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Spinal injury

Spinal cord injury; SCI

 

The spinal cord contains the nerves that carry messages between your brain and body. The cord passes through your neck and back. A spinal cord injury is very serious because it can cause loss of movement (paralysis) below the site of the injury.

Causes

 

A spinal cord injury may be caused by:

  • Bullet or stab wound
  • Traumatic injury to the face, neck, head, chest, or back (for example, a car accident)
  • Diving accident
  • Electric shock
  • Extreme twisting of the middle of the body
  • Landing on the head during a sports injury
  • Fall from a great height

 

Symptoms

 

Symptoms of a spinal cord injury may include any of the following:

  • Head that is in an unusual position
  • Numbness or tingling that spreads down an arm or leg
  • Weakness
  • Difficulty walking
  • Paralysis (loss of movement) of arms or legs
  • Loss of bladder or bowel control
  • Shock (pale, clammy skin; bluish lips and fingernails; acting dazed or semiconscious)
  • Lack of alertness (unconsciousness)
  • Stiff neck, headache, or neck pain

 

First Aid

 

Never move anyone who you think may have a spinal injury, unless it is absolutely necessary. For example, if you need to get the person out of a burning car, or help them to breathe.

Keep the person completely still and safe until medical help arrives.

  • Call the local emergency number, such as 911.
  • Hold the person's head and neck in the position in which they were found. Do not try to straighten the neck. Do not allow the neck to bend or twist.
  • Do not allow the person to get up and walk unassisted.

If the person is not alert or responding to you:

  • Check the person's breathing and circulation.
  • If needed, do CPR. Do not do rescue breathing, do chest compressions only.

Do not roll the person over unless the person is vomiting or choking on blood, or you need to check for breathing. If you need to roll the person over:

  • Have someone assist you.
  • One person should be located at the person's head; the other at the person's side.
  • Keep the person's head, neck, and back in line while you roll him or her onto one side.

 

Do Not

 

  • Do not bend, twist, or lift the person's head or body.
  • Do not attempt to move the person before medical help arrives unless it is absolutely necessary.
  • Do not remove a football helmet or pads if a spinal injury is suspected.

 

When to Contact a Medical Professional

 

Call your local emergency number (such as 911) if you think someone has a spinal cord injury. Do not move the person unless there is urgent danger.

 

Prevention

 

The following may lower your risk of spinal injury:

  • Wear seat belts.
  • Do not drink and drive.
  • Do not dive into pools, lakes, rivers, and other bodies of water, particularly if you cannot determine the depth of the water or if the water is not clear.
  • Do not tackle or dive into a person with your head.

 

 

References

American Red Cross. First Aid/CPR/AED Participant's Manual. 2nd ed. Dallas, TX: American Red Cross; 2014.

Kaji AH, Newton E, Hockberger RS. Spinal injuries. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 43.

 
  • Skeletal spine

    Skeletal spine - illustration

    The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.

    Skeletal spine

    illustration

  • Vertebra, cervical (neck)

    Vertebra, cervical (neck) - illustration

    These are the seven bones of the neck, called the cervical vertebra. The top bone, seen on the right of this picture, is called the atlas, and is where the head attaches to the neck. The second bone is called the axis, upon which the head and atlas rotate. The vertebra are numbered from one to seven from the atlas down, and are referred to as C1, C2, C3, etc.

    Vertebra, cervical (neck)

    illustration

  • Vertebra, lumbar (low back)

    Vertebra, lumbar (low back) - illustration

    These are the five vertebra of the lower back. The last vertebra (on the upper left of the picture) attaches to the sacrum, and the top vertebra (on the right of the picture) attaches to the thoracic section of the back. The vertebra are broader and stronger than the other bones in the spine. This allows them to absorb the added pressure applied to the lower back, but this area remains a common site of injury. The vertebra are numbered from one to five and are labeled L1, L2, L3 etc. from the higher bones to the lower.

    Vertebra, lumbar (low back)

    illustration

  • Vertebra, thoracic (mid back)

    Vertebra, thoracic (mid back) - illustration

    These are twelve vertebra of the mid back. The last vertebra (on the left side of the picture) attaches to the lumbar (lower) spine, and the top vertebra (on the right) attaches to the cervical (neck) section of the back. The vertebra are broader and stronger than the cervical bones. This allows them to absorb the added pressure applied to the mid back, but they remain a common sight of injury. The vertebra are numbered from one to twelve and labeled T1, T2, T3, et cetera, from the upper most bones to the lowest.

    Vertebra, thoracic (mid back)

    illustration

  • Vertebral column

    Vertebral column - illustration

    This is the spine and the sacrum with the cervical (neck), thoracic (mid-back), and lumbar (lower back) vertebra. Notice how the appearance of the vertebra change as you look down the spine. The change in shape and size reflect the different functions of the neck, mid-back, and lower back.

