At a glance
What it is
Traumatic injury to the spinal cord producing a contusion (bruise), partial tear, or complete transection. Because the spinal cord is the main conduit for signals between the brain and body, damage interrupts motor control, sensation, and autonomic regulation below the injury site. Severity ranges from mild contusion (partial, potentially reversible deficit) to complete transection (total permanent loss of sensation and movement below the level of injury). The higher the injury level in the cervical, thoracic, or lumbar cord, the more body systems are affected. Bladder, bowel, and skin infections are common secondary complications.
Symptoms
Spinal shock immediately after injury: temporary loss of all sensation and movement below the lesion. After shock resolves (hours to weeks), the true extent of the deficit emerges. Depending on level and completeness: weakness or paralysis of the limbs (tetraplegia if cervical, paraplegia if thoracic/lumbar), loss of sensation, muscle spasticity, respiratory difficulty (high cervical injuries), heart-rate and blood-pressure instability, bladder and bowel dysfunction. Chronic complications include neuropathic pain, pressure injuries, recurrent urinary tract infections, and deep vein thrombosis.
Approach
Acute: immobilisation at the scene; IV corticosteroids to control cord swelling; urgent surgical stabilisation of fractured vertebrae, decompression of the cord, and repair of associated injuries. Long-term: physical, occupational, and speech rehabilitation to maximise functional recovery; muscle-strengthening and anti-contracture programmes; spasticity management (baclofen — oral or intrathecal); bladder and bowel management; neuropathic pain management including neuromodulation. Mechanical ventilation, bladder catheterisation, or feeding tube support may be required indefinitely for high-level complete injuries.
What spinal trauma is
The spinal cord is a cylindrical bundle of nerve fibres that runs from the base of the brain to approximately the first or second lumbar vertebra. It relays motor commands from the brain to muscles, and sensory information from the body to the brain. It also regulates autonomic functions including blood pressure, heart rate, bladder, and bowel.
**Injury mechanisms**
The leading causes of spinal cord injury are motor vehicle crashes (44%), violence (24%), falls (22%), and sport (8%). Injury occurs from direct impact causing fracture-dislocation of vertebrae, disc herniation into the cord, or penetrating wounds. The cord may sustain a contusion (intact but bruised), a partial tear (some tracts preserved), or complete transection (all tracts severed below the level).
**Immediate response and spinal shock**
In the hours after injury, spinal shock causes a temporary loss of all cord-mediated reflex activity below the lesion — flaccid paralysis, absent reflexes, and loss of bladder and bowel tone. As shock resolves over days to weeks, the true injury pattern becomes clear: upper motor neurone signs (spasticity, hyperreflexia) emerge in incomplete injuries; complete injuries remain flaccid and areflexic below the level.
**Level and completeness determine prognosis**
*Cervical injury* (C1–C8): affects all four limbs; high cervical (C1–C4) may abolish breathing requiring mechanical ventilation; C4–C5 may spare some shoulder and arm function.
*Thoracic injury* (T1–T12): affects the trunk and legs; arm function is preserved; breathing is usually maintained.
*Lumbar injury* (L1–L5): affects the legs, bladder, bowel, and sexual function; walking recovery is more likely.
Complete injuries (no sensory or motor function below the lesion level) carry a poor prognosis for recovery. Incomplete injuries (some function preserved) have variable but often meaningful recovery potential, especially with early intensive rehabilitation.
**Long-term management**
*Spasticity* — increased muscle tone below the lesion is managed with physiotherapy, stretching, Botox® injections into spastic muscles, oral baclofen, or intrathecal baclofen pump for severe cases.
*Neuropathic pain* — central sensitisation and deafferentation pain are common; managed with anticonvulsants (gabapentin, pregabalin), antidepressants, and spinal cord stimulation.
*Bladder dysfunction* — neurogenic bladder requires intermittent self-catheterisation or an indwelling catheter; urological follow-up prevents recurrent infection and upper urinary tract damage.
*Rehabilitation* — intensive multidisciplinary rehabilitation (physiotherapy, occupational therapy, and speech therapy where relevant) is the cornerstone of functional recovery and community reintegration.
Treatment options at Alimran Medical Center
Neuromodulation
Injection therapies
- Botox® injections
- Prolotherapy
- Ozone injection
- Trigger point injections
- Epidural steroid injections
Advanced therapies
Physiotherapy & rehabilitation
- Electrical stimulation
- Short and long wave therapy
- Laser therapy
- Ultrasound therapy
- Spasticity management and functional rehabilitation
- SpineMED® system
- Sigma
Book a consultation
The secretary schedules first appointments during clinic hours; please have prior imaging, operative notes and a current medication list available at the time of the call.
This page provides general information about spinal trauma and is not a substitute for individual medical assessment. If your symptoms are severe or worsening, contact a clinician promptly.