Spinal cord injury (SCI) is defined as injury to the spinal cord that results in a loss of function, such as movement or sensation. In SCI, the spinal cord does not have to be severed to cause a loss of functioning.

If spinal cord injury (SCI) is suspected, patients should be transported to hospital immediately. Often, ambulance personnel will transport the patient. Ambulance personnel are trained in how to protect the patientís spine in cases of suspected injuries. A hard, immovable collar will be placed around the patientís neck and the patient will be strapped to a backboard to prevent movement. These measures are necessary to prevent further injury to the spinal cord.


Type of Spinal Cord Injuries



Spinal cord injuries (SCIís) can be divided into two main categories, complete and incomplete injuries. They may be further classified into several categories according to the extent of motor and sensation loss using the international classification system of the American Spinal Cord Association (ASIA). The classification of a patientís injury is not static, and may change during recovery.


Complete Spinal Cord Injury


It is very rare that a patientís spinal cord is cut and severed. Complete SCI is caused by bruising, pressure on the spinal cord, and loss of blood supply to the cord. The result is entire loss of movement and sensation below the level of the injury.

 

Incomplete Spinal Cord Injury


Incomplete SCI does not result in complete loss of movement and sensation below the level of the injury; patients may have varying degrees of both.








Anatomy of the Spine


The bony spine is the main support and protection for the spinal cord and the nerve pathways that are responsible for carrying messages from your arms, legs, and the rest of your body to and from the brain.

Your spine is composed of 33 bony vertebrae, 31 pairs of nerves, and 40 muscles supported by connecting ligaments and tendons from the base of your skull to your coccyx, or tailbone. Discs, like shock absorbers, cushion your vertebrae as you move and keep your spine flexible. Discs are composed of fibrous, elastic cartilage.


Cervical Spine

 

The cervical spine is composed of 7 vertebrae. These vertebrae allow bending and turning of the head, as well as flexion and extension of the neck. Each vertebrae articulates (forms a joint) with the vertebrae above and below it. Cervical vertebrae are numbered C1-C7.



Thoracic Spine

 

The thoracic spine attaches to the ribs in the chest, and is composed of 12 vertebrae. The spinal canal is smaller in the thoracic spine, making it more vulnerable to injury than the spinal canals in the cervical and lumbar regions. The thoracic spine allows you to rotate your trunk. Ribs prevent much sideways movement. There is a small amount of movement of the thoracic spine when you bend forwards and backwards. Thoracic vertebrae are numbered T1-T12.



Lumbosacral Spine

 

The lumbosacral vertebrae are thicker and wider than vertebrae of the other regions. The lumbosacral spine is composed of 10 vertebrae. These vertebrae allow you to bend at the waist and also allow some backward movement. Some movement to the side also occurs. Lumbar vertebrae are numbered L1-L5, while sacral vertebrae are numbered S1-S5. The bones of the sacrum are fused.



The Spinal Cord


The spinal cord is connected to the brain and is approximately the diameter of one of your fingers. The spinal cord travels down from the brain through the vertebral column, which surrounds and protects it. Cerebral spinal fluid (CSF) bathes the spinal cord and acts as a cushion to protect delicate nerves against injury from striking up against the inside of the bony vertebrae.


The spinal cord consists of millions of nerve fibers. These fibers transmit impulses, or electrical information, to and from the limbs, trunk, and organs of the body. Impulses travel back and forth between the brain and these structures. Ascending tracts of nerves within the spinal cord carry information from the body upwards to the brain, while descending tracts of nerves carry information from the brain downwards to the body to control body functions and movement.


Spinal nerves, or nerve roots, branch off the spinal cord and exit the vertebrae through a hole in each of the vertebrae called the foramen. They carry information to and from the brain to the rest of the body:


Cervical nerves supply movement and feeling to the arms, neck, and upper trunk.

Thoracic nerves supply the trunk and abdomen.


Lumber and sacral nerves supply the legs, bladder, bowel, and sex organs.

It is important to note that spinal cord segments do not correlate exactly to the level of the vertebral bodies. This can cause confusion in describing and classifying injuries, even among physicians.



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