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Spinal cord injury, or SCI, refers to damage caused either directly to the cord itself or
indirectly by injury to the bones, muscles, or soft tissues surrounding the cord. Most spinal
cord injuries are caused by accidents or other traumas, but some are the result of tumors, birth
defects, or diseases that affect the spine or surrounding muscles. The spinal cord can be
compressed by damage to the vertebrae surrounding it or by blood and tissue fluid
accumulating inside the spinal column. The spinal cord can also be completely cut or torn in
an accident or by a knife or gunshot wound.
Spinal cord injuries can be classified in two ways, by degree of severity and by location.
Some doctors refer to an SCI as either complete, meaning that the patient has no sensation or
ability to move muscles below the injury; or incomplete, meaning that the patient has some
degree of sensation or function in the parts of the body below the injury.
The location of a spinal cord injury is identified by the number of the affected vertebra. The
human spine is divided into four segments: cervical (the neck region, containing seven
vertebrae); thoracic (the chest region, containing twelve vertebrae); lumbar (the lower back,
containing five vertebrae); and sacral (the tailbone region, containing five vertebrae). Thus a
C4 injury refers to the fourth cervical vertebra; T12 refers to an injury at the level of the
twelfth thoracic vertebra; and so on.
Injury to the spinal cord at any point along its length involves a series of events that damage
the nerve endings in the cord. The spinal cord contains two major types of neurons, or nerve
cells: sensory neurons that carry messages from the skin, joints, and muscles upward to the
brain; and motor neurons, which carry messages from the brain downward to the various
parts of the body. Thus any injury to the cord interferes with both sensation and movement.
When the spinal cord is compressed, torn, or cut, the cord swells to fill the entire inside of the
spinal column, which cuts off the blood supply to the injured tissue. The patients blood
pressure drops and the nerve endings lose their ability to transmit electrical impulses to or
from the brain. This condition is called spinal shock. It is followed by a secondary phase of
damage that includes inflammation, the overstimulation of injured nerve cells, and the self-
computed tomography (CT) scans, and magnetic resonance imaging (MRI). Another imaging
technique that is often used with spinal cord injuries is myelography. This test consists of
injecting a contrast dye into the spinal column that will show up on an x ray or CT scans.
Patients are usually given a second round of diagnostic tests and imaging studies a few days
after the injury to evaluate the extent of the injury and the patients chances for recovering
sensation and function.
Use appropriate protective equipment when playing football or other contact sports. Avoid
movements that put the head and neck at risk, such as sliding into a base headfirst.
Store firearms in a locked cabinet or safe, and store ammunition in a separate location.
Protect against falls by checking the house or apartment for safety hazards, wearing
properly fitted shoes, and reducing the use of medications that cause drowsiness or loss of
balance.
The Future
As of 2008, Medrol was the only drug that is generally used to bring down inflammation
following an SCI, although another medication called GM-1 ganglioside is being tested as a
treatment for the damage to nerve tissue that follows spinal shock. Other areas of research
include various ways to stimulate the regrowth of damaged nerve fibers; the use of computers
combined with electrodes implanted in the injured person to restore function to paralyzed
limbs; and better ways to control pain in survivors of SCIs.