Spinal Cord Injury
Damage to the spinal cord that disrupts communication between the brain and body
A spinal cord injury (SCI) occurs when trauma or disease damages the spinal cord, disrupting the nerve signals that control movement, sensation, and bodily functions below the injury level. SCIs are classified as complete (no movement or sensation below the injury) or incomplete (some function preserved). Approximately 17,000 new spinal cord injuries occur in the United States each year, most often from motor vehicle accidents, falls, sports injuries, and acts of violence.
Symptoms
- Loss of movement (paralysis) in the arms, hands, trunk, or legs depending on injury level
- Loss of or altered sensation, including the ability to feel heat, cold, and touch
- Loss of bowel or bladder control
- Exaggerated reflex activity or spasms (spasticity)
- Changes in sexual function or fertility
- Pain or intense stinging sensations caused by nerve fiber damage
- Difficulty breathing, coughing, or clearing secretions (cervical injuries)
Causes & Risk Factors
- Motor vehicle accidents — the leading cause of SCI
- Falls — the leading cause for adults over 65
- Violence such as gunshot wounds or stab injuries
- Sports and recreation injuries, especially diving and contact sports
- Medical or surgical complications (rare)
- Diseases such as tumors, infections, or inflammation of the spinal cord
- Vascular conditions reducing blood supply to the cord
Treatment Options
Conservative (Non-Surgical)
- Immobilization and stabilization immediately following injury
- High-dose methylprednisolone (steroids) within 8 hours of injury in selected cases
- Inpatient rehabilitation: physical, occupational, and speech therapy
- Assistive technology: wheelchairs, communication devices, functional electrical stimulation
- Bowel and bladder management programs
- Pain management including medications and nerve blocks
- Psychological counseling and peer support programs
Surgical Options
- Emergency spinal decompression to relieve pressure on the cord
- Spinal stabilization with rods, screws, or plates to realign and immobilize the spine
- Tendon transfer surgery to restore upper limb function in incomplete cervical injuries
- Intrathecal baclofen pump implantation for severe spasticity management
When to see a spine specialist
Any suspected spinal cord injury is a medical emergency. Call 911 immediately and avoid moving the person. After initial stabilization, a spine specialist and rehabilitation team should be involved in care planning as soon as possible. Even with incomplete injuries, early, aggressive rehabilitation significantly improves outcomes.
Frequently Asked Questions
What is the difference between a complete and incomplete spinal cord injury?
A complete SCI means there is no motor or sensory function below the injury level — the cord communication is fully severed or severely disrupted. An incomplete SCI means some signals still pass through — the person retains partial movement, sensation, or both below the injury. Incomplete injuries have a broader range of recovery potential. The distinction is determined by standardized neurological testing, not by imaging alone.
Can spinal cord injuries recover?
Recovery depends on the injury level, the completeness of the injury, and how quickly treatment begins. Incomplete injuries often show meaningful functional recovery, especially with intensive rehabilitation. Complete injuries rarely result in full recovery, but most patients regain some function over time. Research into stem cells, epidural stimulation, and regenerative therapies is ongoing and showing early promise.
What level of spinal cord injury causes paralysis?
Injuries at the cervical (neck) level typically cause quadriplegia (paralysis of all four limbs and sometimes the trunk and breathing muscles). Injuries at the thoracic level cause paraplegia (paralysis of the legs and lower trunk). Lumbar and sacral injuries affect leg movement and bladder/bowel control but less commonly cause complete paralysis. The higher the injury, the more of the body is affected.
What is a spinal cord injury without radiographic abnormality (SCIWORA)?
SCIWORA refers to spinal cord injury symptoms — weakness, numbness, or paralysis — in the absence of any bone fracture or dislocation visible on X-ray or CT scan. It is more common in children due to the flexibility of the pediatric spine. MRI is required to identify cord contusion or swelling in these cases. Treatment follows standard SCI protocols.
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Medical disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for diagnosis and treatment decisions. Last reviewed March 2026. ICD-10: S14.109A.