. But in real life, unlike a highway, there are no detours when the spinal cord is damaged. If the road is closed, the vehicles (messages) that pass through it cannot get where they need to go. If the damage is severe, these road closures can be permanent. That's why severe symptoms like paralysis occur.
How do you classify these damages?
Doctors classify spinal cord injuries (SCI) in two main ways. One is based on the location of the injury. The other is based on the severity of the injury. Remember, this can disrupt the messages that travel to and from all parts of the body below the injury.
Classification by location of damage
Our spine is divided into several parts. Symptoms vary depending on which part is damaged.
- Cervical spine: This is located in your neck. It extends from the base of your head to the level of your shoulders. Damage to this area is the most serious.
- Thoracic spine: This extends from the upper torso to the level of the pelvis.
- Lumbar spine: This is located in the lower trunk.
- Sacral spine: This consists of nerve roots that extend downward from the buttocks.
Classification by severity of damage
This tells you how much damage has been done to the nerve cord.
- Incomplete damage: This is similar to a highway with only a few lanes closed. Some lanes are still operational, so some functionality remains on the sections below the damage.
- Complete: This means that all lanes of the highway are closed. No messages can travel. This usually results in a permanent loss of all functionality below the damage.
Especially after an accident, after the initial injury, a secondary injury can occur within the next few hours and days. This is due to swelling of the spinal cord. This can further increase the damage.
What are the symptoms of this condition?
The symptoms that occur when the spinal cord is damaged depend on which types of messages are disrupted. Three main types of messages can be affected.
| Characteristic type | Description and examples |
|---|---|
| Sensory symptoms | These are messages that carry information from the body to the brain. Examples: sensing things like temperature, pressure, and touch.
|
| Motor symptoms | These are messages from the brain to the muscles to move parts of the body. |
| Autonomic symptoms | These are messages that control processes that occur automatically in our bodies without us thinking about them. |
What are the main causes of spinal cord damage?
There can be many reasons for this serious condition to occur. Accidents are the main cause.
- Car accidents: This is the cause of 37% of spinal cord injuries.
- Falls: Things like falling from heights, slipping, etc. These account for about 31%.
- Violent acts: Spinal cord injuries caused by things like gunshots and stabbings. These account for about 15%.
- Sports accidents: About 8% of injuries occur due to activities such as diving, especially underwater.
In addition to these accidents, other medical conditions can also cause damage to the spinal cord.
- Osteoporosis.
- Tumors and cancer of the spine.
- Fluid-filled cysts within the spinal cord (Syringomyelia).
- Infections.
- Reduced blood flow to the spinal cord (ischemia).
- Some birth defects (Spina bifida).
- Autoimmune conditions such as Guillain-Barré syndrome and multiple sclerosis.
- Electric shock.
What are the dangerous complications of this?
The consequences of spinal cord injury can be severe and lifelong. The most important is paralysis.
- Tetraplegia: This is sometimes called "quadriplegia." This is the loss of power from the neck down. This occurs when the cervical spine is damaged.
- Paraplegia: This is the loss of function in the lower part of the body, that is, the legs and lower torso. This occurs if the thoracic or lower parts are damaged.
In addition to this, many other complications can occur:
- Neuropathic pain
- Pneumonia
- Urinary tract infections
- Blood clots in the legs and lungs
- Pressure sores
- Severe infections like sepsis
- Death (especially if the injury is to the upper back)
Your doctor can best explain the complications you may experience, so don't be afraid to talk to him or her about them.
How does a doctor diagnose this?
When spinal cord injury is suspected, doctors use several methods to confirm it.
1. Physical examination: Get a basic idea of the extent of the damage.
2. Examination of the nervous system: Checking whether the limbs can be moved, strength, sensation, and reflexes.
3. Imaging scans: A CT scan (Computed Tomography) can quickly detect damage to the bones. An MRI scan (Magnetic Resonance Imaging) can produce a very clear picture of the bones, soft tissues, and nerves.
4. Other tests: Tests such as electromyography, which measures electrical signals from the muscles, can help pinpoint the exact location of nerve damage.
How is it treated?
Treatment methods vary greatly depending on the type and cause of the damage.
Very important: If you suspect you have suffered a spinal cord injury as a result of an accident, it is always a medical emergency.
If you suspect that someone has been in an accident and has suffered a back injury, do not try to move or lift them for any reason. The only exception is if the person is not removed and there is a greater risk of life-threatening injury (for example, if the vehicle catches fire). If someone who is not trained moves them, the damage can be even worse. Call an ambulance immediately and take them to the emergency room (ETU) of a hospital.
In the emergency room and hospital intensive care unit (ICU), the main goal of doctors is to stop further damage to the spinal cord.
There are several main treatment methods:
- Surgery: Surgery is performed to reduce pressure on the spinal cord and repair damage to surrounding tissues.
- Medication: Medications such as steroids are given to reduce swelling around the spinal cord.
- Traction: This method is used to keep the injured area immobile.
- Supportive devices: Devices such as collars (braces) and halos help stabilize the injured area.
In addition, doctors have also focused on new treatments that are still in the research stage.
Long-term care and rehabilitation
A person with spinal cord injury will need additional care for weeks and months, perhaps even a lifetime.
- Physical therapy: Helps build strength and adapt to living with the injury.
- Occupational therapy: Training to perform daily tasks independently.
- Speech therapy: Helps people with upper spinal cord injuries with swallowing and communication difficulties.
- Mental health support: When something like this happens, it can be very devastating, not only physically, but also mentally. Therefore, it is very important to seek help from a mental health professional.
Can this situation be avoided?
Most spinal cord injuries are caused by unexpected accidents, but there are things we can do to reduce the risk.
- Wear safety equipment and seat belts correctly.
- Drive carefully and safely.
- Avoid falls. Be careful of slippery surfaces in your home.
- Avoid diving into areas where you cannot see the bottom of the water.
- Avoid alcohol and drug use. These can greatly increase the risk of accidents.
Take-Home Message
- Spinal cord injury (SCI) is damage to the main nerve pathway that carries messages between the brain and the body. It is a very serious condition.
- Car accidents, falls, and violent acts are the main causes of this.
- Symptoms include numbness, tingling, and loss of bladder control.
- If you suspect that the spine has been injured in an accident, never move the patient. Seek medical advice immediately.
- Early treatment can prevent further damage, but most damage is permanent.
- Physical therapy, occupational therapy, and especially mental health support are essential for someone dealing with this condition.
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