Spinal Cord Injury

Spinal cord injury may be diagnosed and evaluated using one or more of the following tests. Movement of the neck or arms by the healthcare team members may be necessary when getting these tests.

Tests used for diagnosis:

• X-Rays
• CT or "CAT Scan" (Computerized Axial Tomography)
• MRI (Magnetic Resonance Imaging)

Spinal cord exam includes checking:

• Movement and strength of arms and legs
• Ability to feel sharp/dull or hot/cold
• Position sense of the arms and legs

How are Spinal Cord Injuries Treated?

The main goal in spinal cord injury treatment is to keep the highest level of function possible. Treatment is also aimed at preventing complications and further injury. Treatments may be non-surgical and/or surgical.

Non-surgical Treatments:

Steroid Infusion: Intravenous (IV) steroid infusions may be given for a spinal cord injury that happens suddenly (trauma). The goal of this treatment is to reduce swelling from the injury. When appropriate, the steroid treatment is started soon after injury.

Stabilization with Cervical (neck) Traction/Alignment: These types of traction often are needed to reduce or re-align the spine:

• Halo Traction
• Gardner-Wells Tongs traction

Bracing: Depending on your level of injury and what your doctor recommends, you may be placed in one of the following braces. These braces may be used before and/or after surgery if needed. (Fig. 13-18)

Cervical (neck) and/or High Thoracic (upper chest) Injuries

Surgical Treatments

Surgery may be needed when the injury has caused the bones to be unstable or when there is pressure on the spinal cord or spinal nerves. The spine is considered unstable if, in spite of bracing, the bones can move and cause further injury.

Decompression: This is removing the pressure on the spinal cord. Whatever is causing the pressure (ie. bone, disc, blood clot, tumor) on your spinal cord or spinal nerves is removed.

Internal Fixation and Instrumentation: Internal fixation means to apply rods, screws and/or hooks (instrumentation) to the vertebrae in order to protect the spinal cord or spinal nerves from further injury. You may think of this as an "internal" brace. Usually a bone graft is also done.

Examples include: (Figures 19, 20, 21)

• Titanium Screws, Hooks
• Titanium Rods

Bone Grafting for Fusion: When internal fixation and instrumentation is needed, most likely a bone graft will also be needed. The bone graft may be taken from the back of your pelvis or rib. This bone is then placed onto the injured bony area. Usually, within three to six months, this bone will bond to your vertebrae and produce a fusion. When the vertebrae have completely fused, this further stabilizes your spine.