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LUMBAR (BACK)
Lumbar means pertaining to the abdominal segment of the torso. There are five vertebrae (bones) in the lumbar region of the back (L-1 – L-5). These are the largest and best of the spinal column. In between each lumbar vertebrae a nerve root exits to form the sciatic nerve. The sciatic nerve runs through the back of each leg and into the feet.
Lumbar Sprain occurs when ligaments (tissue that holds bones together) are torn from their attachments. Muscle strains and lumbar sprains are the most common cause of low back pain. A muscle strain occurs when the muscle fibers are abnormally stretched or torn. These are difficult to distinguish, as both will have similar symptoms. These symptoms can be pain around the lower back and upper buttocks, low back muscle spasms, and pain associated with activities but relieved with rest. Most patients develop a lumbar sprain or muscle strain because they are doing an activity that places their back at risk. This may be a sudden forceful movement, lifting a heavy object or twisting the back in an unusual manner.
 Herniated Disc/Buldging Disc/ Disc Prolapse (Slipped Disc) can be usedinterchangeably. This is less common in the cervical spine and more often occurs in the lumbar region. About 90% will occur at (lumbar) L-4 and L-5 or (sacral region) S-1. A herniated disc may occur suddenly in an event such as a fall or accident, or may occur gradually with repetitive straining of the lumbar region. It occurs when the center of the disc leaks out of the disc and puts pressure on the nerves which ierge from the spine. If the injury is in the cervical region, the patient will present with pain in the neck and shoulder which may radiate down the arm. The pain is exacerbated by neck movement. If the injury is located in the lumbar the patient may have weakness in extending the big toe. They may also complain of numbness and/or pain on top of the foot. If the injury occurs in the sacral region, the patient will have weakness when attempting to stand on their toes and numbness and/or pain on the outside or sole of the foot. A MRI scan is helpful in the diagnosis. The x-rays, physical exam, and patient’s symptoms are information that plays a part in the treatment plan.
Sciatica is inflammation of the sciatic nerve. The most common cause of sciatica is a herniated disc. This compresses the nerves and patients experience pain, weakness, and numbness. Common symptoms include shooting pains from the buttocks down the leg or a burning sensation in the thigh. There are different treatment options for sciatica.
Fracture of the Lumbar Spine (Broken Back) is a serious energy and usually caused by high-energy trauma like a car crash, gun shot wound, or fall. The thoracic region of the spinal cord can also be fractured. The spinal cord may be injured depending on the severity of the fracture. When the lumbar or thoracic region is fractured, surgery or bracing is necessary.
Cervical (Neck)
The cervical (neck) region of the spine consist of 7 vertebrae (bones) C1 – C7. These vertebrae carry the weight of the head. In between the vertebrae are discs, which are cushioning pads to absorb shock. Injury to the cervical region may result in some type of paralysis depending on the exact location of the injury. These are the most common types of injuries:
Herniated Disc /Bulging Disc /Cervical Disc Prolapse (Slipped Disc) can be used interchangeably. This is less common in the cervical spine and more often occurs in the lumbar region. About 90% will occur at (lumbar) L-4 and L-5 or (sacral region) S-1. It occurs when the center of the disc leaks out of the disc and puts pressure on the nerves which emerge from the spine. If the injury is in the cervical region, the patient will present with pain in the neck and shoulder which may radiate down the arm. The pain is exacerbated by neck movements. If the injury is located in the lumbar the patient may have weakness in extending the big toe. They may also complain of numbness and/or pain on top of the foot. If the injury occurs in the sacral region, the patient will have weakness when attempting to stand on their toes and numbness and/or pain on the outside or sole of the foot. A MRI scan is helpful in the diagnosis.
Cervical Fracture (Broken Neck) can result from high energy trauma such as car accidents or falls. Athletes are also at risk for cervical fractures. Injury to the bones of the neck can have serious consequences because the spinal cord runs in the center of these bones. The spinal cord is the main connection between the brain and the body. So, damage to the spinal cord could result in paralysis or death.
