Spinal Cord Injury | Diagnosis & Treatments

In many cases, the full extent of a child’s spinal cord injury isn’t obvious right away. That’s why it’s crucial that you obtain a diagnosis from a qualified medical professional as soon as possible.

Here at Boston Children’s, our trauma specialists will perform a comprehensive physical exam on your child and obtain a detailed account of how and where his injury occurred.

Next, doctors may order any or all of the following:

  • blood tests
  • X-rays, which use small doses of radiation to take pictures of a part of the body
  • magnetic resonance imaging (MRI), a combination of electromagnets, radio frequency waves and computers that takes two-dimensional and three-dimensional images of the spine and other body structures
  • computed tomography (CT) scans, a non-invasive procedure that uses x-ray equipment and powerful computers to create detailed images of the spine, spinal cord and other body parts

What are treatment options for spinal cord injuries?

Like the injuries themselves, the treatment options for SCIs are very specific to the individual child. Your child's treatment team will develop a customized care plan according to:

  • the type and location of spinal cord injury your child has sustained
  • the extent of the injury
  • the extent of complications your child is experiencing your child's age, overall health and medical history
  • your child's tolerance for particular medications, procedures or therapies
  • your family's preferences for treatment

Prior to treatment: Immobilizing the head and neck at the time of the injury

A known or suspected spinal cord injury requires emergency medical attention at the scene.

While you or other bystanders are waiting for emergency personnel, it's imperative to keep your child's head and neck immobilized. Although the impulse to cradle and comfort the child, or to move him to a different position or place, is understandable, it is essential that he not be moved by anyone other than trained medical personnel.

Hospitalization and observation

Any SCI calls for a period of hospitalization, ranging from weeks to several months. Your child will most likely be admitted to the Intensive Care Unit (ICU), where a multidisciplinary team of clinicians will observe him, evaluate his progress and attend to all of his medical needs while helping you plan for the future.

Here at Boston Children's, your child's treatment team will include some or all of the following:

All members of the team will work closely together, and will include you and your family in every aspect of the treatment process.

Surgery for spinal cord injury

While no surgical procedure can reverse or otherwise “fix” a spinal cord injury, surgery can sometimes be beneficial by allowing doctors to:

  • stabilize any spinal fractures
  • releasing pressure on the spinal cord
  • treating any other injuries that occurred at the same time as the SCI

Post-hospital visit care for spinal cord injury

Medication for spinal cord injury

Some medications can be helpful in:

  • reducing swelling around the spinal cord injury
  • controlling pain
  • managing spasticity (involuntary muscle contractions)
  • improving bowel and bladder control

Wheelchairs and other mobility assistance devices

Children whose spinal cord injuries affect their arm and/or leg function benefit greatly from wheelchairs. A wheelchair can make great strides possible in day-to-day living, travel, socialization and even sports!

Breathing support

Children who have sustained a spinal cord injury in the neck area may lose some or all ability to breathe on their own. They may need a machine called a ventilator, which takes over breathing functions by pumping oxygen into the child's lungs and clearing out carbon dioxide.

Bowel and bladder support

Some SCIs can cause a temporary or permanent loss of bowel and bladder control. Urodynamic studies may be performed after the injury to measure how easily the child can empty his bladder (if at all).

There are several tools that can help a child manage incontinence, including Foley catheters, tubes placed into the bladder to drain urine. Once the child's condition stabilizes, catheterization can be done on a periodic basis to make sure his bladder is emptied while lessening the risk of an infection.

Feeding support

A child with a severe SCI that compromises his neck and throat muscles may have difficulty chewing and swallowing, putting him at risk for nutritional insufficiency.

A feeding tube — which is threaded from the nostrils down to the stomach, or directly into the abdomen to reach the stomach — is an effective way of ensuring the child consumes sufficient calories.


Physical therapy and other rehabilitation services are essential for any child with a spinal cord injury. The rehabilitation team will create a plan for your child that focuses on:

  • preventing muscle wasting
  • reducing spasticity
  • retraining the child to use other muscles that help with mobility and movement

Lifelong considerations for children with spinal cord injuries

Spinal cord injuries are often lifelong conditions for a child—and involve lifelong challenges for the entire family.

As difficult as coping with a serious SCI can be, it's important to remember that there is cause for hope: Regardless of the severity of your child's SCI, there are ways to maximize his capabilities at home, at school and in the community.

Positive reinforcement from you and other family members, combined with professional support services, will help your child strengthen his self-esteem and gain the greatest possible level of independence.

Neuromotor Therapy Program

Children who experienced a brain or spinal cord injury very early in life can have a variety of problems with their ability to move, and their needs change frequently as they get older. The Neuromotor Therapy Program at Boston Children's Hospital is devoted to maximizing the motor skills of these children. Learn more.