Spinal Cord Injuries: Overview and Diagnosis

Dear Ask The Doctor: Can a doctor determine if my father has a severed spine even though he has not has an MRI?

Dear ERICA: The spinal cord does not have to be severed for function to be lost. Most people with spinal cord dysfunction present with the cord intact. Cord injuries usually fall into one of the following categories: Contusions, compression injuries, lacerations ( from a gunshot , fall or sharp object), central cord syndrome.  When injury occurs and for a time period following, the spinal cord swells. Loss of function occurs below the level of the injury and may be permanent or temporary. Much depends on the severity of the injury itself. Spinal cord injury (SCI) is usually first diagnosed when the patient presents with a loss of function below the level of injury. The initial evaluation includes x-rays, a CT scan, and possibly a MRI. Fractures are demonstrated on plain radiographs. CT scanning and MRI studies are used to evaluate the soft tissues in the spinal column. In addition, a myelogram may be performed to identify and evaluate spinal cord lesions caused by trauma or disease. The neurologic evaluation includes assessment of the patient's symptoms, which might include loss of motor or sensory function. Other neurologic symptoms may include pain, numbness, paresthesias (tingling), muscle spasm, weakness, and bowel/bladder changes.