Spinal column injuries

The spinal cord is like a super-highway connecting the brain to the rest of the body. When an accident fractures or dislocates the bones of your child’s spinal column, it disrupts this vital nerve communication system, affecting movement and other important body functions.

About spinal cord injuries and spine fractures

The spinal column is made up of small, stacked bones called vertebrae separated by soft, shock-absorbing spinal discs. The spinal column protects the important bundle of nerves known as the spinal cord. When the spinal column experiences trauma, it can cause the spinal cord to bruise (also known as a contusion) or to tear (a complete tear is known as a transection).

The location of the injury determines the impact on your child. Injuries that are higher up in the spinal column are typically more severe and can affect the chest, arms and legs. A spinal cord injury might be considered complete (causing a full loss of sensation and motor function below the fracture point) or incomplete (some sensation and function remains).

Experts in spinal cord injuries and spine fractures

At the AIM Spine Center at Children’s Wisconsin, our pediatric spine experts work together to provide outstanding and compassionate care for even the most complex spinal disorders and spine trauma in infants, children and teens. If your child has already been diagnosed at another center, we invite you to get a second opinion for a spinal column injury at the AIM Spine Center. 

What causes spinal cord injuries and spine fractures?

Sometimes the birthing process can cause spine fractures in babies, particularly in the neck area. More commonly, these breaks occur after an automobile accident or when kids are just being kids — jumping on trampolines, falling from a height, diving in a pool or colliding with another player during contact sports. Violence, such as gun shots, stab wounds or blunt force trauma from child abuse, can also injure the spine. 

Why are spinal cord injuries and spine fractures a concern?

Because of the significant role that the spine and spinal cord play in the body’s movement and function, a spinal column injury is an emergency that requires immediate and proper treatment. These injuries can be life-threatening.

What are the symptoms of spinal cord injuries and spine fractures?

If you suspect your child has a spinal column injury, do not move them and call 911. Symptoms can vary depending on the severity of your child’s injury, but could include:

• Severe pain
• Partial or complete loss of movement and feeling
• Unnatural angle in the affected area
• Loss of bowel and bladder function
• Breathing difficulty

How are spinal cord injuries and spine fractures diagnosed?

The doctor will examine your child and might test their ability to move and sense light touch before using imaging tests to assess your child’s spine. Diagnostic tests could include:

• Radiographic imaging – Used within our emergency department
• EOS scanner – Children’s was one of the first pediatric hospitals in the nation to have this scanner, which provides detailed, 3D images and limits radiation exposure.
• CT scan – More detailed than an X-ray, a CT scan uses a combination of X-rays and computer technology to produce cross-sectional, detailed images of parts of the body, including the bones, muscles, fat and organs.
• MRI– Uses a magnet, radio waves and a computer to create very detailed, 3D still and moving images.

Treatment for spinal cord injuries and spine fractures

Children’s spine specialists will recommend the best treatment for your child based on:

• Your child’s age, overall health and medical history
• Extent of the injury
• Your child’s tolerance for specific medications, procedures or therapies
• Expectations for the course of recovery
• Your opinion or preference

Spinal column injuries may require repair by skilled surgeons. At the AIM Spine Center, our neurosurgeons and orthopedic surgeons work side by side to repair trauma to the spinal cord and surrounding bones. Surgery relieves pressure on the spinal cord and stabilizes and aligns the spine by fusing segments of the spine together with metal rods and screws (known as spinal fusion surgery). Surgery might happen immediately after the injury or later. Your child’s spinal care team will advise you on the best options for your child.

In addition to surgery, treatment will also likely include:

Medical management – Anti-inflammatory medications can relieve children’s pain and swelling.

Bracing – After surgery, your child’s doctor might recommend a back or neck brace to limit movement as your child’s spine heals.

Physical therapy – Physical therapy will help your child regain balance, coordination and strength over time. Our physical therapy program offers experts trained in treating spinal cord injuries and a rehabilitation space designed for spinal conditions.

Cognitive Behavioral Therapy (CBT) - Behavioral health factors can affect everything from a child’s surgical recovery time to their ability to manage pain. Children with spinal concerns can also experience psychological issues like changes in mood and sleep disturbances. Our AIM Spine Center psychologists, Matthew P. Myrvik, PhD, and Nicholas D. Young, PhD, use CBT to help patients with spinal conditions reduce risk, manage problems and promote overall health and healing.

Postoperative care for your child

During the first several hours after the procedure, your child will likely be drowsy from the anesthesia and medications given to ease anxiety and pain. Over time, your child will become more alert. Some children might require recovery time in the pediatric intensive care unit (PICU). 

Your child has access to an extended care team while recovering from surgery. Our dedicated care team includes pain management specialists, physical and occupational therapists, physical medicine and rehabilitation physicians as well as child life specialists. Together, they are equipped to work alongside the spine physicians and providers to help with every aspect of your child’s recovery.  

Your child might need other supportive equipment while in the hospital. They will be kept as comfortable as possible with medications that relieve pain and anxiety, and the staff might also ask for your input on how best to soothe and comfort your child. You will learn how to care for your child at home and will receive instructions on medications, activity limitations and follow-up appointments before your child is sent home.

Care for your child at home following surgical repair for spinal cord injuries and spine fractures

How soon your child is able to go home from the hospital depends on the extent of their injuries. The physician might recommend pain medications, such as acetaminophen or ibuprofen, to keep your child comfortable once at home. Your child could become tired more quickly than before surgery, and bending motions can cause some pain initially. Most children return to school 1-6 weeks after surgery. Your child will need physical therapy as part of the rehabilitation process, and it might be several months before your child is able to resume normal activities. Depending on the severity of the injury, they might not be able to go back to doing everything they did before the accident. Spinal column injuries can also be emotionally traumatic, and your child could benefit from mental health support. Learn more about what to expect after spinal surgery.

Long-term outlook after spinal cord injuries and spine fractures 

The prognosis for spinal column injuries depends on the severity of your child’s injury. Treatment cannot always reverse the damage but can keep it from becoming worse, ensuring the best possible outcome for your child. Although recovery takes time, some children are able to eventually return to sports and other regular activities. Some symptoms such as muscle weakness and back pain can linger. Children with more severe injuries might require the use of wheelchairs and other medical devices in the short- or long-term. Your child will need to be monitored by a spine specialist long-term in case new problems develop.