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patient the best chance of any future improvement that may possibly occur.
This surgery also allows the patient to be moved relatively soon and, therefore, avoid some of the complications usually associated with long-term bed rest such as deep vein thrombosis, pulmonary embolism, and pneumonia.
SPINAL CORD INJURIES
The spinal cord runs from the brain stem at the base of the skull down to the lower chest. Usually it stops at about the level of the kidneys, with only nerve roots present farther down. Spinal cord injuries, therefore, occur mostly with cervical (neck) or thoracic (chest) spine injuries.
KINDS OF SPINAL CORD INJURIES
A spinal cord injury can be complete or partial. It usually starts with a condition called spinal shock, and during this time the spinal cord doesn't function at all. This lasts about 48 hours, and then the spinal cord starts recovering.
If there is no recovery whatsoever after this time period, the injury is considered complete. This is usually an unfavorable sign in terms of recovery of function.
A spinal cord injury is called partial when some form of neurological function is preserved, no matter how small (sensory, movements, or sphincter function). The chance of improvement in this situation is much greater.
In the thoracic (chest) area, the spine is stabilized by the rib cage. Any fracture at that level that is bad enough to sever the spinal cord often causes a complete spinal cord injury. In this region, the blood supply to the spinal cord is poor and the spinal canal is narrow. Injuries of the spinal cord in the thoracic region produce paralysis in the legs and numbness below the level of the injury.
If the spinal cord injury occurs in the cervical (neck) area, it may produce paralysis of the upper extremities. The fibers going to the hands are usually located toward the center of the spinal cord and even a minor spinal cord injury could injure the center more than the edges. Often, therefore, even with partial paralysis in the upper extremities, the hands are often the parts of the body most affected.
"Cervical traction can be utilized to realign the cervical spine."
TREATMENT OF SPINAL CORD INJURY
The general line of treatment for spinal cord injury is to re-align and stabilize the spine if it is out of alignment. Some intravenous medication has been shown to improve the outcome of spinal cord injuries and is usually started as soon as possible.
IN THE EMERGENCY ROOM
Initially when a patient with a traumatic injury arrives at the emergency room, they will be assessed by the emergency room physician and the trauma general surgeons. Many other physicians besides neurosurgeons may also be involved, depending on the various injuries. To have the spine evaluated, the patient will (Continued on page 36)
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