This article was previously published on SpinalCord.com by Zawn Villines.
Though about 12,500 people survive spinal cord injuries each year, few people learn much about these catastrophic injuries until they are injured or must care for an injured loved one.
Most spinal cord injuries are preventable, and knowing the causes of these injuries can help you avoid becoming a victim. And if you or someone you love already deal with the frustration and pain of a spinal cord injury, knowing the most common sources of these injuries can help you feel a bit less alone.
Each year, the National Spinal Cord Injury Statistical Center at the University of Alabama-Birmingham compiles an assortment of statistics on spinal cord injuries. It’s interesting to note that, in almost all category of injuries, men are more likely to be injured than women.
Men account for more than 80% of SCI victims, and the reason for this is quite clear: men are more likely to take risks and play sports that cause SCI. Spinal cord injuries are especially prevalent among younger men, who may be more prone to playing dangerous sports or engaging in risky activities such as high-speed driving.
In 2014, the latest year for which statistics are available, the 10 leading causes of spinal cord injuries, and their percentage of the total number of injuries, were as follows.
Leading Causes of Spinal Cord Injuries, Explained
Auto Accidents
Car accidents are a leading cause of death nationwide, and people under the age of 34 are more likely to die in car accidents than any other single cause. Nationwide, car accidents claim more than 32,000 lives annually. Unsurprisingly, then, car accidents are the leading cause of spinal cord injuries, accounting for 7,205 (29.3%) male injuries and 2,402 (48.3%) female injuries in 2014.
Find out what to do after a car accident.
Falls
You don’t have to be elderly or infirm to suffer a fall. A misplaced step as you navigate stairs, a fight near a flight of stairs, or even a medical event, such as a seizure or fainting, can all lead to catastrophic falls. Such falls were the second-leading cause of SCI in 2014, accounting for 5,406 (22%) male injuries and 1,262 (21.5%) female injuries.
Gunshot Wounds
Gunshot wounds can quickly destroy a body, and even a grazing by a bullet can sever or compress the spinal cord. Gun-related injuries accounted for 4,163 (16.9%) male SCIs in 2014, and 572 (9.1%) female injuries.
Diving Injuries
Propelling head first into the water is an inherently dangerous activity. If the water is too shallow, the diver inexperienced, or there are objects or people in the diver’s way, the injuries can be immediate and catastrophic. 1,718 (7%) men suffered spinal cord injuries due to diving accidents in 2014, with 122 (2.1%) female divers experiencing SCI.
Motorcycle Accidents
Though motorcyclists account for a fraction of motorists on the road, the lack of external protection means that even minor motorcycle collisions can be deadly. In 2014, 1,695 (6.9%) men suffered spinal cord injuries while on motorcycles, with a mere 145 (2.5%) women experiencing such injuries.
Falling Objects
You might not think much about falling objects in your daily life, but collisions with such objects can produce lifelong injuries. Construction sites, falling rock, and even large icicles or hail can damage the brain and spine, particularly when victims are hit at high speeds or at particularly dangerous angles.
Those in industries where falling objects are common are especially vulnerable; this is why construction hats and similar safety gear factor so prominently in the prevention of spinal cord injuries. 822 men (3.3%) and 37 women (.6%) experienced spinal cord injuries due to falling objects in 2014.
Medical and Surgical Complications
Doctors, pharmacists, and other medical experts are on the front lines of the fight against spinal cord injuries. These providers can help you recover from even the most severe injuries, but there is also a dark side to medical care. Medical errors are frighteningly common, killing as many as 440,000 people each year. Even when such errors are not fatal, they can cause catastrophic spinal cord injuries.
Likewise, surgical complications, including infections, can compress the spinal cord. Choosing the right doctor, following his or her post-surgical care advice, reading provider reviews, and carefully monitoring any unusual symptoms can all help you avoid a medically induced SCI. 537 (2.2%) men suffered spinal cord injuries due to medical complications in 2014.
Among women, the numbers were similar, with 298 women experiencing such injuries. But because women are less likely than men to experience traumatic spinal cord injuries, medically induced SCI accounts for a higher proportion (5.1%) of female SCI than male SCI. Among women, medically induced SCIs are the fourth-leading cause of such injuries.
Pedestrian Injuries
Aggressive, distracted, and speeding motorists all contribute to a dangerous walking climate. It’s not just motorists who put people at risk, though. Ample research suggests that pedestrians are often distracted by phones and other devices, and many such pedestrians are in denial about the extent of their distraction. In 2014, 357 (1.5%) men suffered pedestrian-related spinal cord injuries, with 131 women (2.2%) meeting a similar fate.
Bicycle Accidents
Bicycle accidents change lives, especially when the cyclist collides with a car, hits a large object, or is not wearing a helmet. Helmets—even if you are only cycling in your own driveway, and even though you might not like the way helmets look—save lives. Over time, fatal bicycle accidents have generally declined, suggesting that helmet laws are working to keep cyclists safe. Nevertheless, 409 men (1.7%) and 49 women (.8%) suffered bicycling-related spinal cord injuries in 2014.
‘Person-to-Person’ Contact
Person-to-person contact injuries are a cause of spinal cord injuries that, as the name implies, result from contact with another person. In most cases, these injuries are the result of violent altercations, such as when one person pushes another into a heavy object. 234 men (1%) and 66 women (1.1%) suffer spinal cord injuries due to such contact each year.
