Understanding Spinal Chord Injury
By Lou Cutrone

There are very few, if any, personal injuries more severe and more devastating than a spinal chord injury. Anyone who has sustained this kind of injury as a result of an accident is naturally frightened, confused and angry.

Traumatic injuries to the spine usually begin with a blow that fractures or dislocates one or more vertebrae, the bone disks that make up your spine. These injuries don’t necessarily sever the spinal cord. But rather, they cause damage when pieces of vertebral bone impinge on the spinal cord or press down on the nerve paths that communicate with other parts of the body. When the spinal injury is complete, the spinal cord  can no longer relay messages below the level of the injury. In such extreme cases, the injured person is paralyzed below the level of injury. In an incomplete injury, there can be some movement and sensation below the injury.

Diagnosis and Treatment:

Symptoms vary depending on the location of the injury. Spinal cord injury causes weakness and loss of feeling at, and below the injury. How severe symptoms are depends on whether the entire cord is severely injured (complete) or only partially injured (incomplete).

Injuries at and below the first lumbar vertebra do not cause spinal cord injury. However, they may cause “cauda equina syndrome” — injury to the nerve roots in this area. This type of spinal cord injury is a medical emergency and needs immediate surgery.

Injuries at any level can cause:

• Increased muscle tone (spasticity)
• Loss of normal bowel and bladder control (may include constipation, incontinence, bladder spasms)
• Numbness
• Sensory changes
• Pain
• Weakness
• Partial and/or Complete Paralysis

Cervical or Neck Injuries:

When spinal cord injuries occur in the neck area, symptoms can affect the arms, legs, and middle of the body. The symptoms may occur on one or both sides of the body. Symptoms can also include breathing difficulties from paralysis of the breathing muscles, if the injury is high up in the neck.

Thoracic or Mid-Back Injuries:

When spinal injuries occur at chest level, symptoms can affect the legs. Injuries to the cervical or high thoracic spinal cord may also result in blood pressure problems, abnormal sweating, and trouble maintaining normal body temperature.

Lumbar or Lower Back Injuries:

When spinal injuries occur at the lower back level, symptoms can affect one or both legs, as well as the muscles that control the bowels and bladder.

Diagnosis:

Your doctors will perform a physical exam, including a brain and nervous system (neurological) exam. This will help identify the exact location of the injury, if it is not already known.

Some of your reflexes may be abnormal or missing. Once swelling goes down, some reflexes may slowly recover.

The following tests may be ordered:

• CT scan or MRI of the spine
• Myelogram (an x-ray of the spine after injecting dye)
• Somatosensory evoked potential (SSEP) testing or magnetic stimulation
• Spine x-rays

Treatment

A spinal cord injury is a medical emergency that needs to be treated right away. The time between the injury and treatment can affect the outcome.

Corticosteroids, such as dexamethasone or methylprednisolone, are used to reduce swelling that may damage the spinal cord. If spinal cord pressure is caused by a growth that can be removed or reduced before your spinal nerves are completely destroyed, paralysis may improve. Ideally, corticosteroids should begin as soon as possible after the injury.

Surgery may be needed to:

• Remove fluid or tissue that presses on the spinal cord (decompression laminectomy)
• Remove bone fragments, disk fragments, or foreign objects
• Fuse broken spinal bones or place spinal braces

You may need a lot of bed rest  to allow the bones of the spine to heal.

Spinal traction may be recommended. This can help keep the spine from moving. The skull may be held in place with tongs (metal braces placed in the skull and attached to traction weights or to a harness on the body). You may need to wear the spine braces for a long time.

Your health care team will also provide information on muscle spasms, care of the skin, and bowel and bladder dysfunction. Your skin should be protected against pressure sores if you are unable to move about.

You will probably need physical therapy, occupational therapy, and other rehabilitation therapies after the injury has healed. Rehabilitation will help you cope with the disability from your spinal cord injury.

Muscle spasticity can be relieved with medications taken by mouth or injected into the spinal canal. Botox injections into the muscles may also be helpful. Painkillers (analgesics), muscle relaxers, and physical therapy are used to help control pain.

Looking Ahead

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

Paralysis and loss of sensation of part of the body are common. This includes total paralysis or numbness, and loss of movement and feeling. Death is possible, especially if there is paralysis of the breathing muscles.

A person who recovers some movement or feeling within 1 week usually 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 often takes one hour or more each day. Most people with spinal cord injury must perform bladder catheterization regularly.

The home will usually need to be modified.

Many people with a spinal cord injury are in a wheelchair, or need assistive devices to get around.

Presenting the Legal Case for Traumatic Spinal Chord Injuries

The ability to present a complex traumatic spinal chord injury case requires a deep and thorough understanding not only of the injury itself, but of the radical changes such a disability creates in the lives of the injured and their families. It is vital that you choose an attorney who understands this type of injury and can effectively communicate to an insurance company or a jury how the injury was sustained, why someone else is responsible for causing that injury and how that injury has changed your life and the lives of your family.

At Cutrone & Associates, we understand the nature of a spinal chord injury, not only from the perspective of proving the existence of this injury in court or to an insurance company, but also in establishing the full extent of this injury as it impacts the unique and individual lives of our clients. We routinely employ the very best medical experts in neurology, psychology, physiatry, rehabilitation medicine and occupational therapy to develop a clear and persuasive case presentation that includes a comprehensive life care plan for the difficult, painful and expensive road that lies ahead.

If you or a loved one has sustained a traumatic spinal chord injury, contact the attorneys at Cutrone & Associates for a free, no obligation case evaluation.  Put our expertise in this unique area of injury law to work for you or your loved one.  We are an experienced, committed legal team and we genuinely care.

We are standing by to help you and your family, call us today.