Spinal Cord Injury

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Each year in the United Sates, there will be approximately 50,000 new spinal cord injuries caused by accidents. A spinal cord injury occurs when the cord itself is crushed, stretched, or torn by the accident.

Caring for Someone Who Might Have a Spinal Cord Injury

It is impossible to predict how badly someone's spine has been injured before a doctor has evaluated them. Therefore, everyone who is involved in an accident that could have damaged their neck is treated as if they do have an injury to their spine. Most people are familiar with the "backboards" that paramedics use to transport accident victims, but they are unaware of how important these devices are in keeping the spine stable while they are taken to the hospital.

Paramedics and emergency response teams treat accident victims according to strict protocols that have been developed in order to save lives. These protocols are designed to minimize the possibility that someone with a spine injury could be injured while moving him or her from the accident scene or while taking them to a hospital. With these protocols, cervical collars are placed on all accident victims; they are secured on a back-board, and then taken to a hospital for further evaluation.

What Happens in the Hospital

Once they are in the hospital and the patient is stable, the emergency room and trauma doctors will begin to assess the cervical spine by taking a series of x-rays of the neck. The x-rays are used to determine if there have been any obvious injuries to the bones or ligaments in the neck. If the x-rays are completely normal, doctors will then examine the patient by pushing gently on the back of the neck. Doctors call this process "palpation of the spinous processes." The patient has to be awake and alert and not have any other injuries that could be causing them a significant amount of pain, and not be under the influence of drugs or alcohol, for this test to mean anything. If the patient does not have any tenderness then the cervical collar is removed and the patient is instructed on very gradual movements of the head and neck. If these movements do not cause the patient any pain, tenderness or apprehension that something might be wrong, then the cervical collar is removed completely and the patient is "cleared."

If there is any question about the x-rays, and either pushing on the back of the neck or very gentle and gradual movements of the head and neck cause any pain or discomfort, then the patient is taken for further evaluation and imaging studies. It is very important that the cervical collar stays on the patient while this evaluation is taking place. If further imaging studies, like CT scans or MRI scans indicate that there is something injured in the neck, then an orthopedic surgeon or a neurosurgeon will be asked to care for the patient. He or she will be able to provide the best care for the patient who has sustained a neck injury.

In situations where a patient has a sore neck after an accident but all of the X-rays and scans are normal, doctors will usually instruct the patient to wear the collar for several weeks after being discharged from the hospital. This allows the neck to rest and recover after the accident. When the patient returns to be evaluated again, x-rays will be repeated in order to see if there has been any change in the spine during this period of time. Unfortunately, cervical collars are very uncomfortable, and many people want them taken off before they have been completely cleared by doctors. This is very dangerous, and a cervical collar should never be removed unless a doctor specifically states that it is O.K. to do so.

The materials on this Web site are for your general educational information only. Information you read on this Web site cannot replace the relationship that you have with your health care professional. We do not practice medicine or provide medical services or advice as a part of this Web site. You should always talk to your health care professional for diagnosis and treatment.