Spinal Cord Injury
- Published14 Aug 2023
- Author Gail Zyla
- Source BrainFacts/SfN
Our spinal cords often take a back seat to the brain when we think of our central nervous system. But this vital bundle of nervous system tissue — protected by the vertebral column running down our backs — gives us the ability to communicate with our bodies. Injury to the spinal cord can have ranging impacts on mobility, bodily control, and bodily sensation.
A spinal cord injury (SCI) disrupts the neural architecture that carries information along the spinal cord and results in a loss of functions. SCIs can occur when a sudden, traumatic blow to the spine fractures or dislocates vertebrae, destroying nerve cells that carry signals along the spinal cord. SCIs also can arise from other non-traumatic forces, like from tumors, demyelinating conditions, blood clots, strokes, and more. Each year, about 17,000 people suffer spinal cord injuries in the United States, and an estimated 282,000 people in the U.S. currently live with spinal cord injuries.
Vehicle crashes are the leading cause of spinal cord injuries, followed by falls, acts of violence (primarily gunshot wounds), and injuries from contact sports and recreational activities. No two spinal cord injuries are the same. SCIs can vary in their damaging impacts depending on the severity of injury and where along the spinal cord the injury occurs, leading to different outcomes. Death rates among people with spinal cord injuries are significantly higher during the first year after the injury, especially people whose injuries cause severe neurological impairments.
There are currently no FDA approved remedies to prevent or repair neurological damage incurred by injuries to the spinal cord; however, some methods like spine realignment and stabilization and surgery are standard practice to help limit the damage that develops after the initial injury. In addition, there are ongoing efforts to support better rehabilitation techniques, as well as research into repairing and regenerating injured tissue and nerve cells to restore communication.
SCIs can permanently damage nerve cells and cause a wide range of disabilities — including various degrees of paralysis. *Pregabalin, an anticonvulsant and pain reliever, can help with the management of neuropathic pain commonly experienced following a SCI. But there are no drugs or treatment approaches yet approved to restore function following a SCI. Other future treatment candidates aim to assist nerve regrowth after the injury.
There is no cure for spinal cord injuries, but scientists are investigating new ways to repair damaged spinal cords. These include protecting surviving nerve cells from further damage, replacing damaged nerve cells, stimulating the regrowth of axons and targeting their connections, and retraining nerve circuits to restore bodily functions. In addition, scientists constantly search for new methods for rehabilitating patients with SCI and improving their quality of life. Rehabilitation focuses on physical therapy to strengthen muscles and improve mobility. Occupational therapy focuses on enhancing fine motor skills, such as the skills needed to write or type.
Electrical muscle stimulation is sometimes used in the clinic to help restore function to muscles affected by the injury. Scientists have developed experimental procedures to stimulate the spinal cord directly, which has demonstrated promising results for restoring some limited functions lost after spinal cord injury.
Stem cells can be used to repair circuits at the site of injury. These cells grown in the lab, which can be derived from a patient’s own tissues, can develop into different kinds of cell types like other nerve cells — helping them integrate to and repair circuits they are introduced to. Researchers are continuing to understand how certain neurochemical and cellular barriers that prevent regrowth and repair can be overcome and how the newly born cells can be induced to integrate into the injured circuit.
*This section was updated August 14, 2023, to include information on Pregabalin, a treatment for neuropathic pain associated with SCI.
Adapted from the 8th edition of Brain Facts by Gail Zyla.
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