Injuries to the spine
Last reviewed: 23.04.2024
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Causes of trauma to the spine
In the United States, an average of more than 10,000 spinal cord injuries occur throughout the year. Approximately 40% occur in road traffic accidents and 25% occur as a result of violent actions, the rest are related to falls, sports and industrial injuries. More than 80% of patients are men.
Damage to the spinal cord occurs with the direct physical impact of a force that damages the vertebra, ligaments or discs of the spine and causes crushing or rupturing of the spinal cord tissue, and with penetrating spinal cord injuries (gunshot or stab wounds). Such effects can also damage the vessels with the formation of ischemia or bruising (usually extradural), aggravating the trauma.
Symptoms of a trauma of a backbone
A reliable indication of damage to the spinal cord is a clear definition of the level of injury, above which there are no neurological changes, and below neurological functions are either completely absent or significantly reduced. The features of clinical manifestations depend on the level and degree of damage to the spinal cord (complete or partial).
Spine injuries, as well as other fractures or dislocations, are very painful, but patients suffering from pain caused by other concomitant injuries (for example, fractures of long bones), as well as with impaired consciousness due to intoxication or TBI, complaints of back pain may not present.
Injury of the spine - Symptoms
Damage to the spinal cord in children
Although in children <10 years old, spinal cord injuries are less common than in other age groups, such traumas still occur. In any child after an auto accident, a fall from a height of more than 3 m, or a trauma from bathing, one should suspect a spinal cord injury, until the opposite is proved by the survey data including visualizing methods.
In children <8 years of age, cervical spine lesions usually localize above C4, at the age> 8 years, the level between C5 and C7 is more often affected. In patients of childhood, great importance is the recognition of spinal cord injury without obvious data in direct radiography. This type of spinal injury occurs almost exclusively in children and is associated with direct traction of the spinal cord, its concussion or vascular lesions.
Treatment is similar to that in adults, with immobilization and careful control of oxygenation, ventilation and circulation, may include the administration of high doses of glucocorticoids (taking into account the body weight of the child). Children with severe spinal trauma should be transferred to a specialized children's traumatology center as soon as possible.
Where does it hurt?
Diagnosis of spine injury
Damage to the spinal cord with trauma is not always obvious. Damage to the spine and spinal cord must be suspected in patients with CCI, pelvic fractures, penetrating wounds of the spine, after most car accidents and always after falling from a height or diving into water bodies.
Injury of the spine - Diagnosis
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What do need to examine?
How to examine?
Prognosis and treatment of spine trauma
After complete crossing or degeneration, the nerve endings are not restored, and functional disturbances become permanent. The tissue of the compressed nerve can restore its function. Restoration of movements and sensitivity in the first week after the injury indicates a favorable prognosis. Dysfunction lasting more than 6 months after the injury is likely to become permanent.