Spinal injury

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

In the event of a spinal column injury (spinal column trauma), the spine is damaged by mechanical force. This can also damage the internal structures (spinal cord and nerve roots) or neighboring soft tissues (such as muscles). A spinal injury can have serious consequences - not least if the first aid is incorrect. Therefore, read how you can recognize a spine injury and how you as a first aider react correctly in such an emergency.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. S22T08S33S24S12S34S32T09S23S14S13

Brief overview

Symptoms of a spinal injury: back pain, limited / no longer existing mobility and / or sensitivity, swelling
Diagnosis of a spinal injury using imaging tests such as X-rays, MRI, CT
Therapy of spinal injuries: immobilization / stabilization, surgical intervention if necessary, medical treatment for pain or muscle cramps

Caution!

Car and sports accidents are the most common causes of spinal injuries. After a fall or a violent collision, injuries to the spine are often visible on X-rays.
If the spinal cord is injured in children, the nerves may only function temporarily. This means that they have short-term pain that shoots into the legs or arms in a flash.
If partial paralysis from a spinal injury resolves within a few weeks, the chances of a full recovery are good. On the other hand, complaints that are still present after six months remain permanent in many cases.

Spine Injury: Symptoms

They depend on which structures were damaged and to what extent during the spinal injury. In general, a spine injury causes symptoms such as

Back pain
Restriction of mobility or inability to move
Swelling and bruises
Sensitivity disorders, motor weakness (paresis) or symptoms of paralysis, if nerves have also been damaged

When the spine is injured, the nerves and spinal cord are also affected because the structures are close together.

Symptoms of spinal cord injuries

If the spinal cord is affected by a spinal column injury, this is reflected in functional disorders under and at the injured area. For example, if the injury is in the neck area, the affected person may no longer be able to move their arms (properly). If the spinal cord is damaged further down, this can manifest itself in functional disorders of the legs. Sometimes he can no longer control the intestines and urine.

Furthermore, the affected person has pain in the affected area.

Symptoms of nerve damage

In the case of nerve injuries, the affected person loses feeling in and around the injured area and often no longer has control over the muscles that are supplied by the nerves concerned. This restriction can be total or partial, temporary or permanent. The latter is the case, for example, when the nerve tracts in the spinal cord have been destroyed or the spinal cord is severed.

Symptoms of muscle injuries

Loss of muscle tension can be a symptom of a spinal injury with accompanying muscle damage. In addition, some or all of the muscle reflexes can fail. Experts speak of muscle weakness when the person affected has partially lost control of the injured muscles. If he can no longer control certain muscles, they are paralyzed.

If the movement of certain parts of the body is permanently restricted or impossible as a result of a spinal injury, the muscles that are no longer used can become permanently shortened.

Spinal Injury: Diagnosis

The doctor will use imaging techniques to determine the exact position and extent of the spinal column injury (bone, spinal cord) and any accompanying injuries (e.g. adjacent muscles). This includes:

X-ray: An X-ray shows whether bony structures (e.g. vertebrae) are injured. However, damage to the spinal cord is not visible on it.
Computed tomography (CT): It can show injuries to the bony spine much more precisely than an X-ray examination. You can also see other tissue structures in the CT.
Magnetic resonance tomography (MRT): This method, also known as magnetic resonance tomography, provides very detailed images like computed tomography. They help the doctor to identify injuries to the spinal cord or ligaments of the spine, for example. However, this procedure shows bone injuries less precisely.

Spinal Injury: Therapy

For vertebral injuries, medical therapy is first of all to immobilize the patient - movement can make the injury worse. Even the smallest movements are often enough to build up pressure on the spinal cord by shifting vertebrae, which under certain circumstances can lead to paralysis.

Surgical intervention may be necessary if there is a spinal injury, for example if the doctor has to remove bits of bone or accumulations of blood that are pressing on the spinal cord. He then immobilizes the patient or the spine until the bones and other tissues have healed. Sometimes it is also necessary to insert steel bolts during surgery to stabilize the injured spine.

Pain resulting from a spinal injury can be relieved with pain relievers (analgesics). Active ingredients such as ibuprofen or paracetamol help with moderate symptoms. After an operation, on the other hand, stronger pain relievers (opiates) are often necessary.

If a spinal injury results in paralysis due to muscle cramps (spastic paralysis), the doctor prescribes muscle relaxants - drugs that relieve the cramps. Such spastic paralysis can occur weeks after the accident.

After the acute treatment, the patient usually receives physical and occupational therapy so that he or she recovers from the spinal injury as quickly and as completely as possible.

Sometimes a spinal injury leaves the patient permanently (partially or completely) paralyzed. This can put a lot of psychological strain on the person affected, up to and including depression. Then antidepressants can be necessary and helpful - together with psychotherapy or professional emotional support.

Spine Injury: What To Do?

If a spinal injury is suspected, first aiders have to be extremely careful - even the smallest movement can lead to permanent paralysis. The first aid for a spinal injury is therefore as follows:

Call the ambulance immediately!
Calm down the victim.
If the injured person is conscious, do not move him if possible. Ask him to keep his head and neck very still. Once you have mastered the neck brace grip (see below), you can use it to stabilize the head and neck area.
If the injured person is unconscious, you have to put them in a stable position on their side - unconsciousness is more dangerous than any damage caused by moving the injured person. In the case of an unconscious person lying on their back, the slack tongue or vomit can obstruct the airways and lead to suffocation.

For the neck brace grip, kneel on the head of the injured person, grip his neck with one hand, supporting the neck with your fingers and placing your thumb on the collarbone. With the other hand, hold the head firmly and press it lightly against the opposite forearm, which then becomes a supportive splint.

Spine Injury: When to See a Doctor?

If you suspect someone has injured their spine, you should always call an ambulance. Spinal injuries can cause severe and permanent damage and cannot be fully recognized by laypeople or with the naked eye. Therefore, if spinal injuries are suspected, medical help and imaging examinations are always necessary.

Prevent spinal injuries

A spinal injury occurs in otherwise healthy people as a result of unusually strong violence, for example a violent fall, a (motorcycle) accident or the like. The main way to prevent injuries is to behave carefully when exercising and driving and not taking any unnecessary risks. Motorcyclists can and should wear special protectors for the spine, motorists should make sure that the headrests of the seats are well adjusted so that they stabilize the neck area.

What else you can do: Regular, targeted strength training strengthens the back muscles, which in turn can better support the spine. In the event of unforeseen violence, this can prevent spinal injuries under certain circumstances.

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