Spinal Cord Injuries
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.
