Spinal Injuries:


Spinal injuries can involve many parts of the back and or neck (the weakest part). Trauma can include injury to bones (vertebrae), muscles, ligaments, or the spinal cord, which is the most serious area to damage.


A spinal cord injury (SCI) is damage or trauma to the spinal cord that results in a loss or impaired function causing reduced mobility or feeling. The cords is about 18 inches long and extends from the base of the brain to about the waist.


The nerves situated in the spinal cord are called upper motor neurons and their function is to carry messages backwards and forwards to and from the brain. The nerves that branch out from the spinal cord to other parts of the body are called lower motor neurons and they communicate with specific areas of the body, some to initiate movement and others to provide sensation such as pain and temperature. The spinal cord does not have to be severed in order for loss of function to occur. In most people with SCI the cord is intact but the cellular damage to it results in loss of function.


The Vertebra is a ring of bones surrounding the spinal cord and constitute the spinal column more commonly known as the back bones. It is possible for someone to ‘break their neck’ yet not sustain a spinal cord injury.


The vertebrae are named according to their location:


There are eight Cervical C1 to C8. Cervical SCI usually causes loss of function in the arms and legs-quadriplegia. There are 12 Thoracic (chest) vertebrae. Injuries in this region usually effect chest and legs –paraplegia. Lumbar vertebrae L1 to L5 and the Sacral Vertebrae S1 to S5. Injuries here usually results in some loss of function in hips and legs.


When to suspect a spinal Injury

The most important indicator is what we call the ‘mechanism of injury’. How and what has happened to the patient involved in trauma. We are looking for any abnormal forces which may have been exerted on the back or neck. Such examples can be seen below:

  • Blow to the head, neck or back.
  • Falling from a height.
  • Awkward fall whilst doing gymnastics or trampolining.
  • Diving into a shallow pool and hitting the bottom.
  • Thrown from a horse.
  • Heavy object falling across the back.
  • Multiple injuries.
  • Thrown from a motor bike.
  • High speed RTC (Road Traffic Collision).


These are but a few examples.


Signs & Symptoms:

  • Pain or tenderness in the neck or back at or near the site of injury.
  • Loss of control over limbs, movement restricted.
  • Loss of feeling, sensation in limbs.
  • Pins and needles or burning in the limbs.
  • Loss of bladder and/or bowel control.




Conscious Patient

  • Reassurance, tell patient not to move to prevent any further injury.
  • Maintain the position of the patient as you found them.
  • Using your hands, hold their head still keeping it in line with the upper body.
  • If on your own, support the head both sides, then dial 999.
  • Otherwise, get someone else to dial 999.


Unconscious Patient

  • Maintain an open airway.
  • Using your hands, hold their head still keeping it in line with the upper body.
  • If you feel the patient will vomit, or you have to leave to dial 999, place them in the recovery position.
  • Keep the patient warm and still, constantly monitoring Airway & Breathing until the arrival of the paramedics


Managing the airway with spinal injuries

  • Jaw thrust.
  • Log roll.
  • Recovery position.



We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.


You might also be interested in this blog post about 'How to recognise a seizure'.


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