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Cervical Spine and Spinal Cord Injuries
Questions and Answers
1
How common are traumatic spine injuries (TSIs)?
There are an estimated 12,000 injuries per year in the United States, with the majority occurring as a result of motor vehicle crashes and falls.
2
Why is this subject important?
The morbidity associated with severe TSI results in significant change in quality of life and financial costs. Patients with severe TSI have significant reductions in life expectancy, and average lifetime expenses can be in the millions of dollars for one patient with an incomplete spinal injury. Over 50% of injuries are of the cervical spine, which are associated with much higher morbidity and long-term cost than injuries of the thoracic and lumbar spine. The elderly constitute an at-risk population, as patients with osteoporosis and other spinal arthropathies, such as rheumatoid arthritis, are at higher risk of injury.
3
Why are we so worried about the cervical spine?
The cervical spine consists of seven vertebrae separated by intervertebral disks and is held in place by the anterior and posterior longitudinal ligaments. The cervical spine has the greatest degree of mobility and is therefore the most vulnerable portion of the spine. The cervical canal from the base of the skull to the inferior portion of C2 is fairly large but narrows at the level of C3, making injury to the spinal cord at this level and distal much more likely. The cervical spinal cord is also of critical importance because the phrenic nerves that innervate the diaphragm originate at the C3–5 levels. A complete spinal cord injury in this area can as a result cause apnea and death. Extreme care must be taken to avoid converting a patient with an incomplete cord injury who can breathe to a patient with a complete cord injury who then would become apneic.
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