Spinal Injuries

Usually the result of trauma to the head or neck, spinal injuries (other than spinal cord damage) include fractures, contusions, and compressions of the vertebral column. Spinal injuries most commonly occur in the twelfth thoracic, first lumbar, and fifth, sixth, and seventh cervical areas. The real danger from such injuries is associated damage to the spinal cord.

Causes

Most serious spinal injuries result from motor vehicle crashes, falls, diving into shallow water, and gunshot and related wounds. Less serious spinal injuries typically are caused by improper lifting of heavy objects and by minor fails. Spinal dysfunction may also result from hyperparathyroidism and neoplastic lesions.

Symptoms

• Numbness or tingling that radiates down an arm or leg
• Weakness
• Unconscious
• Stiff neck, headache, or neck pain
• No bladder or bowel control

Diagnostic tests

Spinal X-rays, myelography, and computed tomography scans and magnetic resonance imaging are used to locate the fracture and site of the compression.

Treatment

The primary treatment after spinal injury is immediate immobilization to stabilize the spine and prevent cord damage; other treatment is supportive.

Cervical injuries require immobilization by application of a hard cervical collar, sandbags on both sides of the patient's head, or skeletal traction with skull tongs or a halo device. When a patient shows clinical evidence of spinal cord injury, high doses of I.V. methylprednisolone are started.

Treatment of stable lumbar and dorsal fractures consists of bed rest on a firm surface (such as a bed board), analgesics, and muscle relaxants until the fracture stabilizes (usually in 10 to 12 weeks). Later treatment includes exercises to strengthen the back muscles and a back brace or corset to provide support while walking.

An unstable dorsal or lumbar fracture requires a plaster cast, a turning frame and, in severe fracture, laminectomy and spinal fusion.

Prevention

• Wear seat belts.
• Avoid drinking alcohol and driving.
• Avoid diving into pools, lakes, rivers and surf, particularly if you cannot determine the depth of the water, or if the water is not clear.
• Avoid motorcycles and all-terrain vehicles.
• Avoid "spearing" (tackling or diving into a person with your head).

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