Cervical Spinal Cord Injury
Written by Andrew Sarski on July 30, 2013
Cervical injuries, or neck injuries, can be extremely painful and debilitating, especially if the injury is severe enough to affect the spinal cord nerves linked to other parts of the body. In addition to causing disability or paralysis and difficulties with daily living and self-care, cervical injuries may result in significant medical expenses and a devastating loss of income. For these reasons, many victims of cervical injuries are forced to deal with overwhelming financial hardships in the face of their tragic injury. Many cervical injuries are caused by motor vehicle accidents, and others are caused by slip and fall accidents, sports injuries or workplace accidents, often the result of unsafe working conditions or another person’s negligence or reckless actions. If you or a loved one has suffered from a cervical spinal cord injury because of an accident or fall, contact a personal injury attorney to explore your compensation options.
Segmental Spinal Cord Level and Function
The spinal cord is divided into different sections, called the cervical (neck) segment, the thoracic (chest) segment, and the lumbosacral segment, made up of the abdominal section of the torso and the pelvis. The following represent the different cervical segments of the spinal cord and the bodily functions that they control:
C1-C6: Control neck flexors
C1-T1: Control neck extensors
C3, C4, C5: Supply diaphragm
C5, C6: Control shoulder movement, ability to raise arm (deltoid), elbow flexion (biceps); C6 externally rotates the arm
C6, C7: Extend elbow and wrist (triceps and wrist extensors); pronates wrist
C7, T1: Control wrist flexion and supply small muscles of the hand
Signs and Symptoms of Cervical Injuries
Cervical injuries can result in tragic complications, including long-term disability or permanent paralysis. However, depending on the location of the injury and the severity of the trauma, limited function may be retained. The following are different levels of cervical injuries and the associated loss of function and/or disability:
Injuries at the C1/C2 levels – Often result in loss of breathing, requiring the use of mechanical ventilators or phrenic nerve pacing.
C3 vertebrae and above – Typically causes loss of diaphragm function, necessitating the use of a ventilator for breathing.
C4 injuries – Results in significant loss of function at the biceps and shoulders.
C5 injuries – Results in potential loss of function at the biceps and shoulders, and complete loss of function at the wrists and hands.
C6 injuries – Causes limited wrist control and complete loss of hand function.
C7 and T1 injuries – Causes loss of dexterity in the hands and fingers, but allows for limited use of arms.
Causes of Cervical Injuries
Spinal cord injuries, especially cervical injuries, are most often traumatic, caused by lateral bending, rotation, dislocation, axial loading, and hyperflexion or hyperextension of the spinal cord. Motor vehicle accidents are the most common cause of spinal cord injuries, while other causes include work-related accidents, falls, sports injuries, and penetrations such as gunshot or stab wounds.
Treatment for Cervical Injuries
Modern trauma care involves clearing the cervical spine, in which a patient with a suspected injury is treated as if he or she has a spinal injury until that type of injury is ruled out. Patients are immobilized at the scene of the injury using a device called a long spine board, and, once they are transported to the hospital, they are evaluated for spinal injury using an x-ray or CT scan. If a cervical injury is diagnosed, surgery may be necessary to remove any bone fragments from the spinal canal and to stabilize the spine. Since inflammation can cause further damage to the spinal cord, patients may be treated with corticosteroid drugs to reduce swelling. The rehabilitation process associated with a spinal cord injury usually involves physical therapists, occupational therapists, social workers, psychologists and other healthcare professionals working as a team to decide on goals appropriate for the patient’s condition.
Complications Associated with Cervical Injuries
Cervical injuries often result in full or partial quadriplegia, a term describing paralysis caused by injury that results in the partial or total loss of use of all of the limbs and torso. Patients who suffer complete injuries above C7 typically cannot handle activities of daily living and cannot function independently. Additional complications of cervical injuries include the inability to regulate blood pressure, heart rate, sweating and body temperature, as well as abnormal increases in blood pressure, sweating, and other autonomic responses to pain or sensory disturbances. Long-term effects of cervical injuries can include respiratory failure, neurogenic shock, pneumonia, pulmonary edema and deep venous thrombosis.
Cervical Injury Prognosis
The prognosis for patients with cervical injuries depends on the location and severity of the injury. In general, patients with complete injuries recover very little lost function, and patients with incomplete injuries have a better chance of recovery. Some patients that are initially assessed as having complete cervical injuries are later upgraded to incomplete injuries. Recovery is typically quickest during the first six months, with very few patients experiencing any significant recovery more than nine months after the injury.