5-12. PATHOPHYSIOLOGY
a. It should be assumed that any unconscious patient who is the victim of an
accident may have a spinal injury. Detection of spinal injuries can be difficult. The
patient may not have signs or symptoms of damage to the spinal cord immediately. It is
often assumed that a person with spinal cord damage will be completely or partially
paralyzed. This is not always the case. The patient's spinal cord may be damaged, but
initially he may not have paralysis or paresis (partial paralysis, weakness).
NOTE:
There is a difference between paralysis and paresis. Paralysis is loss of
movement; paresis is weakness or incomplete loss of muscular power.
b. Be cautious in moving the patient. Incorrect movement may cause
irreparable spine damage even if there are no signs or symptoms of spinal injury.
c. Do not rely on the fact that the patient does not exhibit the usual
signs/symptoms of spinal cord injury. The patient's ability to move his extremities or the
absence of numbness, tingling, and other signs of neurological damage only indicate
the spinal cord is intact so far. This is NOT an indication that there is no injury to the
spinal cord.
5-13. INJURY TO THE SPINAL CORD
A number of injuries to the spinal cord are possible as the direct result of an
accident. The resulting dysfunction depends on the location of the spinal cord damage.
Symptoms of spinal cord trauma can occur in body parts below the site at which injury
to the spinal cord occurred.
a. Types of Spinal Cord Damage as a Direct Result of an Accident.
Included are the following:
(1)
Cutting of the spinal cord --complete or incomplete.
(2)
Pinching of the spinal cord -- with or without vertebral displacement.
(3)
Stretching of the spinal cord.
(4)
Compression fractures of vertebrae in the spinal cord.
(5)
Displacement of vertebrae -- small or complete.
(6)
Bruise of the spinal cord.
(7) Overstretching and other damage to ligaments and muscles involved in
the spinal cord.
MD0572
5-20