No nerve communication is detected below the injury level. This does not necessarily mean the cord was physically severed, but it generally indicates more extensive loss of movement, sensation, and body function.
What to Know About Spinal Cord Injuries At Birth
A spinal cord injury can affect a baby’s movement, sensation, breathing, and other body functions, depending on where and how severely the cord is damaged. This page can help you understand your child’s diagnosis, the care that may be needed, and when it may be appropriate to ask whether medical negligence played a role.
What is a spinal cord birth injury?
A spinal cord birth injury is damage to the spinal cord or the structures surrounding it that occurs before, during, or shortly after delivery. The spinal cord is the pathway that carries messages between the brain and the rest of the body. An injury can interrupt those messages and cause temporary or permanent changes in movement, sensation, muscle control, breathing, bowel and bladder function, and other automatic body processes.
The effects depend on both the level of the injury and how much nerve communication remains. A higher injury can affect more of the body, while a lower injury may primarily affect the trunk or legs. Most spinal cord injuries do not involve the cord being completely cut.
Signs and symptoms
Signs may be present immediately after birth or become clearer as doctors evaluate a baby’s breathing, movement, reflexes, and muscle tone. Possible signs include:
- Weak or absent movement in the arms, legs, or both
- Floppy or unusually low muscle tone, sometimes followed later by stiffness or muscle spasms
- Reduced or absent reflexes below the level of injury
- Little or no response to touch or painful stimulation in affected areas
- Apnea, irregular breathing, a weak respiratory effort, or the need for breathing support
- Problems with bowel or bladder function
- A pattern of weakness that affects both sides of the body or more than one limb
These symptoms can overlap with a brachial plexus injury and other neurologic conditions. A pediatric neurologic examination and imaging, often including an MRI, may be needed to identify the location and extent of injury.
What causes a spinal cord birth injury?
Spinal cord injuries in newborns are uncommon and can have more than one possible cause. A careful review of the pregnancy, labor, delivery, imaging, and newborn course is often necessary to understand what happened. Possible causes include:
- Excessive traction, rotation, or hyperextension of the baby’s head, neck, or spine during a difficult delivery
- A breech, transverse, or other abnormal presentation, particularly when the head or neck is extended or delivery becomes obstructed
- Compression, fracture, dislocation, bleeding, or swelling that damages or places pressure on the spinal cord
- An interruption of blood flow to the spinal cord, sometimes called an ischemic spinal cord injury
- An underlying congenital or prenatal condition that affects the spinal cord or makes it more vulnerable to injury
The presence of a known delivery complication does not, by itself, establish that the medical team acted improperly. The key question is whether the providers recognized the risks, selected an appropriate delivery plan, and responded reasonably as circumstances changed.
When a spinal cord birth injury may be medical malpractice
Not every spinal cord birth injury is caused by medical malpractice. Some injuries occur despite appropriate care, and others may result from a condition that could not reasonably have been predicted or prevented. However, the following circumstances may point to negligence when they fall below the accepted standard of care and contribute to the injury:
- Using excessive force, traction, rotation, or hyperextension during delivery
- Using forceps or another delivery instrument in a way that places avoidable force on the baby’s neck or spine
- Failing to recognize a breech, transverse, hyperextended, or otherwise high-risk fetal position and plan for a safer delivery
- Delaying a cesarean delivery when labor is obstructed, the baby is not descending, or continued vaginal delivery creates an unreasonable risk
- Failing to respond appropriately to signs that the baby is not tolerating labor or may be experiencing reduced blood flow
- Failing to recognize serious newborn signs such as apnea, profound low muscle tone, absent movement, or loss of reflexes
- Delaying spinal stabilization, diagnostic imaging, specialist consultation, or treatment for suspected compression, bleeding, or instability
Wais, Vogelstein, Forman, Koch & Norman, LLC works with medical experts to review prenatal, labor, delivery, imaging, and neonatal records and assess whether the care met accepted medical standards.
Treatment and long-term outlook
Treatment is individualized based on the level and severity of the injury, whether the spine is stable, and whether the baby can breathe independently. Early care may include protecting and stabilizing the spine, respiratory support, MRI or other imaging, and surgery when there is instability or pressure on the spinal cord that can be treated.
Long-term care may involve a coordinated team of pediatric neurologists, neurosurgeons, rehabilitation physicians, pulmonologists, orthopedists, urologists, physical therapists, occupational therapists, and other specialists. Depending on a child’s needs, care may include:
- Physical and occupational therapy to support strength, movement, positioning, and daily activities
- Respiratory therapy, airway clearance, or ongoing breathing support for higher-level injuries
- Mobility equipment, braces, seating systems, and other assistive technology
- Bowel and bladder management
- Monitoring for muscle tightness, spinal curvature, joint problems, skin injury, and other complications
- Developmental, educational, and family support as the child grows
The outlook varies widely. Some children with incomplete injuries regain meaningful function over time, while others have lasting weakness, paralysis, breathing difficulties, or other medical needs. The injury level, the amount of nerve tissue affected, MRI findings, early clinical course, and response to treatment all help the care team develop a more individualized prognosis.
Injury Types: Spinal Cord Birth Injury
Recognizing the types of spinal cord birth injury.
Spinal cord injuries are described by how much function remains and where the injury occurred. Understanding both classifications can help families make sense of symptoms, treatment recommendations, and future support needs.
Complete injury
Higher-level injury
An injury in the cervical region can affect the arms, legs, trunk, and breathing. Higher injuries often require more intensive respiratory, positioning, and mobility support.
Incomplete injury
Some messages still pass between the brain and body below the injury. A child may retain or regain some movement or sensation, although the degree of recovery and long-term needs vary.
Lower-level injury
An injury farther down the spinal cord may affect the trunk, legs, bowel, bladder, and lower-body sensation more than the arms. The exact effects depend on the location and extent of damage.
Frequently Asked Questions
Common questions about spinal cord birth injuries.
A diagnosis can bring many questions, and clear information can help your family feel more prepared for the conversations ahead.
How is a spinal cord birth injury different from a brachial plexus injury?
A spinal cord injury affects the central pathway that carries messages between the brain and body, so it can affect multiple limbs, both sides of the body, breathing, sensation, and bowel or bladder function. A brachial plexus injury affects the network of peripheral nerves that controls the shoulder, arm, and hand, and it more often causes weakness or paralysis in one arm. Because early signs can overlap, specialists may use a neurologic examination and imaging to distinguish between them.
Is a spinal cord injury always caused by medical malpractice?
No. A spinal cord injury can occur despite appropriate care or result from an underlying condition that was not caused by delivery. Malpractice may be a concern when providers used excessive force, failed to plan for a known delivery risk, delayed a necessary intervention, or did not promptly evaluate and treat warning signs, but the medical records must be reviewed before any conclusion can be reached.
What treatment may a child need after a spinal cord birth injury?
Treatment may include spinal stabilization, respiratory support, imaging, surgery in selected cases, and ongoing rehabilitation. Many children also benefit from physical and occupational therapy, mobility or positioning equipment, bowel and bladder care, orthopedic monitoring, and coordinated follow-up with pediatric specialists.
How long do families have to file a spinal cord birth injury claim?
The deadline, or the statute of limitations, depends on the state, the child’s age, when the injury was discovered, the type of healthcare provider involved, and whether special notice rules apply. Some deadlines can be much shorter than families expect, so speaking with a birth injury attorney promptly can help preserve records and clarify the time limits that may apply.
