Injuries to the Spine

Anatomy- Spine Spine consists of several curvatures in specific regions of the spine Cervical and lumbar spine are concave Thoracic spine is convex

Anatomy- Cervical The cervical spine consists of 7 vertebrae Movements of the neck Extension Flexion Rotation Lateral Flexion C1- Atlas First cervical vertebrae Articulates with the occipital bone and forms the atlantooccipital joint Allows for nodding of head C2- Axis Second cervical vertebrae Articulates with atlas and forms atlantoaxial joint Allows for rotation of the head on the neck

Injuries to the Cervical Spine Historically it was thought that forced flexion of the neck was the most common MOI Any injury to the neck has the potential for neurological complications It is important to take every injury to this region seriously

Injuries to the Cervical Spine Sprains and Strains Fractures and Dislocations Most of these injuries are self- correcting and will resolve over a period of time Signs and symptoms are similar Localized pain Point tender over injury site Pain with certain movements Treatment Ice and rest Refer to physician if neurological symptoms are present or pain does not resolve Will result from direct or indirect trauma to the head or neck region Signs and symptoms Athlete may report feeling pop or snap in their neck Severe pain in the cervical area Complete absence of sensation in the extremities Treatment If suspected, initial EAP immediately Spineboarding and emergency transport is necessary

Anatomy- Thoracic Thoracic spine consists of 12 vertebrae Thoracic vertebrae, ribs and sternum compose the thoracic cage Thoracic spine is much less mobile than cervical or lumbar spine Majority of movements aid in respiration

Skeletal Problems Scoliosis – lateral and/or rotary curvature of the spine Lordosis – increased concavity of the spine (sway back) Kyphosis- exaggeration of the normal curve of the thoracic spine

Ribs 12 pairs of ribs Rib fractures will occur due to a direct blow 7 pairs- True ribs 8-10 attach via common costal cartilage 11-12 do not connect to the sternum Rib fractures will occur due to a direct blow Fractures can occur anywhere in the rib, most commonly occur at the angle of the rib

Rib Fractures Signs and symptoms Initial Treatment Painful respiration Deformity in the region of the injury Swelling and discoloration Pain when rib cage is compressed In severe cases, the rib can dislodge and puncture a lung resulting in a traumatic pneumothorax Initial Treatment Secure area with 6 inch (double) elastic wrap Treat for shock Refer to physician for further evaluation

Rib Fractures Complications of these injuries are rare but can be quite severe if mistreated Displaced rib fractures may damage internal thoracic structures Pneumothroax- collapse of lung as a result of air in the pleural cavity Hemothorax- bloody fluid in the pleural cavity

Sprains & Strains- Ribs Sprains and strains will occur whenever a joint is forced through an abnormal range of motion Evaluation of sprain or strain is difficult and must be based on history of injury Athlete will report having sustained an “unusual” movement of the thoracic spine Signs and symptoms are hard to differentiate from each other Dyspnea- Difficult or painful breathing

Sternal Fracture Infrequent in sports Complications Manubrium is dislocated and moves posteriorly resulting in an airway obstruction Sternum and ribs are separated resulting in a flail chest Loss of stability to the thoracic cage