b'Neck and Spinal InjuryChapterThe spinal cord is very delicate and if it is damaged, loss of power, sensation and mobility can be permanent. A fracture or dislocation to the vertebral bones may result in injury to the spinal cord. The direct mechanical injury from the traumatic impact can compress or sever the nervous tissue. Secondary injury may follow, caused by ongoing bleeding into the spinal cord as well as continued swelling at the injured site and surrounding area.The possibility of spinal injury must be considered in the overall management of all trauma patients.Injury to the spine can involve:The neck (cervical spine), the back of the chest (thoracic spine) and the lower back (lumbar spine).The bones (vertebrae). The spinal chord.The discs of tissue that separate the vertebrae.The surrounding muscles and ligaments.The nerves that branch off from the spinal cord.Injury to the spinal cord presents the most serious risk to the patient.Damage may include: Partial loss of sensation or mobility below the injured area.Displaced discs or bone fragments pressing on nerveroots causing temporary damage and long term pain.The spinal cord may be completely severed resultingin permanent damage (paralysis). The extent of the paralysis depends on which area of the spinal cord is damaged.The cervical spine is most vulnerable to injury, which must be suspected in any patient with injuries above the shoulders. More than half of spinal injuries occur in the cervical region. Suspected spinal injuries of the neck, particularly if the patient is unconscious, pose a dilemma for the rescuer because correct principles of airway management often cause some movement of the cervical spine.94 Head, Neck and Spinal Injury'