Spinal Cord Injury
Spinal cord injuries occur most frequently during road traffic accidents. Contact sports such as Rugby and American Football occasionally see such injuries. Another common cause is diving into shallow water.
The spinal cord runs from the brain down the neck and the full length of the back. It is housed within the spinal column - a hollow 'tunnel' formed by the posterior (back) aspect of the vertebrae where they sit one on top of the other. These act to protect the spinal cord from injury.
The spinal cord is basically a large bundle of nerves. As it passes down the back (to around waist level), branches of nerves pass out through the gaps between the vertebrae, to supply the individual muscles, organs, skin and other structures at that level.
What is a Spinal Cord Injury?
The most common way for the spinal cord to be injured is via a fracture of one of the bones of the spine (vertebrae) with the bone fragment then compressing or tearing the spinal cord. However it should also be noted that it is possible to suffer a fractured vertebrae without sustaining a spinal cord injury.
A spinal cord injury can vary massively in severity depending on the amount of damage to the spinal cord and the location of the damage. Damage to the spinal cord can result in a loss of function or sensation. The level at which the injury occurs depends on where movement or sensation is lost. A complete rupture of the spinal cord high in the neck can lead to full paralysis (known as quadriplegia or tetraplegia). A rupture lower down in the thoracic or lumbar spine may mean that the individual can function above this point, but may be paralysed from there down, meaning that moving the legs would not be possible (known as paraplegia).
Nerve Root Injury Consequences
Below is a table which demonstrates the highest level of movement or ability for injuries at different levels of the spinal cord.
|Above C4||May require a ventilator to breathe|
|C5||Loss of hand/forearm control. Maintain Biceps control|
|C6||Wrist control but no hand function|
|C7/T1||Can straighten arms but dexterity problems in hands|
|T1-T8||Control of the hands but poor trunk control due to abdominal muscles|
|T9-T12||Abdominal control and ability to sit upright|
|Lumbar & sacral||Loss of leg control, decreasing with lower level of damage.|
Injuries to the spinal cord can be less severe than a full rupture. Partial ruptures and compression injuries may lead to partial or even temporary disablement. In some cases, compression may be from swelling or bleeding into the spinal column and so any resulting symptoms clear once the excess fluid drains away from the area.