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Tests and diagnosis
By Mayo Clinic staffIn the emergency room, a doctor may be able to rule out a spinal cord injury by careful inspection, testing for sensory function and movement, and asking some questions about the accident. But if the injured person complains of neck pain, isn't fully awake, or has obvious signs of weakness or neurological injury, emergency diagnostic tests may be needed.
These tests may include:
- X-rays. Medical personnel typically order these tests on all people who are suspected of having a spinal cord injury after trauma. X-rays can reveal vertebral (spinal column) problems, tumors, fractures or degenerative changes in the spine.
- Computerized tomography (CT) scan. A CT scan may provide a better look at abnormalities seen on an X-ray. This scan uses computers to form a series of cross-sectional images that can define bone, disk and other problems.
- Magnetic resonance imaging (MRI). MRI uses a strong magnetic field and radio waves to produce computer-generated images. This test is extremely helpful for looking at the spinal cord and identifying herniated disks, blood clots or other masses that may be compressing the spinal cord.
- Myelography. Myelography allows your doctor to visualize your spinal nerves more clearly. After a special dye is injected into your spinal canal, X-rays or CT scans of your vertebrae can suggest a herniated disk or other lesions. This test is used when MRI isn't possible or when it may yield important additional information that isn't provided by other tests.
If your doctor suspects a spinal cord injury, he or she may prescribe traction to immobilize your spine.
A few days after injury, when some of the swelling may have subsided, your doctor will conduct a neurological exam to determine the level and completeness of your injury. This involves testing your muscle strength and your ability to sense light touch and a pinprick.
- Spinal cord injury: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/sci/detail_sci.htm. Accessed July 2, 2009.
- Spinal trauma. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec21/ch311/ch311a.html. Accessed June 17, 2009.
- Spinal cord injury FAQ. American Association of Neurological Surgeons. http://www.neurosurgerytoday.org/media/fact/spinal.asp. Accessed July 2, 2009.
- Hansebout RR. Acute traumatic spinal cord injury. http://www.uptodate.com/home/index.html. Accessed June 16, 2009.
- Mayer RS. Rehabilitation of individuals with cancer. In: Abeloff MD, et al. Abeloff's Clinical Oncology. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/147442859-5/0/1709/1.html?tocnode=55014515&fromURL=1.html#4-u1.0-B978-0-443-06694-8..X5001-5--TOP_1. Accessed July 2, 2009.
- Spinal cord injury (SCI): Prevention tips. Centers for Disease Control and Prevention. http://www.cdc.gov/ncipc/factsheets/sciprevention.htm. Accessed July 2, 2009.
- Chiodo AE, et al. Spinal cord injury medicine: Long-term medical issues and health maintenance. Archives of Physical Medicine Rehabilitation. 2007;88:S76.
- Wuermser LA, et al. Spinal cord injury medicine: Acute care management of traumatic and nontraumatic injury. Archives of Physical Medicine Rehabilitation. 2007;88:S55.
- Beck LA (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 21, 2009.
- Facts and figures at a glance. National Spinal Cord Injury Statistical Center. http://www.spinalcord.uab.edu/show.asp?durki=119513&site=4716&return=19775. Accessed Aug. 25, 2009.
