SPINE AND SPINAL CORD INJURIES
When a person receives a severe trauma (for instance, an injury from a fall or from a car crash), a possibility exists that the spine could be injured. When the trauma or injury is significant, x-rays of the cervical spine (neck) are obtained as a first step to rule out fractures. Sometimes it is necessary to x-ray the regions of the spine known as the thoracic (chest) and lumbar (lower back) spine as well.
The spine is a complex part of the body and may be fractured in a wide variety of ways. Managing these breaks depends on where they are located and to what degree the fractures may be stable or unstable.
To say that the spine is unstable as a result of a fracture means there has been some loss of the ligaments and bone that give it structural integrity. Potentially the spine could wobble and injure the spinal cord or nerve roots.
For purposes of evaluation the spine is usually divided into the anterior, middle, and posterior parts. In general, disruption of two of the three parts of the spine means that it is not stable and that movement would risk further injury to the spinal cord and/or nerve roots.
TREATING SPINE INJURIES
Treatment of spine injury varies with the severity of the injury. Treatment ranges from bracing and/or bed rest for minor spine injuries to surgery for injuries that have made the spine unstable. With surgery techniques to stabilize the spine
"One version of a thoraco-lumbo-sacral orthosis (TLSO) brace offers good stability for injuries to the thoracic (chest) and lumbar (lower back) regions. It keeps the back straight by using specially designed front and back panels held together with Velcro."
UNSTABLE SPINE INJURIES
Some potentially unstable neck injuries in which the bones still seem well aligned and straight can be treated by outfitting the patient with a halo device in the cervical neck region. For lumbar (back) injuries of this type, a brace--possibly with a leg extension--may be used.
" A halo device stabilizes injuries to the cervical (neck) area in which the bones still seem well aligned"
The most unstable spine fractures and lesions happen with twisting movements that occur with certain falls and roll-over vehicle crashes. In these cases, the surgeon may suggest the option of stabilizing surgery as the best choice for the patient.
The purpose of this surgery is to align the injured area of the spine by means of a stabilizing system consisting of implanted rods, screws, and hooks. This method has been shown in severe cases to give the best long-term results and to give the
(Continued on page 35)