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Spinal Injuries - Diagnosis
Last reviewed: 04.07.2025
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Spinal cord injuries are not always obvious from trauma. Injuries to the spine and spinal cord should be suspected in patients with TBI, pelvic fractures, penetrating injuries to the spine, after most motor vehicle accidents, and always after falls from heights or diving into bodies of water.
Motor function is assessed in all extremities. Sensation assessment should include tactile sensation (posterior spinal cord function), pin prick (anterior spinothalamic tract), and postural awareness. Determination of the level of sensory loss is best done from distal to proximal or by assessing thoracic root function with the patient supine to avoid cervical spine problems. In the acute phase of spinal injury, priapism may occur, indicating spinal cord injury. Anal sphincter tone may be decreased, and lower extremity reflexes may be increased or decreased.
Direct radiography of all potentially damaged areas is performed. CT is used to examine the most complex and/or suspicious areas. In some trauma centers, CT is used immediately for spinal cord injuries. MRI helps to determine the type and level of spinal cord injury. Trauma manifestations can be characterized by the ASIA (American Spinal Injury Association) injury scale or similar scales.
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