Whiplash
Whiplash is the most common injury caused by car accidents. The 32 joints in the neck (along with other muscles and ligaments) are easily stretched and injured if too much force is applied in any one direction. When the joints are stretched beyond their normal limitations, they can lose there elasticity limiting their ability to return to their original length.
The sudden movement, upon impact, causing the head to go backwards and forwards or sideways, is referred to as whiplash. It is more accurately called cervical acceleration/deceleration (CAD) trauma or syndrome. As the muscles and other tissues within the neck stretch toward their physical limits, extreme tension builds and muscles “snap” or “whip” in the opposite direction. The spinal cord and nerve roots can get stretched ad become irritated. The injuries left on the muscles, ligaments, nerves ( soft tissues) and joints within the neck, after and accident will generally cause headaches, nausea, dizziness, pain in the shoulders, arms and hands, reduced ability to turn and bend, and lower back problems.
Victims with severe whiplash, which may be caused from bruising of the brain, have experienced blurred vision, ringing in the ears, nausea and numbness.
Degenerative Joint Disease (DJD) (Osteoarthritis) is the most common form of arthritis. DJD of the spine is caused by general wear and tear as we get older. It begins when the discs lose their ability to absorb stress on the spine and as a result the vertebrae (bones) of the spine can start to form spurs because the cushioning has eroded. The nerves of the cervical spine can become irritated or pinched causing pain in the neck or arms. Osteoarthritis can also occur in the knees, hips, and fingers.
Information obtained from: http://www.neurolaw.com
The Spinal Cord
The spinal cord is part of the nervous system and is the largest nerve in the body. Specifically, nerves are cordlike structures which are made up of nerve fibers. These nerve fibers are responsible for the communication systems of the body which include sensory, motor and autonomic functions.
The spinal cord is surrounded by protective bone segments called the vertebral column, or the spinal column. It is made up of seven cervical vertebrae, twelve thoracic vertebrae, five lumbar vertebrae and five sacral vertebrae.
The spinal cord is about 18 inches long and extends from the base of the brain, down the middle of the back, to about the waist. The nerves that lie within the spinal cord are upper motor neurons (UMNs) and their function is to carry the messages back and forth from the brain to the spinal nerves along the spinal tract. The spinal nerves that branch out from the spinal cord to the other parts of the body are called lower motor neurons (LMNs). These spinal nerves exit and enter at each vertebral level and communicate with specific areas of the body. The sensory portions of the LMN carry messages about sensation from the skin and other body parts and organs to the brain. The motor portions of the LMN send messages from the brain to the various body parts to initiate actions such as muscle movement.
Traumatic Spinal Cord Injury
The term "spinal cord injury" refers to any injury of the neural (pertaining to nerves) elements within the spinal canal. SCI can occur from either trauma or disease to the vertebral column or the spinal cord itself. Most spinal cord injuries are the result of trauma to the vertebral column. These injuries can affect the spinal cord's ability to send and receive messages from the brain to the body systems that control sensory, motor, and autonomic function below the level of injury. Depending on the location and severity of the injury, the body can be affected in a myriad of ways. Typically, the nerves above the injury site continue to function as they always have and the nerves below the site do not.
The type of spinal cord injury is classified by the doctor as "complete" when the nerve damage obstructs every signal coming from the brain to body parts below the injury; it is considered "incomplete" when only some of the signals are obstructed. In an incomplete injury, the amount and type of message that can pass between the brain and parts of the body will depend on how many nerves have not been damaged. The level of injury is determined by which vertebrae of the spinal cord has been injured. The closer the injury is to the brain, the greater the loss of function and feeling will be. A person is said to have paraplegia when he or she has lost feeling and is not able to move the lower parts of the body. Someone with tetraplegia (formerly called quadriplegia) has lost movement and feeling in both the upper and lower parts of the body.
Sometimes the spinal cord is only bruised or swollen after the initial injury and as the swelling goes down, the nerves may begin to work again. Unfortunately, there are no tests which will determine how many nerves, if any, will work again. However, the longer there is no improvement, the less improvement will occur.
In addition to movement and feeling, a spinal cord injury affects other bodily functions, such as breathing, bowel and bladder control. There may also be changes in sexual function.
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