Spinal Cord Injury: Making a Difference Today

Spinal cord injury is an uncommon, but real, risk in our daily activities. Each year, thousands in the United States experience damage to the nerve bundles that carry messages from the brain to the rest of the body.

Normally, information easily travels between the brain and the rest of the body through the backbone. In a spinal cord injury, however, connecting nerve cells are partially or completely destroyed, leading to a loss of sensation and movement.

Patients face the possibility that they may never walk again, move their arms, or feel a touch.

• About 262,000 Americans live with a spinal cord injury, and about 12,000 new injuries occur each year.
• Spinal cord injury more often affects the young, although this is changing as the population ages. The average age of injury, once around 29, is now 40.
• A spinal cord injury in a 25-year-old requires between $700,000 and $3.2 million in medical care. Patients also lose more than $2.75 million from unemployment and reduced productivity over their lifetimes.
• Motor vehicle accidents account for more than 40 percent of spinal cord injuries. Other leading causes are falls (28 percent), violence (15 percent), and sport accidents (8 percent).

Fortunately, neuroscientists funded by the National Institutes of Health and other research organizations are working on ways to minimize or repair the damage caused by such injuries.

Research Breakthroughs

Spinal cord injury is most often caused by trauma, but tumors, disease, and other conditions also can be responsible. The injury causes nerve cells in the spinal cord to die or become permanently damaged.

Spinal cord injury is most often caused by trauma, but tumors, disease, and other conditions also can be responsible. The injury causes nerve cells in the spinal cord to die or become permanently damaged.

Symptoms depend on the type and location of the injury. A blow high in the neck that severs the nerve fibers usually leads to a complete loss of control and feeling in the arms and legs. In addition, people often suffer chronic pain, loss of bladder control, and loss of sexual function. A milder injury lower in the back might cause no obvious symptoms.

In the initial hours and days after an injury, doctors attempt to minimize further damage caused by the body’s immune response. They commonly use the steroid methylprednisolone to reduce inflammation, although it is unclear whether this provides any benefits. Another treatment gaining popularity is to inject cold saline into the spine to induce hypothermia, but effectiveness studies of this technique are still pending.

Rehabilitation, education, and physical therapy are used to help those with spinal cord injuries assess their abilities, learn strategies for managing their condition, and gain some ability to care for themselves.

In recent years, brain scientists have developed advanced training techniques for helping patients regain some movement ability. Based on basic research performed in cats, doctors are investigating whether intense training on a treadmill can give even those with complete spinal cord injuries the ability to step "automatically," allowing them to walk for a limited period using a walker. Studies show that even passive exercise can help the nervous system repair lost connections and promote the brain’s innate ability to recover from damage.