After spinal cord injury, patients are susceptible to developing spinal instability below their injury level. Marked bony loss of a vertebra(e) along with destruction of the disc space(s) can occur.
Such instability can lead to back pain, worsening neuropathic pain, spasticity, autonomic dysreflexia, and neurologic and functional loss. Surgery involves decompression of the markedly deteriorated vertebral body(s) and disc space(s) along with appropriate stabilization with instrumentation and fusion.
A progressive curvature to the spine can develop after spinal cord injury.
If the curvature becomes extreme enough, similar to Charcot spinal instability, scoliosis can cause back pain, worsening neuropathic pain, spasticity, autonomic dysreflexia, hyperhidrosis (abnormal sweating), and neurological and functional loss.
Surgical correction involves cautious spinal realignment with instrumentation and fusion.
Spinal Stenosis, Ruptured Disc
Those with spinal cord injury can develop a progressively degenerative spine with a narrowing of the spinal canal (spinal stenosis) or ruptured intervertebral disc. Both can put pressure on the spinal cord and/or nerve roots and can lead to loss of neurologic function, worsening spasticity, neuropathic pain, autonomic dysreflexia, and hyperhidrosis (abnormal sweating).
Surgical correction involves taking pressure off of the spinal cord and nerve roots by appropriate bony, ligament, and disc removal. Sometimes a bony fusion is required.