Spinal Cord Injuries Essay, Research Paper

As an Emergency Medical Technician (EMT), when someone has a spinal injury,

additional movement may cause further damage to the spine. EMT?s must always

immobilize the patient?s head and torso in the position found. The purpose of an EMT is

to prevent further harm to the patient until more professional medical help can be

obtained. If in doubt about whether a person has received a spinal injury, always assume

he or she has. A spinal cord injury (SCI) is very serious because it can mean the loss of

sensation and function in the parts of the body below the site of the injury.

SCI?s are caused in many different ways. Some of the most common ways a

person may obtain a SCI are- motor vehicle accidents, bullet or stab wound, diving

accidents, electric shock, awkward positioning of the body, falls, sports injuries (such as

football or diving), industrial accidents, assault and gunshot wounds. Polio, Spina Bifida

and Friedreich?s Ataxia are some of the frequent diseases that cause SCI. SCI may also be

know in other names such as spinal cord compression (SCC) and spinal cord trauma

(SCT). According to an article in , SCI?s occur in approximately 12,000 to 15,000 people

per year in the U.S. About 10,000 of these people are permanently paralyzed, and many

of the rest die as a result of their injuries. Most spinal cord trauma occurs to young,

healthy individuals. Males between the ages of 15 and 35 are most commonly affected.

The spinal cord is about 18 inches long and extends from the base of the brain,

down the middle of the back, to about the waist. It is composed of 33 bones called

vertebrae, 31 pairs of nerves, 40 muscles and numerous connecting tendons and ligaments

running from the base of the skull to the tailbone. Between the vertebrae are fibrous,

elastic cartilage called discs. These absorb shock and keep your spine flexible and cushion

the hard vertebrae as it moves.

The nerves that lie within the spinal cord are upper motor neurons (UMN?s) and their

function is to carry the messages back and forth from the brain to the spinal nerves along

the spinal tract. The spinal nerves that branch out from the spinal cord to the other parts

of the body are called lower motor neurons (LMN?s). These spinal nerves exit and enter

at each vertebral level and communicate with specific areas of the body. The sensory

portions of the LMN carry messages about sensation from the skin and other body parts

and organs to the brain. The motor portions of the LMN send messages from the brain to

the various body parts to begin actions such as muscle movement.

The brain and the spinal cord both make up the Central Nervous System. Motor

and sensory nerves outside the central nervous system make up the Peripheral Nervous

System and another diffuse system of nerves that control involuntary functions such as

blood pressure and temperature regulation are the Sympathetic and Parasympathetic

Nervous Systems.

Rings of bone called vertebra surround the spinal cord, and these bones make up

the spinal column or backbones. Most often, the higher in the spinal column the injury

occurs, the more dysfunction a person will experience. The vertebras are named

according to their location. The 8 vertebra in the neck are called the Cervical Vertebra.

The top vertebra is called C-1; the next is C-2, and etc. Cervical SCI?s usually cause loss

of function in the arms and legs, resulting in quadriplegia. The 12 vertebra in the chest are

called the Thoracic Vertebra. The first is called the T-1 and it?s where the top rib

attaches. Injuries to this region usually affect the chest and the legs and result in

paraplegia. The vertebra in the lower back between the thoracic and the pelvis, are called

the Lumbar Vertebra. The sacral vertebras run from the pelvis to the end of the spinal

column. Injuries to the 5 Lumbar vertebra and similarly to the 5 sacral vertebra generally

result in some loss of functioning in the hips and legs.

The effects of SCI depend on the type of injury and the level of the injury. SCI

can be divided into two types of injury- complete and incomplete. A complete injury

means that there is no function below the level of the injury, no sensation and no voluntary

movement. Both sides of the body are equally affected. An incomplete injury means that

there is some functioning below the primary level of injury. A person with an incomplete

injury may be able to move one limb more than another, may be able to feel parts of the

body that cannot be moved, or may have more functioning on one side of the body than

the other. With the advances in treatment of SCI, incomplete injuries are becoming more

common.

The level of injury is very helpful in predicting what parts of the body paralysis and

loss of function might affect. Injuries above the C-4 level may require a ventilator for the

person to breathe. C-5 injuries often result in shoulder and biceps control, but no control

at the wrist or hand. C-6 injuries generally affect wrist control, but no hand function.

Individuals with C-7 and T-1 injuries can straighten their arms but still may have problems

with the hand and fingers. At T-1 to T-8 there is most often control of the hands, but

poor trunk control as the result of lack of abdominal muscle control. T-9 to T-12 injuries

allows good trunk and good abdominal muscle control.

Individuals with SCI also experience other changes. They may have dysfunction of

the bowel and bladder. Sexual functioning is frequently with SCI. Men have their fertility

affected, while women?s fertility is not affected. Other affects of SCI include low blood

pressure, inability to regulate blood pressure effectively, reduced control of body

temperature, inability to sweat below the level of injury and chronic pain. SCI may also

bring other possible complications like Skin Breakdown (also termed as ?decubitus ulcers?

or ?pressure sores?), which occurs as a result of excessive pressure over the bones of the

buttock. Osteoporosis and Fractures occurs when muscle activity is decreased or

eliminated and the legs no longer bear the body?s weight and begin to lose calcium and

phosphorus which makes them become weak and brittle. Usually occurring 2 years after

the initial SCI. Pneumonia, Atelectasis and Aspiration are the injuries above the T-4 level

of injury that are at risk of developing restriction in respiratory functions 5-10 years after

the SCI. Heterotopic Ossification happens within 12-18 months, occurs when the joints

stiffen and fusion.

Safety practices during work and recreation can prevent many SCI?s. Use proper

protective equipment if an injury is possible, and practice appropriate safety measures.

Always check the depth of water before diving, and look for rocks or other possible

obstructions. Football and sledding injuries often involve sharp blows or abnormal

twisting and bending of the back or neck and can result in SCT. Use caution when

sledding and inspect the area for obstacles. Use appropriate techniques and equipment

when playing football or other contact sports. Falls while climbing at work or during

recreational activities may cause serious SCI?s. Always use defensive driving practices

and improved vehicular design may prevent many automobile accidents, and the use of

seat belts will greatly reduce the risk of serious injury if there is an automobile accident.

Using and remembering these tips will always reduce your chances of ever encountering a

situation where you could be the victim of a spinal cord injury.

Bibliography

1) ?Spinal Cord Injury: Spinal Cord 101? (15 March. 2000).

2) ?Spinal Cord Injury: Possible Complications? (15 March. 2000).

3) ?Spinal Cord Injury: Basic Anatomy of the Spinal Cord? (15 March. 2000).

4) ?Spinal Cord Trauma? (18 March. 2000).

5) ?Spinal and Neck injuries? (19 March. 2000).