TRAUMATIC SPINE INJURY
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Traumatic Spine Injury
The spinal cord delivers messages between the brain and the other parts of the body. Layers of tissue (meninges) and a column of vertebrae (spinal bones) encircle and protect the spinal cord. In most cases, spinal cord injuries are the result of a sudden, traumatic blow to the vertebrae. Then, the fractured bones damage the spinal cord and nerves. In some rare cases, an injury can even completely split the spinal cord.
Damage to any part of the spinal cord or nerves at the end of the spinal canal can cause permanent alterations in strength, and sensation along with other body functions below the injured site. Spinal cord injury might leave a negative impact on every aspect of your child’s life. The effects of your child’s injury can be mental, emotional, and social. When it comes to treatment, many scientists are conducting research to completely repair spinal cord injuries. Also, advanced treatments and rehabilitation are allowing many people with such injuries to again lead independent and productive lives.
Types
The degree for which your child will be able to control his or her limbs after a spinal cord injury is determined by two factors – the site of injury on the spinal cord and the severity of the damage. The lowest part of your child’s spinal cord that is undamaged after an injury is called the neurological level of injury. And the severity of the injury is referred to as “completeness” and is classified in two ways:
Complete –
When the spinal cord injury completely damages all feeling (sensory function) and all ability to control movement (motor function), this is a complete injury.
Incomplete –
If your child has some sensory or motor function below the injured area, it is an incomplete injury. There are various degrees of incomplete injury. On the other hand, the paralysis resulting from a spinal cord injury is of two types:
Tetraplegia or Quadriplegia
In this type, your child’s hands, arms, leg, trunk, and all pelvic organs are affected by the spinal cord injury.
Paraplegia
This paralysis entirely or partially affects the trunk, legs, and pelvic organs. Spine doctors will perform various tests to determine the completeness and neurological level of your child’s injury.
QUESTIONS AND ANSWERS
What is the extent of my child's spinal injury, and what are the potential long-term effects?
The extent of a traumatic spine injury can vary widely, ranging from mild injuries with temporary symptoms to severe injuries with lasting consequences. Healthcare professionals typically use imaging studies, such as X-rays, CT scans, or MRIs, to assess the extent of the injury.
The specific long-term effects depend on factors like the location and severity of the injury. Some children may experience full recovery with appropriate medical care and rehabilitation, while others may face ongoing challenges. The healthcare team will provide a detailed assessment of the injury and work with parents to develop a comprehensive treatment plan.
What treatment options are available for my child's traumatic spine injury?
The treatment plan for a traumatic spine injury in a child depends on the nature and severity of the injury. Common treatment options may include:
- Immobilization: Stabilization of the spine is crucial to prevent further injury. This may involve the use of braces, casts, or other orthopedic devices.
- Surgery: In cases of severe trauma, surgery may be necessary to realign the spine, stabilize fractures, or address other complications.
- Rehabilitation: Physical therapy and rehabilitation are often essential components of treatment. These programs aim to improve mobility, strength, and overall function.
- Medication: Pain management and medications to reduce inflammation may be prescribed as part of the treatment plan.
- Monitoring and Follow-up Care: Ongoing monitoring and follow-up appointments are essential to assess the child’s progress and make adjustments to the treatment plan as needed.
What can I do to support my child's recovery, and what challenges should I be prepared for?
Supporting a child’s recovery from a traumatic spine injury involves a multidisciplinary approach. Key aspects include:
- Emotional Support: Traumatic injuries can be emotionally challenging for both the child and the family. Ensuring emotional support through counseling, peer groups, or other resources is essential.
- Adherence to Treatment Plans: Following the healthcare provider’s recommendations, including medication schedules, rehabilitation exercises, and activity restrictions, is crucial for optimal recovery.
- Education and Advocacy: Parents should educate themselves about the injury, treatment options, and potential challenges. Advocating for the child’s needs within the healthcare system and school environment is important to ensure a supportive and accommodating environment.
- Rehabilitation: Consistent participation in rehabilitation programs, both supervised and at home, is vital for promoting recovery and regaining function.
It’s essential for parents to have open and ongoing communication with the healthcare team, ask questions as they arise, and actively participate in their child’s care and rehabilitation process. Each traumatic spine injury is unique, and personalized medical guidance is crucial for the best outcomes.
Schedule an appointment and see a pediatric orthopedist spine doctor quickly at Medical City Children’s Orthopedics and Spine Specialists.
Traumatic Spine Injury Symptoms
The symptoms of traumatic spinal cord injury depend on the type and location of the damage. If your child experiences any of the following issues after an injury, get immediate medical attention:
- Weakness in the limbs.
- Decreased sensation in the limbs.
- Loss of bladder or bowel control.
- Unusual lumps on the spine.
- Severe pain in the neck or back.
- Difficulty breathing.
- Loss of movement
- Lack of sensation, along with the ability to feel, touch, heat, and cold
- Exaggerated spasms or reflex activities
- In adults, changes in sexual sensitivity, sexual function, and fertility
- Coughing or clearing secretions from your child’s lungs
Traumatic Spine Injury Causes
Some possible causes of traumatic spinal cord injuries are:
- Fall from a considerable height – Most often, a spinal cord injury at an older age is caused by a fall.
- Motor vehicle accidents – Considering almost half of the new spinal cord injuries each year, auto and motorcycle accidents are the leading cause of spinal cord injuries.
- Sports injuries – Athletic activities especially high-impact sports and diving in shallow water cause around 10% of spinal cord injuries.
- Diseases – Diseases like cancer, arthritis, osteoporosis, and inflammation of the spinal cord can cause spinal cord injuries.
