Spinal Cord Injury - Introduction
An injury to this fragile structure is life threatening and should be treated as a medical emergency. The most common cause of injury is through traumatic injury. Other non-traumatic causes are epidural hematomas, (blood clots), spinal tumours/ metastases and epidural abscesses.
CausesThe functional changes after a spinal trauma can be complex. Damage at the level of the spine results in either a fracture of the vertebral body and of the facet joints or a displacement of the intervertebral discs and the surrounding ligaments. The resulting spinal instability can put pressure on the spinal cord causing a tearing of nerves and of blood vessels. This loss of blood flow and nerve damage could trigger a chain inflammatory response which could spread many levels above and below the site of damage. 20% of traumatic injuries occur in the neck area of the spine. Recent studies show that around 15 out of a million people in Europe are affected by traumatic spinal cord compression. Young men make up the majority. Motor vehicle and sporting accidents are the leading cause of trauma. Increasingly, spinal cord injuries, particularly those involving the neck (cervical spine) occur in older patients who have previous stiffness and wear in the neck and then suffered a simple fall.
A metastasis/ tumour of the spine can also compress the spinal cord. 60% of spinal metastases occur in the upper (thoracic) spine. Breast, kidney and lung metastases are seen to be more frequent.
A bacterial infection around the spinal cord area can remain undetected for weeks. The resulting symptoms of cord compression may be abrupt. Risk factors for abscess formation are diabetes, kidney failure, suppression of the immune system, intravenous drug use and alcohol abuse. Previous surgical interventions are also a risk factor.
Epidural hematomas (a bleed) may be caused after traumatic injuries, or spontaneously in patients with clotting problems or in patients with long-term anti-clotting treatment.