Dr Colum Nolan
Senior Consultant Spine & Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
The spinal cord is an important group of nerves that runs through the spine, carrying movement and sensory signals between the brain and the rest of the body. When the spinal cord is injured, these signals can be disrupted, resulting in weakness, loss of sensation or, in severe cases, paralysis. Recognising the early signs of a spinal cord injury is therefore crucial, as prompt medical attention can help limit further damage and improve long-term outcomes.
Common Causes of Spinal Cord Injury
Spinal cord injury occurs when the spinal cord or the structures surrounding it are damaged. Common causes include:
- Trauma: Falls, road traffic accidents, sports injuries and workplace incidents can directly injure the spinal cord.
- Degenerative Cervical Myelopathy: Age-related changes in the cervical spine may gradually compress the spinal cord over time.
- Spinal Tumours: Growths within or around the spinal canal can place pressure on the spinal cord.
- Spinal Infections: Infections affecting the vertebrae or surrounding spinal structures may damage the spinal cord.
- Herniated Discs or Bone Spurs: Severe compression arising from a slipped disc, for example, particularly in the cervical spine, can affect spinal cord function.
- Vascular Problems: Reduced blood flow to the spinal cord can lead to tissue damage and neurological deficits.
Possible Signs of a Spinal Cord Injury You Shouldn’t Ignore
- Sudden or Progressive Weakness: Weakness in the arms, legs, or both may signal that the spinal cord is affected. This may range from difficulty lifting objects to trouble walking or standing.
- Numbness, Tingling or Loss of Sensation: Patients may experience pins-and-needles, reduced sensitivity or complete loss of feeling below the injury site.
- Problems With Balance or Coordination: Spinal cord injury may lead to clumsiness, unsteady walking or difficulty with fine motor tasks such as buttoning clothing.
- Neck or Back Pain, Especially After Trauma: Severe or persistent pain in the neck or back following a fall, accident or sudden impact may indicate spinal injury.
- Changes in Bowel or Bladder Function: Difficulty urinating, loss of bladder control, constipation or bowel incontinence are concerning symptoms that require urgent evaluation.
- Electric-Shock Sensations: Some patients report shock-like pain running down the spine or into the arms or legs, especially when bending the neck.
- Changes in Reflexes: Overactive reflexes, muscle spasms, or jerking movements can be signs of spinal cord irritation. These may be detected during a clinical examination.
How Spinal Cord Injuries Are Diagnosed
Diagnosing a spinal cord injury requires a careful combination of clinical assessment and imaging studies. The aim is to identify the cause, location and severity of the injury so that appropriate treatment can be started promptly.
Medical History and Physical Examination
The doctor will first review the circumstances of the injury, current symptoms and relevant medical history. A detailed physical and neurological examination is then performed to assess muscle strength, sensation, reflexes and coordination. These findings help determine whether the spinal cord has been affected and to what extent.
Imaging Tests
Imaging plays a critical role in confirming the diagnosis and identifying structural damage. Common studies include:
- X-rays, which assess spinal alignment and detect fractures or dislocations
- MRI scans, which provide detailed views of the spinal cord, discs and soft tissues and are particularly important for identifying compression, swelling or direct cord injury
- CT scans, which offer a detailed evaluation of bony structures and are useful in traumatic injuries
Neurological Assessments
Neurological tests are performed in all suspected spinal cord injuries. These evaluations measure motor and sensory function to help pinpoint the level of injury and determine its severity.
Additional Tests
In selected cases, blood tests or other investigations may be ordered to rule out infections, inflammatory conditions or other underlying factors contributing to spinal cord damage.
Treatment Options for Spinal Cord Injuries
Treatment for spinal cord injuries depends on the underlying cause, severity of symptoms and whether the injury is traumatic or degenerative. The primary goals are to prevent further damage, relieve pressure on the spinal cord and optimise neurological recovery.
Conservative Management
Mild injuries or conditions may be managed without surgery. This approach is often suitable for early or less severe cases and requires close monitoring.
Conservative treatment may include:
- Rest and activity modification to reduce strain on the spine
- Immobilisation with braces to support spinal alignment and limit harmful movement
- Medications to control pain, inflammation or muscle spasm
- Physiotherapy to maintain strength, improve mobility and support functional recovery
Urgent or Emergency Care
Traumatic spinal cord injuries or sudden neurological deterioration require immediate medical attention. Rapid stabilisation, urgent imaging and timely intervention are critical to prevent permanent neurological damage. In these situations, early treatment can significantly influence long-term outcomes.
Surgical Options
Surgery may be recommended when there is significant spinal cord compression, progressive neurological symptoms, spinal instability or compression caused by a tumour, infection or structural abnormality. The primary aim is to relieve pressure on the spinal cord while restoring spinal stability.
Common procedures include:
- Laminectomy: In this approach, part of the vertebra known as the lamina is removed to widen the spinal canal and reduce pressure on the spinal cord.
- Spinal Fusion: This procedure stabilises affected segments of the spine by joining two or more vertebrae using bone grafts, screws or rods, limiting abnormal movement that could worsen symptoms.
- Discectomy: During this procedure, a herniated or damaged disc that is compressing the spinal cord or nearby nerves is carefully removed.
The most suitable treatment will depend on the underlying cause, neurological findings and individual patient factors. Early evaluation by a spine specialist helps ensure timely and appropriate management.
When to Seek Medical Attention
- Sudden numbness or weakness
- Loss of bowel or bladder control
- Severe neck or back pain after trauma
- Difficulty walking or maintaining balance
- Rapidly worsening symptoms
Let Oxford Spine Aid in Early & Effective Intervention
Possible signs of spinal cord injury should never be ignored, as early symptoms may worsen without timely intervention. Because spinal cord damage can affect movement, sensation and key bodily functions, prompt assessment is key to preventing further neurological deterioration.
If you are experiencing symptoms such as weakness, numbness, balance difficulties or changes in bowel or bladder control, our experienced team at Oxford Spine & Neurosurgery Centre can provide a thorough evaluation and appropriate guidance. Contact us today to make an appointment.
Our Spine Specialist in Singapore
Dr Colum Nolan
Senior Consultant Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
Dr Colum Nolan is a Senior Consultant Neurosurgeon and the Medical Director of Oxford Spine & Neurosurgery Centre. He undertook specialist neurosurgery training in Ireland and Australia, and later on completed a complex spine surgery fellowship at Addenbrooke’s Hospital in Cambridge, UK.
Dr Column held key leadership roles including Director of the Spine and Spinal Disorders Programme at the National Neuroscience Institute (NNI), as well as the Head of Neurosurgery Service at Sengkang General Hospital.
With his depth of experience, Dr Colum is committed to guiding each patient towards the safest and most effective treatment for their needs.
