Someone who is being seen for a spinal injury will most likely be evaluated in the hospital emergency room. Determining the exact location of injury is critical in making accurate predictions about the specific parts of the body that may be affected by paralysis and loss of function. Various diagnostic tests will be performed, such as locating the points of paralysis, pain, numbness and dysfunction, whether through muscle movements, skin pricking and reflex and other motor skill function tests.
The E.R. attending physician will order one or more of the following tests:
X-ray: an x-ray is usually the first test ordered, and shows which bones, if any, have fractured
Computerized tomography (CT) is a noninvasive procedure that uses x-rays to produce a three-dimensional image of the spine. A CT shows more detail than an X-ray, and can identify the bones in greater detail, and show the nerves, spinal cord, and any possible damage to them.
Magnetic resonance imaging (MRI): An MRI uses magnetic fields and radio-frequency waves to create an image of the spine, and can reveal fine details of the spine, including nerves, clearer bone detail, and unstable areas. An MRI scan can show details in the spine that can’t normally be seen on an x-ray. Sometimes a contrast agent is injected into a vein in the hand or arm during the test, which highlights certain tissues and structures to make details even clearer.
The test results will allow the doctor to diagnose the completeness of the injury. For more information on completeness classification, see Symptoms of Spinal Cord Injuries.
Urgent care is necessary to provide stability to the spine, and ensure no further damage will occur. Once the diagnosis of a spinal cord injury is made, the following treatments are prescribed:
Immobilization: Usually, emergency workers transport the patient to the hospital already immobilized with hard neck collar, back bracing, and a carrying board. Sometimes the patient is heavily sedated, to keep them from even the slightest movement, which could cause spinal cord injury. This immobilization treatment is often continued after the patient is admitted to the hospital, including traction, where weights are used to keep the head and neck from moving.
Surgery: Surgery is often needed to remove fragments of bone, repair ruptured or herniated discs, or to fuse portions of the spine together. Research shows that early surgery in a Level I trauma center should be attempted.
Reviewed by Dr. Roger Härtl
Last reviewed/last updated: August 2023