Symptoms vary somewhat depending on the location of the injury. Spinal cord injury results in varying degress of weakness and sensory loss at and below the injury. The pattern depends on whether the entire cord is injured (complete) or only partially (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, varying degrees of symptoms can affect both the arms and the legs:

• weakness, paralysis
• breathing difficulties (from paralysis of the breathing muscles)
• spasticity (increased muscle tone)
• sensory changes
• numbness
• pain
• loss of normal bowel and bladder control (constipation, incontinence, bladder spasms)

THORACIC (CHEST-LEVEL) INJURIES

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

• weakness, paralysis
• breathing difficulties (from paralysis of the breathing muscles)
• spasticity (increased muscle tone)
• sensory changes
• numbness
• pain
• loss of normal bowel and bladder control
  • constipation
  • incontinence
  • bladder spasms

Injuries to the cervical or high thoracic cord may also result in:

• abnormal blood pressure
  • blood pressure fluctuates quickly and through a wide range
  • can be worsened with pain or bladder spasms
• abnormal sweating; trouble maintaining proper temperature

Symptoms may develop immediately after injury or may occur gradually because of fluid accumulation around the spinal cord or swelling within the spinal cord itself. Spinal cord injury is a medical emergency requiring immediate attention to minimize the long-term effects.

A neurologic examination indicates the location of the injury, if it is not immediately evident. The reflexes may be abnormal or may be absent in affected areas of the body. There may be some recovery of reflexes after swelling has subsided. Muscle spasticity is common as a late effect of spinal cord injury.

• Spine X-rays may show fracture or damage to the bones of the spine.
• A CT scan or MRI of the spine may pinpoint the location and extent of spinal cord trauma and demonstrate any compressive lesions like blood clots (hematomas).
• Rarely a myelogram (an X-ray of the spine after injection of dye) may be necessary.
• Somatosensory evoked potential (SSEP) testing or magnetic stimulation may determine if signals can get through the spinal cord.