- Acts of violence – Around 12% of spinal cord injuries result from violent encounters, usually from gunshot wounds. Knife wounds also are common.
- Surgical complications.
The main causes of spinal cord injuries are damage to the spinal cord itself or ligaments, vertebrae, and disks of the spinal column. The reason behind a traumatic spinal cord injury is a sudden direct traumatic blow to your child’s spine that dislocates, fractures, crushes, or compresses one or multiple vertebrae. Other reasons can be a gunshot or knife wound that penetrates and cuts your child’s spinal cord. Other types of damage stem from swelling, bleeding, inflammation, and fluid accumulation in and around the spinal cord. On the other hand, a nontraumatic spinal cord injury can result from inflammation, infections, arthritis, cancer, or disk degeneration of the spine.
Traumatic Spine Injury Diagnosis
In an emergency, spine doctors make sure a spinal cord injury does not have any impact on your child’s breathing or heart rate. In the next step, they’ll evaluate how your child’s nerves are working. The doctor checks:
- Sensory function (ability to feel touch).
- Motor function (ability to move parts of the body).
They also recommend certain imaging tests that can help diagnose a spinal cord injury:
- CT scan – To check blood clots, broken bones, or blood vessel damage.
- MRI – To check the soft tissues or spinal cord.
- X-ray – To check spinal dislocations (bones knocked out of place), broken bones, etc.
- EMG (Electromyogram) – To check the electrical activity in muscles and nerve cells to find any co-existing peripheral nerve injury. However, this test is usually not required in a spinal cord injury.
Management & Treatment
Doctors may recommend emergency surgery for a spinal cord injury in case there is trauma to another part of the body. Surgery can also help address spinal cord damage caused by blood clots, broken bones, or damaged tissue. Furthermore, some research suggests that a corticosteroid injection may help with spinal cord injuries. Doctors recommend that the patient take the medication within eight hours after the injury occurs. This treatment may:
- Improve blood flow
- Preserve nerve function
- Relieve inflammation
Surgery
Traumatic spine injuries in children and adolescents often require careful consideration and, in some cases, surgical intervention to stabilize the spine, address spinal fractures, and minimize the risk of further damage. The specific type of surgery depends on the nature and severity of the injury. One common surgical approach is spinal fusion, a procedure that involves joining two or more vertebrae together to restrict movement and promote stability. Surgeons may suggest Spinal fusion if there is significant vertebral instability or if the spinal cord is at risk of compression due to fractures. Surgeons use instrumentation, such as rods, screws, or plates, to hold the vertebrae in place during the fusion process, aiding in the healing of the spine.
In cases where there is compression or damage to the spinal cord or nerve roots, surgeons may perform decompression surgery. This procedure involves expertise to remove structures or fragments that are impinging on the spinal cord or nerves, alleviating pressure and preventing further neurological deficits. Only surgeons with years of experience and expertise should be involved in utilizing advanced techniques such as laminectomy or discectomy to address specific issues related to traumatic spine injuries. The goal of these surgeries is to create a more favorable environment for the spinal cord to heal and restore optimal neurological function.
It’s important to note that the decision to pursue surgery is individualized and based on careful evaluation by a multidisciplinary team of healthcare professionals specializing in pediatric orthopedics and spine surgery. Furthermore, the overall treatment plan, including surgery and postoperative rehabilitation, is tailored to the unique needs of each child or adolescent with a traumatic spine injury.
Risk Factors for Traumatic Spine Injury
Even though a spinal cord injury is usually the result of an accident, it can happen to anyone. Moreover, certain factors can put your child at higher risk of having a spinal cord injury. For example:
- Being male – Spinal cord injuries affect a considerable number of men. In addition, only about 20% of traumatic spinal cord injuries in the United States occur in females.
- Being between the ages of 16 and 30 – More than 50% of spinal cord injuries occur in people in this age range. Also, research indicates that for people under 65, motor vehicle crashes are the leading cause of spinal cord injuries.
- Being 65 and older – Another spike in spinal cord injuries occurs at age 65. Falls lead to most injuries in older people.
- Alcohol Consumption – Alcohol consumption is involved in about 25% of traumatic spinal cord injuries.
- Engaging in Risky Activities – Diving into shallow water or playing sports without taking proper precautions or wearing proper safety gear can lead to spinal cord injuries.
- Certain Diseases – Even a comparatively minor injury can cause a spinal cord injury if your child has another bone deterioration disease that affects their joints or bones. For example – osteoporosis.
Traumatic Spine Injury Complications
At first, you will find overwhelming changes in your child’s body functions. Complications include:
- Bladder control – Your child’s bladder will continue storing urine increasing the risk of urinary tract infections.
- Bowel control – Control of your child’s bowel movements often changes.
- Circulatory control – A traumatic spinal cord injury can cause circulatory problems such as low blood pressure when your child rises (orthostatic hypotension), swelling of your child’s extremities, life-threatening rise in blood pressure (Autonomic Dysreflexia), etc.
Other complications are respiratory problems, bone density loss, muscle tone problems, sexual problems, pain, depression, etc.
Traumatic Spine Injury Conclusion
No matter how severe the spinal cord injury is or how trivial the symptoms are, make sure you consult our experienced spine doctors as soon as you can. From proper diagnosis, and treatment, to aftercare – we will provide complete support to promote quality of life and independence.
Traumatic Spine Injuries can occur as mild or severe. Our spine doctors and surgeons at Medical City Children’s Orthopedics and Spine Specialists are highly trained and skilled in the diagnosis, treatment, and management of all different kinds of spine conditions. We will provide the optimal treatment. With the use of an individualized treatment plan, we provide a comprehensive plan of care. For your convenience, we have offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX.
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Footnote:
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