Other SCI Injury Sources
Though the above-mentioned sources account for the overwhelming majority of spinal cord injury causes, there are many other possibilities. The next 10 leading causes of injury, in order from most to least prevalent, are as follows:
- Unclassified, which includes injuries that don’t fit neatly into a single category, or for which adequate data is not available.
- Penetrating wounds, such as an object entering the brain or spinal cord.
- All-terrain vehicle (ATV) accidents.
- Accidents in other vehicles, such as jet skis and boats.
- Snow skiing.
- Football.
- Winter sports such as snowboarding.
- Horseback riding.
- Surfing, including body surfing.
- Other sports-related injuries.
An estimated 12,500 spinal cord injuries occur in the U.S. every year, leaving the injured people, their friends, and their family, to cope with the aftermath of the catastrophe. For many, navigating the challenges of the health care system can feel a bit like going to medical school. Suddenly you’re learning a veritable cornucopia of new terms, and may be spending endless hours Googling spinal cord anatomy to fill in the gaps in your knowledge.
An educated patient is better equipped to advocate for his or her needs and interests. An education in spinal cord anatomy helps you understand what your doctor is saying, ask intelligent questions, and detect medical errors before they endanger your health.
Spinal Cord Anatomy: The Basics
Though you might think of your spinal cord as one single piece, it’s actually a column of nerves protected by a sheath of myelin and then further secured by 31 butterfly-shaped vertebrae (singular: vertebra).
Medical providers divide the spinal cord into four distinct regions. Knowing the region in which the injury is located is often the key to understanding diagnosis and treatment. The four spinal cord regions are:
- The cervical spinal cord: This is the topmost portion of the spinal cord, where the brain connects to the spinal cord, and the neck connects to the back. This region consists of eight vertebrae, commonly referred to as C1-C8. All spinal cord numbers are descending, so C1 is the highest vertebra, while C8 is the lowest in this region.
- The thoracic spinal cord: This section forms the middle of the spinal cord, containing twelve vertebrae numbered T1-T12.
- The lumbar spinal cord: This is a lower region of the spinal cord, where your spinal cord begins to bend. If you put your hand in your lower back, where your back bends inward, you’re feeling your lumbar region. There are five lumbar vertebrae, numbered L1-L5.
- The sacral spine: This is the lower, triangle-shaped region of the spine, also with five vertebrae. While the lumbar cord bends inward, the vertebrae of the sacral region bend slightly outward. There is no actual spinal cord in this section, it is made up of nerve roots which exit the spine at their respective vertebral levels.
- The coccygeal region, sometimes known as the coccyx or tail bone, consists of a single vertebra at the very base of the spinal cord.
Types of Spinal Cord Injuries
All spinal cord injuries are divided into two broad categories: incomplete and complete.
- Incomplete spinal cord injuries: With incomplete injuries, the cord is only partially severed, allowing the injured person to retain some function. In these cases, the degree of function depends on the extent of the injuries.
- Complete spinal cord injuries: By contrast, complete injuries occur when the spinal cord is fully severed, eliminating function. Though, with treatment and physical therapy, it may be possible to regain some function.
Incomplete spinal cord injuries are increasingly common, thanks in part to better treatment and increased knowledge about how to respond—and how not to respond—to a suspected spinal cord injury. These injuries now account for more than 60% of spinal cord injuries, which means we’re making real progress toward better treatment and better outcomes.
Some of the most common types of incomplete or partial spinal cord injuries include:
- Anterior cord syndrome: This type of injury, to the front of the spinal cord, damages the motor and sensory pathways in the spinal cord. You may retain some sensation, but struggle with movement.
- Central cord syndrome: This injury is an injury to the center of the cord, and damages nerves that carry signals from the brain to the spinal cord. Loss of fine motor skills, paralysis of the arms, and partial impairment—usually less pronounced—in the legs are common. Some survivors also suffer a loss of bowel or bladder control, or lose the ability to sexually function.
- Brown-Sequard syndrome: This variety of injury is the product of damage to one side of the spinal cord. The injury may be more pronounced on one side of the body; for instance, movement may be impossible on the right side, but may be fully retained on the left. The degree to which Brown-Sequard patients are injured greatly varies from patient to patient.
Knowing the location of your injury and whether or not the injury is complete can help you begin researching your prognosis and asking your doctor intelligent questions. Doctors assign different labels to spinal cord injuries depending upon the nature of those injuries. The most common types of spinal cord injuries include:
- Tetraplegia: These injuries, which are the result of damage to the cervical spinal cord, are typically the most severe, producing varying degrees of paralysis of all limbs. Sometimes known as quadriplegia, tetraplegia eliminates your ability to move below the site of the injury, and may produce difficulties with bladder and bowel control, respiration, and other routine functions. The higher up on the cervical spinal cord the injury is, the more severe symptoms will likely be.
- Paraplegia: This occurs when sensation and movement are removed from the lower half of the body, including the legs. These injuries are the product of damage to the thoracic spinal cord. As with cervical spinal cord injuries, injuries are typically more severe when they are closer to the top vertebra.
- Triplegia: Triplegia causes loss of sensation and movement in one arm and both legs, and is typically the product of an incomplete spinal cord injury.
Injuries below the lumbar spinal cord do not typically produce symptoms of paralysis or loss of sensation. They can, however, produce nerve pain, reduce function in some areas of the body, and necessitate several surgeries to regain function. Injuries to the sacral spinal cord, for instance, can interfere with bowel and bladder function, cause sexual problems, and produce weakness in the hips or legs. In vary rare cases, sacral spinal cord injury survivors suffer temporary or partial paralysis.
SOURCE: SpinalCord.Com