Spinal Cord Injury

The spinal cord serves not just one critical function, but several. A compact but extremely powerful package of nerves, it works with the brain to transmit important messages that are responsible for functions in every area of the body.

Anatomy of the spinal cord

To understand how and why spinal cord injuries have different effects on different parts of the body, it’s helpful to understand the anatomy of the surrounding area. The spinal cord is divided into sections that correspond with the neighboring bones of the spine:
  • cervical (neck area)
  • thoracic (mid-back)
  • lumbar (lower back) 
  • sacrum (base of the spine)

Typically, the higher the location of the injury, the more significant the resulting damage. Serious SCIs are categorized as either paraplegic — resulting in a loss of sensation and function in the lower half of the body — or quadriplegic/tetraplegic, resulting in a loss of feeling and movement from the chest down, including both arms and both legs.

Types of spinal cord injuries

Because the spinal cord plays such an essential role, any injury has the potential for widespread and serious damage. Spinal cord injuries (SCIs) can occur as:

  • bruises (called contusions
  • partial tears
  • complete tears (called a transection)

In addition, SCIs can be:

  • incomplete, causing only a partial loss of feeling and movement below the level of the injury 
  • complete, causing a complete loss of sensation and function below the level of the injury

Spinal cord injury statistics

  • Children account for only 5 percent of all individuals who sustain spinal cord injuries.
  • 60 to 75 percent of all SCI occur in the neck area.
  • 20 percent of all SCI affect the chest or upper back.
  • The remaining 5 to 20 percent involve the spinal cord in the lower back.

While treatment options depend on the specifics and severity of the particular injury, you can rest assured that Boston Children’s Hospital has the world-renowned expertise and state-of-the-art tools to give you, your child and your family the care you need.

How is a spinal cord injury defined?

A spinal cord injury is any damage to the spinal cord that is caused by trauma, rather than a birth defect or medical condition that involves the spinal cord (such as a spinal cord tumor or tethered spinal cord syndrome).

What causes spinal cord injuries in children?

Virtually any type of trauma can result in a SCI. Some of the most common traumatic situations children experience are:

  • falls
  • motor vehicle accidents (either with the child riding as a passenger or struck as a pedestrian)
  • sports injuries
  • child abuse or other incidences of violence

What are the symptoms of a spinal cord injury?

The exact symptoms your child experiences will depend on the degree of severity and particular location of her SCI.

Right after the trauma, she may go through spinal shock a pronounced loss of feeling, muscle movement and reflexes below the level of her injury. This is caused by swelling. In the case of minor SCIs (such as bruises), spinal shock can subside over the next couple of days as the swelling goes down, and some or all sensation and functions may gradually return.

When a SCI is more severe, however, other symptoms will start to emerge. These can include any or all of the following, depending on the location of the injury:

  • muscle weakness
  • partial or complete loss of muscle movement in the chest, arms or legs
  • breathing difficulty
  • partial or complete loss of feeling in the chest, arms or legs
  • loss of bowel and bladder function

In general, the higher in the back or neck the injury is located, the more extensive the symptoms will be. For example, if your child’s injury is in the lower portion of her spinal column, she may have reduced or absent feelings in (and impaired control of) her legs, bladder and bowels. If her SCI is in the upper neck region, she may be unable to move her arms or legs or to breathe on her own.

SCIs can be severe and potentially life-threatening injuries. You should always seek immediate help for your child from trained, qualified emergency medical responders.