    Vertebral column

    illustration

  • Central nervous system

    Central nervous system - illustration

    The central nervous system is made up of the brain and spinal cord. The brain functions to receive nerve impulses from the spinal cord and cranial nerves. The spinal cord contains the nerves that carry messages between the brain and the body. Spinal cord injury can occur when there is damage to the cells within the spinal cord or when the tracts of nerves that run up and down the spinal cord are severed.

    Central nervous system

    illustration

  • Spinal cord injury

    Spinal cord injury - illustration

    A severe spinal cord injury often causes loss of feeling and paralysis, the loss of movement and voluntary control over the muscles in the body. Spinal cord damage also causes loss of reflex function below the point of injury interrupting bodily functions such as breathing, bowel control, and bladder control. In the event of a spinal injury prompt medical attention can help to minimize further spinal cord damage.

    Spinal cord injury

    illustration

  • Spinal anatomy

    Spinal anatomy - illustration

    The vertebral column provides structural support for the trunk and surrounds and protects the spinal cord. The vertebral column also provides attachment points for the muscles of the back and ribs. The vertebral disks serve as shock absorbers during activities such as walking, running, and jumping. They also allow the spine to flex and extend.

    Spinal anatomy

    illustration

  • Two person roll - series

    Two person roll - series

    Presentation

    • Skeletal spine

      Skeletal spine - illustration

      The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.

      Skeletal spine

      illustration

    • Vertebra, cervical (neck)

      Vertebra, cervical (neck) - illustration

      These are the seven bones of the neck, called the cervical vertebra. The top bone, seen on the right of this picture, is called the atlas, and is where the head attaches to the neck. The second bone is called the axis, upon which the head and atlas rotate. The vertebra are numbered from one to seven from the atlas down, and are referred to as C1, C2, C3, etc.

      Vertebra, cervical (neck)

      illustration

    • Vertebra, lumbar (low back)

      Vertebra, lumbar (low back) - illustration

      These are the five vertebra of the lower back. The last vertebra (on the upper left of the picture) attaches to the sacrum, and the top vertebra (on the right of the picture) attaches to the thoracic section of the back. The vertebra are broader and stronger than the other bones in the spine. This allows them to absorb the added pressure applied to the lower back, but this area remains a common site of injury. The vertebra are numbered from one to five and are labeled L1, L2, L3 etc. from the higher bones to the lower.

      Vertebra, lumbar (low back)

      illustration

    • Vertebra, thoracic (mid back)

      Vertebra, thoracic (mid back) - illustration

      These are twelve vertebra of the mid back. The last vertebra (on the left side of the picture) attaches to the lumbar (lower) spine, and the top vertebra (on the right) attaches to the cervical (neck) section of the back. The vertebra are broader and stronger than the cervical bones. This allows them to absorb the added pressure applied to the mid back, but they remain a common sight of injury. The vertebra are numbered from one to twelve and labeled T1, T2, T3, et cetera, from the upper most bones to the lowest.

      Vertebra, thoracic (mid back)

      illustration

    • Vertebral column

      Vertebral column - illustration

      This is the spine and the sacrum with the cervical (neck), thoracic (mid-back), and lumbar (lower back) vertebra. Notice how the appearance of the vertebra change as you look down the spine. The change in shape and size reflect the different functions of the neck, mid-back, and lower back.

      Vertebral column

      illustration

    • Central nervous system

      Central nervous system - illustration

      The central nervous system is made up of the brain and spinal cord. The brain functions to receive nerve impulses from the spinal cord and cranial nerves. The spinal cord contains the nerves that carry messages between the brain and the body. Spinal cord injury can occur when there is damage to the cells within the spinal cord or when the tracts of nerves that run up and down the spinal cord are severed.

      Central nervous system

      illustration

    • Spinal cord injury

      Spinal cord injury - illustration

      A severe spinal cord injury often causes loss of feeling and paralysis, the loss of movement and voluntary control over the muscles in the body. Spinal cord damage also causes loss of reflex function below the point of injury interrupting bodily functions such as breathing, bowel control, and bladder control. In the event of a spinal injury prompt medical attention can help to minimize further spinal cord damage.

      Spinal cord injury

      illustration

    • Spinal anatomy

      Spinal anatomy - illustration

      The vertebral column provides structural support for the trunk and surrounds and protects the spinal cord. The vertebral column also provides attachment points for the muscles of the back and ribs. The vertebral disks serve as shock absorbers during activities such as walking, running, and jumping. They also allow the spine to flex and extend.

      Spinal anatomy

      illustration

    • Two person roll - series

      Presentation

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Spinal injury

           

             

            Review Date: 4/13/2015

            Reviewed By: Dennis Ogiela, MD, orthopedic surgery and physical medicine and rehabilitation, Danbury Hospital, Danbury, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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