What are the symptoms and effects of having a spinal injury?

Symptoms and Effects of Spinal Injury

Spinal injuries can cause a range of symptoms from pain and limited mobility to complete paralysis, with the severity depending on the location and extent of damage to the spinal cord and surrounding structures. 1

Initial Symptoms and Presentation

Symptoms of spinal injury may include:

• Pain and sensory changes:

  • Localized pain at the injury site
  • Radiating pain to extremities
  • Numbness or tingling in extremities
  • Loss of sensation below the level of injury

• Motor function impairment:

  • Weakness in limbs
  • Paralysis (partial or complete)
  • Limited range of motion
  • Spasticity or flaccidity of muscles

• Autonomic dysfunction:

  • Loss of bladder or bowel control
  • Sexual dysfunction
  • Difficulty regulating body temperature
  • Abnormal blood pressure (often hypotension)
  • Respiratory difficulties (especially with higher cervical injuries)

Severity and Classification

The severity of symptoms depends on:

1. Location of injury: Higher injuries (cervical spine) typically cause more extensive symptoms than lower injuries (thoracic or lumbar)
2. Completeness of injury: Complete injuries result in total loss of motor and sensory function below the injury level, while incomplete injuries preserve some function
3. Type of damage: Whether the injury affects the spinal column (vertebrae), spinal cord, or both

Long-Term Effects and Complications

Spinal cord injuries can lead to significant long-term effects:

• Neurological deficits: Up to 29.4% of cases with delayed diagnosis of cervical spine injury develop permanent neurological deficits 1
• Functional limitations: Depending on injury level, patients may experience varying degrees of disability affecting mobility and self-care
• Secondary complications:
  • Pressure ulcers
  • Deep vein thrombosis
  • Respiratory complications (particularly with high cervical injuries)
  • Urinary tract infections
  • Chronic pain
  • Depression and psychological adjustment issues

Special Considerations by Injury Level

Cervical Spine Injuries

• Injuries at C4 or above often require immediate intubation due to respiratory compromise 2
• May cause quadriplegia (paralysis of all four limbs)
• Can affect diaphragm function and breathing
• May cause loss of temperature regulation

Thoracic Spine Injuries

• Typically result in paraplegia (paralysis of lower limbs)
• May affect trunk stability
• Often preserve upper limb function

Lumbar Spine Injuries

• May cause varying degrees of lower limb weakness or paralysis
• Often preserve some lower extremity function
• Bladder and bowel function commonly affected

Recovery Expectations

Recovery from spinal injury varies considerably:

• Most recovery occurs within the first 9-12 months, with relative plateau reached by 12-18 months post-injury 3
• Complete injuries have limited recovery potential, with only 10-20% converting to incomplete during the first year 3
• Incomplete injuries have more variable outcomes, with 20-75% of individuals recovering some walking capacity by 1 year 3
• The presence of any sensation below the injury level is a positive prognostic sign

Warning Signs Requiring Immediate Medical Attention

Anyone with the following symptoms after trauma should seek immediate medical care:

• Neck or back pain following trauma
• Any weakness, numbness or tingling in extremities
• Loss of bowel or bladder control
• Difficulty breathing
• Paralysis of any body part

First Aid for Suspected Spinal Injury

If spinal injury is suspected:

• Keep the person as still as possible unless safety considerations warrant movement 1
• Activate emergency medical services immediately 1
• Do not attempt to move the person unless absolutely necessary for safety
• Avoid routine use of rigid cervical collars and spine boards by first aid providers 1

Common Pitfalls

• Failing to recognize spinal injury in patients with distracting injuries or altered mental status 4
• Premature mobilization of patients with unstable spinal injuries
• Overlooking associated injuries, as spinal cord injuries are often associated with significant injuries to the head, brain, chest, and abdomen 1
• Delayed diagnosis, which may lead to secondary neurological injury at rates up to 10 times higher than immediate diagnosis 1

Spinal injuries represent serious medical emergencies that require prompt recognition and appropriate management to minimize long-term disability and optimize recovery potential.