The vertebral column protects the spinal cord, just as the skull protects your brain. Unfortunately, vertebrae can only handle so much force before their structural integrity is compromised. During an injury, the spinal cord typically sustains compressive and contusive forces due to broken or displaced vertebrae. The cord itself is rarely cut in half, even in cases of severe injury.
The initial impact of a SCI can damage neurons – cells that transmit the signals to and from the brain. Just like other parts of the body that sustain a physical insult, the spinal cord bruises when impacted. The damage and bruising of the initial injury cause an inflammatory response. Ongoing tissue damage continues for weeks following injury – spreading from the injury epicenter in all directions. At a certain point, your body essentially walls off the damaged tissue to prevent its spread. This is referred to as glial scarring. While beneficial, glial scarring can impede the body’s attempt at regenerating damaged neurons and restoring normal signaling connections.
Damage to neurons and support cells due to SCI can affect all types of singling in the spinal cord. Movement of muscles, sensory function and control of your internal involuntary systems (autonomic function) can be impaired due to injury. The effects of injury are dependent on the level or region of injury and can affect arm and leg function, regulation of digestion, bowel and bladder function, regulation of blood pressure and heart rate and sensitivity to painful stimuli.
What Can be Done?
Spinal surgeons can stabilize the broken and displaced vertebrae in order to prevent ongoing compression/damage. In essence, they aim to recreate the stable and permissive vertebral column that existed prior to the injury.
In terms of drugs that can be delivered to help prevent the spread of damage following the initial injury, the options are limited. Depending on the circumstances, doctors might deliver methylprednisolone, an anti-inflammatory steroid that has shown modest benefits in clinical trials. Despite the lack of clinical options to treat SCI, there are many exciting treatments on the horizon that are showing great promise in pre-clinical studies. In the long term, rehabilitation efforts can help injured patients to regain function in the legs and/or arms.