Spinal Cord Injury

Life with a spinal cord injury or disease is demanding enough without secondary symptoms such as spasticity, which tightens muscles and can make daily activities more challenging. That’s why we have therapies to help manage spasticity.

Definition

Spinal cord injury refers to damage of the spinal cord resulting from a blunt or penetrating trauma.

Causes

Spinal cord injury is usually the result of an accident (for example, motor vehicle accident, fall, sports injury) or acts of violence such as gunshot wounds. It can also be caused by surgical complications2 or by disease (for example, polio, spina bifida, Friedreich’s Ataxia).3

Risk Factors

Spinal cord injury can happen to anyone, but some people are at higher risk, including:

  • Men – 80% of spinal cord injuries1, 2
  • Young adults 16 to 30—more than half of spinal cord injuries1, 2
  • People who engage in risky behavior – such as diving into shallow water or playing sports without proper safety gear or precautions1, 2
  • People with an underlying bone or joint disorder – for example, arthritis, osteoporosis1

Symptoms

Even if the spinal cord has not been severed, a spinal cord injury can still result in loss of function. In fact, most people with impaired functioning due to spinal cord injury still have an intact spinal cord.3

Symptoms of possible spinal cord injury include:2

  • Extreme pain or pressure in the neck, head, or back
  • Tingling or loss of sensation in the hand, fingers, feet, or toes
  • Partial or complete loss of control over any part of the body
  • Urinary or bowel urgency, incontinence, or retention
  • Difficulty with balance and walking
  • Abnormal band-like sensations in the thorax (pain, pressure)
  • Impaired breathing after injury
  • Unusual lumps on the head or spine

In addition, studies show that most spinal cord injury survivors have at least one secondary problem resulting from their injury, including:4

  • Spasticity
  • Obesity
  • Pain
  • Urinary tract infection
  • Pressure sores

Diagnosis

Spinal cord injury is usually first diagnosed by loss of function below the injury site, along with other symptoms of spinal cord injury.

If your clinician suspects spinal cord injury, he or she will:

  • Perform a full physical evaluation
  • Take a detailed medical history
  • Perform specialized diagnostic tests

About Spasticity Due to Spinal Cord Injury

Spasticity is caused by damage or injury to the part of the central nervous system (the brain or spinal cord) that controls voluntary movement. This damage disrupts important signals between the nervous system and muscles, creating an imbalance that increases muscle activity or spasms.

Spasticity can make movement, posture, and balance difficult. It may affect your ability to move one or more of your limbs, or to move one side of your body. Sometimes spasticity is so severe that it gets in the way of daily activities, sleep patterns, and caregiving. In certain situations, this loss of control can be dangerous for the individual.

References

  1. Spinal Cord Injury Risk Factors. Mayo Clinic. www.mayoclinic.com.
  2. Spinal Cord Injury. American Association of Neurological Surgeons. www.ans.org.
  3. Spinal Cord 101. Spinal Cord Resource Center. www.spinalinjury.net.
  4. Anson C, Shepherd C. Incidence of secondary complications in spinal cord injury. Int J Rehabil Research 1996;19:55-66

Treatment Options for Severe Spasticity

People with spasticity can treat their condition in many ways: rehabilitation, medication, injection therapy, even surgery. There is also Medtronic ITB TherapySM (Intrathecal Baclofen Therapy), also called the baclofen pump, which may be helpful for reducing your severe spasticity.

There is currently no cure for severe spasticity. However, there are a number of treatment options available for managing your symptoms. They include:

Rehabilitation Therapy

Rehabilitation therapy usually takes place in a clinic, a hospital, or at home. It can include any combination of physical, occupational, or speech therapy.

Oral Medication

Oral medications may help some people treat the symptoms of spasticity.

Neurosurgeries

Neurodestructive surgical procedures include selective dorsal rhizotomy, in which the dorsal (sensory) nerve roots are severed.

Injection Therapy

Injection therapy is usually intended for specific muscle groups (for example, one hand, one foot, one shoulder).

Orthopedic Surgery

Orthopedic surgeries include soft tissue procedures like tendon transfers and osteotomies (cutting a bone to change its alignment).

ITB Therapy (Baclofen Pump)

ITB Therapy, also called the baclofen pump, is an adjustable, reversible treatment for severe spasticity. A surgically placed pump and catheter deliver liquid baclofen (Lioresal® Intrathecal) directly to the fluid around the spinal cord, where it’s needed most.

PBNeuroRehab’s Spasticity Clinic offers the above treatments for severe spasticity.