Spine Injuries

 Spinal Injuries

The vast majority of closed spinal injuries leave the cord and roots unscathed. Most of those associated with cord damage have a fracture-dislocation in the cervical region (50%), or at the thoracolumbar junction (40%). Some cervical injuries follow hyperextension and may then be associated with a head injury (a frontal blow causing the hyperextension). A relatively trivial injury of this kind, without a racture, may produce profound paralysis if the patient already suffers from cervical spondylosis.

Immediate management of spinal cord injury

In the majority of patients, damage to the spinal cord is maximal at the time of injury and that is why the emphasis in treatment is on preventing further damage, and then on starting early rehabilitation. Pathological studies have however shown that immediately after injury there may be little apparent cord damage; but within a few hours patony necrosis develops and this eventually progresses to cavitation with gliosis and fibrosis. There is an associated reduction in blood flow and oxygen tension.