The potentially devastating consequences of SCI can include major dysfunction to the motor sensory and autonomic systems Appropriate pre hospital management and consideration of the mechanism of injury can significantly improve outcomes in patients with SCI Mechanism and Pathophysiology SCI is usually caused when two or more vertebrae have an unstable fracture but can also be caused by ruptured ligaments allowing movement of the vertebra to damage the spinal cord without an actual fracture Marsland and Kapoor 2008 127 Blunt trauma to the head and neck is the most common cause of fracture or ligament rupture 50 80 of SCI result from a hyperflexion rotation injury Cole 2009 SCI can occur both in isolation or with other injuries Hess et al 2016 However it only presents in 2 6 of trauma patients although this figure doubles in patients with a head injury and trebles in those with decreased level of consciousness Milby et al 2008 Halpern et al 2010
A SCI can be complete or incomplete In a complete spinal injury sensation and motor function below the point of injury are lost whether or not the spinal cord is severed Bledsoe and Benner 2006 394 In an incomplete SCI full or partial motor or sensory function are preserved below the level of injury Wyatt et al 2012 369 A patient's level of injury is defined as the lowest level of full sensation and function Greaves and Porter 2007 282 Paraplegia occurs when the legs are affected by spinal cord damage in thoracic lumbar or sacral injuries and tetraplegia occurs when all four limbs are affected as a direct result of cervical spine damage Douglas et al 2013 260 As spinal nerve tissue is very similar to brain tissue the nature of injuries are comparable Spinal nerve tissue can be concussed bruised and suffer cell death It can also be subject to compression and swelling Bledsloe and Benner 2006 394 Serious SCI result in a high percentage of permanent damage with poor outcomes for the patient's quality of life Dixon et al 2014