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Spinal Cord Injury and Related Neurotrauma
Gillette Children’s Specialty Healthcare offers the Twin Cities’ top program for children and teens who sustain spinal cord injuries. We support patients and their families with comprehensive medical, surgical and rehabilitative care.
Our mission is to help children and teens achieve their highest levels of health and independence before returning to their homes, schools and communities.
Why Choose Gillette?
- Gillette is one of the nation’s Best Children’s Hospitals in pediatric neurology and neurosurgery.
- We collaborate with Regions Hospital to operate Minnesota’s first Level I Pediatric Trauma Center, providing the highest possible level of care for children who experience traumatic injuries.
- Ours is the Twin Cities’ only pediatric comprehensive inpatient rehabilitation program certified by the Commission on Accreditation of Rehabilitation Facilities (CARF).
- We offer comprehensive rehabilitation therapies, including occupational, physical, and speech and language therapy.
- Our patients benefit from on-site schooling, family support services and transition planning for the journey back home.
- We offer facilities and technology designed to support the unique needs of children and teens who have spinal cord injuries.
Definition and Types
The spinal cord is a thick cord of nerve tissue located within the bones of the spine (back bone). It carries signals from the brain to the rest of the body. Spinal cord injuries disrupt communication among the brain, spinal cord and peripheral nerves. That disruption can result in loss of movement (paralysis) and loss of sensation—including the ability to feel heat, cold and touch—below the site of injury.
Spinal cord injuries affect all people differently, depending on the location and severity of the injury. Injuries higher on the spinal cord affect more areas of the body than lower-level injuries do. For example, a neck-level injury could cause paralysis in both arms and legs (quadriplegia) and make breathing without a ventilator impossible. An injury lower on the spinal cord might affect only the legs (paraplegia) and lower parts of the body.
The spine is composed of 33 small bones called vertebrae. The vertebrae are grouped into four categories based on their location on the spine.
Cervical Spine (Vertebrae C1 – C8)
Thoracic Spine (Vertebrae T1 – T12)
Lumbar Spine (Vertebrae L1 – L5)
Sacral Spine (Vertebrae S1 – S5)
When talking about spinal cord injuries, care providers often refer to the specific vertebra associated with the location of the injury.
Spinal cord injuries range in severity. With an incomplete injury, the spinal cord can communicate some messages to and from the brain. People who experience incomplete injuries might retain some sensation and motor function below the injury. With a complete injury, however, all motor function and sensation below the injury is lost.
Gillette uses the American Spinal Injury Association (ASIA) Scale to describe an injury’s severity:
- A = Complete: No motor or sensory function is preserved in the sacral segments S4 – S5.
- B = Incomplete: Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4 – S5.
- C = Incomplete: Motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade less than 3.
- D = Incomplete: Motor function is preserved below the neurological level, and at least half of key muscles below the neurological level have a muscle grade of 3 or more.
- E = Normal: Motor and sensory function are normal.
Providers at Gillette’s Neurotrauma Clinic also see patients who experience concussions and related neurotrauma (including cervical injuries and what some people call “spine concussions”).
Causes of Spinal Cord Injuries
Spinal cord injuries occur in many ways. The most common causes include:
- Motor vehicle accidents
- Traumatic injuries
- Sports and recreation accidents
- Diseases, such as tumors, infections and inflammation of the spinal cord
- Vascular syndromes
Symptoms and Complications of Spinal Cord Injuries
Spinal cord injuries can lead to a number of complications and effects. Some of the most common include:
- Loss of movement (paralysis) below the injury
- Loss of sensation—including the ability to feel heat, cold and touch—below the injury
- Exaggerated reflexes or muscle spasms below the injury
- Loss of bowel and bladder control
- Autonomic dysreflexia (a potentially life-threatening over-activity of the autonomic nervous system, which controls body functions such as heart rate, blood pressure and breathing)
- Difficulty breathing, coughing or clearing secretions from the lungs
- Difficulty swallowing
- Changes in sexual function and fertility
Care and Rehabilitation Following Spinal Cord Injuries
Although complete damage to the spinal cord is currently irreversible, comprehensive treatments can help people live fully. As researchers continue to make progress in identifying potential breakthroughs, Gillette focuses on helping children and teens develop strength, skills and confidence to achieve their highest levels of health, independence and happiness.
