The cervical spinal column protects one of the most critical areas of the body.
Seven vertebrae come together to encase the spinal cord, a bundle of nerves that carry messages from the brain to the rest of the body. Those bones are the only things between a normal life and devastating injuries.
What does the cervical spine do?
The cervical spine is important because not only does it encase the spinal cord, but it also holds up your head, which is fairly heavy. Cervical bones are small, but they are strong enough to hold up the approximately 10 to 13 pounds of your head, as well as rotate, side bend, whip to the side, and whatever other dance moves you feel like doing.
Additionally, the cervical spine allows for blood to flow to your brain. It is the gateway that keeps the operation running. So when those bones are compromised, the entire operation comes to a halt.
What happens when the cervical spinal column is damaged?
Injuries to the cervical spine can happen at any time and because of any activity. The most common are motor vehicle accidents, high-contact sports, industrial accidents, assaults and falls. The injuries can range in intensity:
- Bone bruises
- Disc degeneration
- Nerve compression by discs
- Compression or injury to the spinal cord
- Fragments of metal or bone lodged in spinal cord
Bone bruises are painful, almost to the level of a fracture, but they generally just need time in order to heal. Disc degeneration, on the other hand, happens to all of us because discs lose water as we age. This means they lose their height, which lessens their threshold for shock absorption. As such, their ability to handle forces from running, jumping and other activities is not what it used to be, and the bones become weakened. This leads to them herniating or bulging.
If a cervical injury just involves the vertebral discs, this is actually the best outcome because it's the easiest to treat.
Vertebral discs act as shock absorbers between the vertebrae, allowing the bones to move freely and have more range of motion. The discs have an outer shell and an inner jelly that can leak out and inflame the surrounding nerve roots. Sometimes a disc can bulge out of place and trap a nearby nerve, causing intense pain. Treatments include steroid shots, selective nerve root blocks, radiofrequency ablation, Botox injections and sometimes surgery if the nerve needs to be released.
Injuries that compress the spinal cord or cause foreign objects to become lodged within it are highly dangerous, as any damage to the cord itself can lead to paralysis or other issues, as we will discuss in more detail below.
What about the spinal cord itself?
The cervical spinal cord is a powerhouse within the human body. As you move higher up toward the brain, the more severe the damage becomes.
A spinal injury can be "complete" or "incomplete", which is based on whether you have any feeling underneath the level of injury. If you were injured at C6 and can still feel your left leg, then you have suffered an incomplete injury. Electrical signals can still reach the brain, and the spinal cord has not been fully compromised. If you have suffered a complete injury, you would not feel anything beneath C6 and would not be able to move.
Higher cervical injuries (C1-C4 vertebrae) result in the most damage and require around-the-clock medical care. Christopher Reeve of Superman fame is the most popular example of this sort of injury. After being thrown from his horse in 1995, his skull was actually separated from his spinal cord. This left him a quadriplegic who was unable to breathe without a respirator. He was still able to speak, which can be hit or miss with this sort of injury.
Lower cervical injuries (C5-C7 vertebrae) control the arms and hands, so the patient might feel pins, needles, tingling or pain. There may also be partial or total paralysis in the trunk, hands, wrists and legs. While the patient will likely be able to breathe and speak without assistance, it could take considerable effort. Like a higher cervical injury, the patient would not be able to control his or her bowels or bladder.
Surgery can sometimes relieve the pressure upon the spinal cord and restore some sensation or movement, but results vary and are not consistent. The surgery would need to be performed very soon after the injury, and even so it might not reverse the cord damage. The patient still might experience a loss of sensation throughout the body; paralysis; the inability to control his bowels or bladder; loss of sexual function; and pain, weakness and tingling.
What if I suffer a spinal cord injury?
Make sure to call 911 immediately. If you have a friend with you, let them assume control of the situation – have them put something firm on each side of your head, like heavy towels or even books, in order to keep your head from moving. If you're alone, call 911 and then keep as still as possible until medical assistance arrives.
There are many organizations and resources in place to help you transition after your immediate hospital care, including one created by Christopher Reeve himself. You and your family will have a necessary period of adjustment, and that can be an emotionally taxing time. There is no such thing as needing "too much help." It's a very serious injury, and it will take a village to make you feel whole again. Never be afraid to ask for what you need.
Spinal cord injuries can change your entire world in a moment. Look through our resources to see if there are groups that can help. Remember that there will be successes and setbacks in your journey to recovery, and that no matter what, your resiliency will surprise you.