Spinal Cord Injury

Spinal cord injury (SCI) is an important contributing factor to morbidity and mortality in the U.S.

Spinal cord trauma can be caused by any number of injuries to the spine. They can result from motor vehicle accidents, falls, sports injuries (particularly diving into shallow water), industrial accidents, gunshot wounds, assault, and other causes.

A minor injury can cause spinal cord trauma if the spine is weakened (such as from rheumatoid arthritis or osteoporosis) or if the spinal canal protecting the spinal cord has become too narrow (spinal stenosis) due to the normal aging process.

Direct injury, such as cuts, can occur to the spinal cord, particularly if the bones or the disks have been damaged. Fragments of bone (for example, from broken vertebrae, which are the spine bones) or fragments of metal (such as from a traffic accident or gunshot) can cut or damage the spinal cord.

Direct damage can also occur if the spinal cord is pulled, pressed sideways, or compressed. This may occur if the head, neck, or back are twisted abnormally during an accident or injury.

Bleeding, fluid accumulation, and swelling can occur inside the spinal cord or outside the spinal cord (but within the spinal canal). The accumulation of blood or fluid can compress the spinal cord and damage it.

A spinal cord trauma is a medical emergency requiring immediate treatment to reduce the long-term effects. The time between the injury and treatment is a critical factor affecting the eventual outcome.

How well a person does depends on the level of injury. Injuries near the top of the spine result in more extensive disability than do injuries low in the spine.

Recovery of some movement or sensation within 1 week usually means the person has a good chance of recovering more function, although this may take 6 months or more. Losses that remain after 6 months are more likely to be permanent.

Routine bowel care frequently takes one hour or more on a daily basis.

A majority of people with spinal cord injury must perform bladder catheterization from time to time.

Modifications of the person's living environment are usually required.

Most people with spinal cord injury are wheelchair- or bed-bound, or have impaired mobility requiring a variety of assistive devices.

FIND RESOURCES IN YOUR AREA

There are many resources available to survivors of spinal cord injury. Please review our Spinal Cord Injury Resource Guide to find out more.
 Did You Know?

Occurrence


  • About 200,000 people are currently living with SCI in the United States.2,14
  • Annually, 15 to 40 new cases per million people—or 12,000 to 20,000 new patients—are estimated to occur.2,3,9,11
  • Alcohol has been found to play a major factor in 25% of spinal cord injuries

Causes


  • Motor vehicle accidents: 46% 1,2,3,8,9,11
  • Use of a seatbelt can reduce the odds of a spinal cord injury by 60%4,16
  • Use of a seatbelt and airbag combined can reduce the odds of injury by 80%
  • Falls: 22%1,2,3,8,9,11
  • Violence: 16%1,2,8,9,11
  • Sports: 12%1,2,9,11

References

  1. Beers, MH, Kaplan, JL, editors. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Sharp & Dohme Corp; 2006.
  2. Bernhard M, Gries A, Kremer P, Böttiger BW. Spinal cord injury (SCI) – prehospital management. Resuscitation 2005 August;66(2):127–39.
  3. Burke DA, Linden RD, Zhang YP, Maiste AC, Shields CB. Incidence rates and populations at risk for spinal cord injury: a regional study. Spinal Cord 2001 May;39(5):274–8.
  4. Clayton B, MacLennan PA, McGwinn Jr. G, Rue III LW, Kirkpatrick JS. Cervical spine injury and restraint system use in motor vehicle collisions. Spine 2004 February;29(4):386–9.
  5. Craig A, Tran Y, Middleton J. Psychological morbidity and spinal cord injury: a systematic review. Spinal Cord 2009;47:108–14.
  6. French DD, Campbell RR, Sabharwal S, Nelson AL, Palacios PA, Gavin-Dreschnack D. Health care costs for patients with chronic spinal cord injury in the Veterans Health Administration. Journal of Spinal Cord Medicine 2007;30(5):477–81.
  7. Hitzig SL, Tomack M, Campbell KA, McGillivray CE, Boschen KA, Richards K, Craven BC. Secondary health complications in aging Canadian spinal cord injury sample. American Journal of Physical Medicine and Rehabilitation 2008 July;87(7):545–55.
  8. Jackson AB, Dijkers M, DeVivo MJ, Poczatek RB. A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Archives of Physical Medicine and Rehabilitation 2004 November;85(11):1740–8.
  9. National Spinal Cord Injury Statistical Center (NSCISC).External Web Site Icon [cited 2010 Sept 15].
  10. Savic G, Short DJ, Weitzenkamp D, Charlifue S, Gardner BP. Hospital readmissions in people with chronic spinal cord injury. Spinal Cord 2000;38(6):371–7.
  11. Sekhon LHS, Fehlings MG. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine 2001 December;26(245):S2–S12.
  12. Siddall PJ, McCleland JM, Rutkowski SB, Cousins MJ. A longitudinal study of the prevalence and characteristics of pain in the first 5 years following spinal cord injury. Pain 2003 June;103(3):249–57.
  13. Spinal cord injury: emerging conceptsExternal Web Site Icon. [cited 2010 Sept 14].
  14. Spinal Cord Injury Information NetworkExternal Web Site Icon [updated 2008; cited 2010 Sept 15].
  15. Strauss D, DeVivo MJ, Shavelle R. Long-term mortality risk after spinal cord injury. Journal of Insurance Medicine 2000;32:11–6.
  16. Thompson WL, Steill IG, Clement CM, Brison RJ. Association of injury mechanism with the risk of cervical spine fractures. Canadian Journal of Emergency Medicine 2009;11(1):14–22.