Symptoms:

Symptoms vary somewhat depending on the location of the injury. Spinal cord injury causes weakness and sensory loss at and below the point of the injury. The severity of symptoms depends on whether the entire cord is severely injured (complete) or only partially injured (incomplete).

The spinal cord doesn't go below the 1st lumbar vertebra, so injuries at and below this level do not cause spinal cord injury. However, they may cause "cauda equina syndrome" -- injury to the nerve roots in this area.

CERVICAL (NEAR THE NECK) INJURIES

When spinal cord injuries occur near the neck, symptoms can affect both the arms and the legs:

• Breathing difficulties (from paralysis of the breathing muscles)
• Loss of normal bowel and bladder control (may include constipation, incontinence, bladder spasms)
• Numbness
• Sensory changes
• Spasticity (increased muscle tone)
• Pain
• Weakness, paralysis

THORACIC (CHEST-LEVEL) INJURIES

When spinal injuries occur at chest level, symptoms can affect the legs:

• Breathing difficulties (from paralysis of the breathing muscles)
• Loss of normal bowel and bladder control (may include constipation, incontinence, bladder spasms)
• Numbness
• Sensory changes
• Spasticity (increased muscle tone)
• Pain
• Weakness, paralysis

Injuries to the cervical or high-thoracic spinal cord may also result in blood pressure problems, abnormal sweating, and trouble maintaining normal body temperature.

LUMBAR SACRAL (LOWER-BACK) INJURIES

When spinal injuries occur at the lower-back level, varying dgrees of symptoms can affect the legs:

• Loss of normal bowel and bladder control (may include constipation, incontinence, bladder spasms)
• Numbness
• Pain
• Sensory changes
• Spasticity (increased muscle tone)
• Weakness and paralysis

Signs and tests:

Spinal cord injury is a medical emergency requiring immediate attention.

The health care provider will perform a physical exam, including a neurological exam. This will help identify the exact location of the injury, if it is not already known. Some of the person's reflexes may be abnormal or absent. Once swelling goes down, some reflexes may slowly recover.

The following tests may be ordered:

• A CT scan or MRI of the spine may show the location and extent of the damage and reveal problems such as blood clots (hematomas).
• Myelogram (an x-ray of the spine after injection of dye) may be necessary in rare cases.
• Somatosensory evoked potential (SSEP) testing or magnetic stimulation may show if nerve signals can pass through the spinal cord.
• Spine x-rays may show fracture or damage to the bones of the spine.