Spinal Cord Injury

It is a medical emergency if your child’s spinal cord is injured, and they need immediate treatment. If your child is experiencing sudden back or neck pain, especially after trauma such as an accident or fall, they should be evaluated right away for a spinal injury.

Emergency signs include:

• Difficulty breathing after an injury
• Problems with walking and balance
• Loss of bowel or bladder control
• Weakness or paralysis (inability to move) anywhere in your child’s body
• Numbness or tingling in their hands or feet
• Severe back pain or pressure in the back, head, or neck
• A twisted neck or back that appears to be in an odd position

If your child has experienced trauma to their back or neck, you should assume they have a spinal injury. Serious spinal injuries are not always apparent right away, so you should seek medical help before other problems (such as numbness or paralysis) potentially develop.

If you think your child has injured their neck or back, don’t move them, since you might make the injury worse. Keep your child still and call 911 or your local emergency number. Roll up towels or blankets and set them on both sides of the head, or hold your child’s head, to keep them from moving until emergency help arrives. Try to make your child comfortable, and provide basic first aid (such as stopping bleeding).

Spinal cord injuries are often the result of an accident, which can happen to anyone. Common causes of spinal cord injury include falls, motor vehicle accidents, sports injuries, and acts of violence. Injury can also come from diseases or illnesses that you can’t control.

Your child’s doctor will do a physical exam to test for sensory function and movement. During this exam, you should tell your doctor if your child had an injury and if they are having any other symptoms. If your child has neck pain or signs of weakness or nerve damage, the doctor may want to run further tests. These include:

• X-rays, commonly taken when there has been trauma to the back. X-rays can show problems in the spinal column bones (vertebrae), tumors, fractures, or degenerative conditions
• A CT scan, which takes pictures that form a series of cross-sectional images so doctors can better see bone, disc, and other spinal problems
• An MRI, which helps to identify problems in the tissues, such as herniated discs or blood clots

If there is swelling around your child’s spinal cord, your doctor may want to examine them again a few days later after the swelling has gone down.

Depending on your child’s injury, their rehabilitation team may include specialists such as a:

• Neurologist [noo-RALL-oh-jist], a specialist in nervous system disorders
• Neurosurgeon [NOO-roh-SUR-jun], a specialist in spinal cord injuries
• Physical therapist
• Occupational therapist
• Rehabilitation nurse
• Rehabilitation psychologist
• Social worker
• Dietitian
• Recreation therapist

Many of these specialists further specialize in children’s health (pediatrics [pee-dee-AT-riks]).

How Your Child’s Team Can Help

If your child is having issues with body functions or sensation (feeling) below an injured site on the spinal cord, their team of healthcare providers will help them develop strategies to address the changes caused by the injury. This includes issues with bladder and bowel control, breathing and circulation, skin sensation, and muscle tone.

Some other issues your child’s team can help with are avoiding muscle or joint pain from overusing certain muscle groups due to a spinal cord injury, nerve pain in those with an incomplete injury, and depression from coping with the changes spinal cord injury brings and living with pain.

Therapists will educate you and your child on the effects of a spinal cord injury. They can help your child develop the skills and learn strategies to accomplish their daily tasks. Your child can still have a good quality of life with equipment and technology. Medicines may be used to manage some of your child’s symptoms.

Some spinal injuries can’t be prevented, since they’re due to illness, disease, accidents, and trauma. However, you can help your child practice good back and spine health habits to take the best care of their spine and prevent a lot of pain.

• Teach your child how to lift properly and avoid heavy lifting when they can.
• When your child’s doctor says it’s OK, encourage your child to exercise regularly with both aerobic and core-strengthening exercises. Be sure to warm up by stretching the muscles first.
• Always use a car seat that is the proper fit for your child’s age, weight, and height, and make sure they are buckled in every time.
• Help your child understand the risks of reckless play, such as jumping from heights or diving headfirst.
• If your child is involved in sports, make sure you they use the right equipment that fits and is in good condition. Talk to their coach if you are concerned about the possibility of injury.

The back is made up of several systems. A spinal cord connects the brain to the rest of the body. The cord is a long, fragile tube of nerves protected by back bones (vertebrae [VEHR-teh-bray]) of the spine (the spinal column).

This central nerve sends messages between the brain and different parts of the body. Spinal injuries can cause problems with those signals. Injury may result from damage to the spinal cord or vertebrae [VEHR-teh-bray], ligaments, or discs of the spinal column. Some spinal pain is caused by congenital [KAHN-jen-ih-TUHL] defects that children are born with.

Traumatic vs. Nontraumatic Injury

Traumatic [traw-MAT-ik] spinal cord injuries are usually due to a sudden force or blow that fractures or dislocates your child’s spine. The most common cause of a spinal cord injury in children is motor vehicle crashes, followed by falls. Sometimes, a baby can be born with spinal trauma [TRAW-mah] from a difficult labor. About 20% of all spinal injuries happen to children and teens.

Nontraumatic injuries or pain can be caused by juvenile arthritis [ahr-THRAY-tis], spinal stenosis [sten-OH-sis], cancer, infections, or inflammation. Damage from both traumatic and nontraumatic injuries affects the nerves around the injured site and impairs nerve signals from the muscles and nerves below the injury.

Types of Injuries

A tear or bruise on the spinal cord is an incomplete injury. Most spinal pain is due to an incomplete injury, with something out of place in the back, such as pieces of vertebrae or disc tissue pressing against nerves in the spinal cord.

A complete injury means that the spinal cord is severed, so the brain can’t send or receive nerve signals below that point. This results in paralysis [pah-RAL-uh-sis] below the injury point.

Long-term Effects

If a child gets a spinal injury before reaching puberty, they are very likely to develop scoliosis (curving of the spine). Your child’s doctor should carefully monitor your child for signs of scoliosis as they grow.

When the spine is injured, the nerve cells are damaged or destroyed. Nerve cells in the spinal cord do not regrow, so there is no way to reverse damage. Researchers are working to find treatments, such as medicines that help nerve cells to regrow or function better after a spinal cord injury.

For now, treatment focuses on helping people with spinal cord injury to live as productive and active a life as possible with aids such as medicine, rehabilitation, and prosthetic [prohs-THET-ik] or assistive devices.