Every patient’s path is unique, but people who have spinal cord injuries often need the following types of care.
Spinal cord injuries often result from traumatic injuries caused by car accidents, sports injuries and other events. Some patients come to us directly through the Level I Pediatric Trauma Center, which we operate in partnership with Regions Hospital. Some require immediate surgery to relieve pressure on their spinal cord or to stabilize their spinal column. Some also need surgery and medical treatment for secondary injuries. Others receive emergency care elsewhere, then transfer to Gillette because of our expertise in rehabilitation.
Following emergency treatment, children and teens who’ve experienced spinal cord injuries often need close monitoring in a critical care setting. Gillette’s Pediatric Intensive Care Unit (PICU) provides the highest level of care for children and teens who are critically injured. We begin comprehensive therapy services soon after patients arrive in our PICU.
Among our many services and specialties, we also offer pulmonology and respiratory care for children whose injuries affect their ability to breathe. We also support families’ emotional and social needs with psychology, social work, chaplaincy and child life services.
Comprehensive inpatient rehabilitation care plays a central role in maximizing health, independence and happiness for people who have spinal cord injuries. Gillette is the region’s top provider of comprehensive pediatric inpatient rehabilitation care.
Under the direction of experts in rehabilitation medicine and rehabilitation therapies, our patients undergo daily physical, occupational and speech and language therapy in an environment designed specifically for their needs.
Therapy might include technology such as robotic assisted locomotor training (Lokomat®) or functional electrical stimulation. Our certified rehabilitation nurses provide direct care and help patients practice what they learn in therapy. In addition, occupational therapists and speech-language pathologists collaborate with assistive technology specialists to provide evaluations for equipment, such as augmentative and alternative communication (AAC) devices and computer access equipment.
Throughout a patient’s hospital stay, care coordinators serve as the point of contact for families, ensuring excellent communication among family members and the care team. Routine family conferences provide opportunities to share information as patients progress toward discharge. From the moment a patient arrives at the hospital, our goal is to facilitate a successful return to home, school and the community.
Assistive technology—including orthoses (braces), seating and mobility equipment, and augmentative and alternative communication (AAC) devices—can help patients manage the day-to-day challenges that accompany a spinal cord injury.
Therapists work closely with Gillette’s assistive technology experts to assess and recommend equipment for each patient’s needs. Patients often try various pieces of equipment during their hospital stay to determine which options meet their needs most effectively.
Social and Emotional Care
Gillette provides support to help patients and families manage the social and emotional challenges associated with spinal cord injuries. Pediatric psychologists, for instance, can provide counseling to children and families who are adjusting to a disability. Child life specialists offer activities that promote growth and development. And social workers can provide emotional support and connect families with community resources.
Gillette partners with the St. Paul Public Schools to provide school services to children who are hospitalized for more than two weeks. Our teachers communicate frequently with community schools, helping patients remain on track with lesson plans as much as possible. Teachers also work closely with psychologists and rehabilitation therapists to help schools prepare for a student’s return following an injury.
Our Spinal Cord Injury Services
Gillette offers comprehensive services for children and teens who experience spinal cord injuries. Our providers collaborate to develop custom treatment plans for every patient.
Caring for patients who have spinal cord injuries most often involves these specialties and services:
- Assistive technology
- Child life
- Comprehensive inpatient rehabilitation care
- Ear, nose and throat (ENT or otolaryngology)
- Music therapy
- Nutrition and feeding
- Pediatric intensive care (critical care)
- Pediatrics and general medicine
- Pulmonology and respiratory care
- Radiology and imaging
- Rehabilitation medicine
- Rehabilitation therapies
- School services
- Social work
- Therapeutic recreation
For more information about Gillette’s specialties and services, search Conditions and Care.
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