Spinal injuries
LIFE-THREATENING DISORDERAside from spinal cord damage, spinal injuries include fractures, contusions, and compressions of the vertebral column. These injuries usually are the result of trauma to the head or neck. The real danger lies in possible spinal cord damage. Spinal fractures most commonly occur in the 5th, 6th, and 7th cervical, 12th thoracic, and 1st lumbar vertebrae.
Under studyThe expression of some genes changes significantly in the early stages following spinal cord injury, indicating the complexity of secondary spinal cord injury. In studies, 45 genes changed significantly in the early stages following spinal cord injury—22 genes up-regulated and 23 genes down-regulated in expression.
Causes
Most serious spinal injuries result from motor vehicle accidents, falls, diving
into shallow water, and gunshot and stab wounds; less serious injuries, from lifting heavy objects, contact sports such as football, and minor falls. Spinal dysfunction may also result from hyperparathyroidism and neoplastic lesions.
into shallow water, and gunshot and stab wounds; less serious injuries, from lifting heavy objects, contact sports such as football, and minor falls. Spinal dysfunction may also result from hyperparathyroidism and neoplastic lesions.
Signs and symptoms
The most obvious symptom of spinal injury is muscle spasm and back pain that worsens with movement. In cervical fractures, pain may produce point tenderness; in dorsal and lumbar fractures, it may radiate to other body areas such as the legs.
If the injury damages the spinal cord, clinical effects range from mild paresthesia to quadriplegia and shock. After milder injuries, such symptoms may be delayed for several days or weeks. During this time, the patient may unknowingly aggravate the condition
Clinical TipBecause the diaphragm is innervated by cervical levels 1 to 4, damage to this level will result in respiratory compromise. Also, be aware of edema at levels C5 to C7, which may expand up into these areas, resulting in problems.
Complications
The following are complications of spinal injuries: autonomic dysreflexia, spinal shock, and neurogenic shock.
Also known as autonomic hyperreflexia
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