Spinal Cord Injuries

Spinal cord injury (SCI) damages the communication between the brain and the rest of the body. Causes include road-traffic accidents, falls from height, sports, diving into shallow water, and violence. Outcomes depend on the level and completeness of injury. Prompt, careful emergency care and good rehabilitation transform the long-term picture.

At the scene — crucial

• Do not move the person unless absolutely necessary for safety.
• Stabilise the head and neck in line with the body; keep spine straight.
• Dial 112; wait for trained responders with cervical collar and spine board.
• If breathing stops and CPR is needed, prioritise breathing/compressions with minimal neck movement.
• Note the mechanism of injury for the medical team.

Symptoms

• Weakness or paralysis below the level of injury — legs (paraplegia) or arms and legs (tetraplegia, for cervical injuries).
• Loss of sensation.
• Loss of bladder and bowel control.
• Breathing difficulty — in high cervical injuries.
• Neck or back pain, visible deformity, blood.
• Priapism can occur after SCI.

In hospital

• Imaging (CT/MRI), stabilisation (collar, brace, traction).
• Surgery — decompression, stabilisation as needed.
• Blood-pressure, oxygenation, temperature management in early hours.
• Prevention of complications — pressure sores, blood clots, chest infection, bladder infection.
• Early rehabilitation — starts in hospital.

Long-term care and rehabilitation

• Physiotherapy, occupational therapy — mobility, strength, transfers, activities of daily living.
• Wheelchair provision and home modifications.
• Bladder and bowel training; intermittent self-catheterisation where needed.
• Skin care — pressure-sore prevention; repositioning every 2 hours.
• Autonomic dysreflexia — a dangerous BP surge in high SCI; any new headache/sweating/flushed face above the level of injury warrants urgent review.
• Spasticity management.
• Sexual and reproductive health — men and women — specialised counselling exists; family planning is possible.
• Mental-health support — depression and grief are common; take seriously.
• Peer support and networks — The Spinal Foundation, NGO networks; genuinely valuable practical help.
• Disability certificate + ALIMCO/ADIP aids + vocational training — through state and central schemes.

Prevention — the biggest lever

• Helmets and seat belts every time.
• Never dive into unknown/shallow water.
• Fall prevention in older adults.
• Safe working at heights — construction safety rules.
• Road safety — a large share of Indian SCIs come from preventable road trauma.