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Among the fractures of entire skeletal system , spinal bone assumes special importance because of the fact it harbors precious neural structures

Nerves and spinal cord which are directed into specific position are protected by spinal column. Destabilizing fractures ( three column injuries ) are a potential immediate threat to the function of spinal cord.

Increase in road traffic accidents ( high velocity injuries , over congestion , lack of safely protocols  all contribute to this ) is the most common reason for spinal cord injury which can result in temporary or permanent paralysis of limbs . Low velocity injuries in fragile bones – PATHOLOGICAL FRACTURES also can lead to paralysis if the fracture pattern has lot of communition and retropulsion .

Cervical spine fractures and dorsal /dorsolumbar fractures can result in weakness of four limbs / only lower limbs respectively. Point of concern is more often in development of this weakness due to further destabilization of the spinal bones once the injury has happened by

1. Improper ways of shifting patients after injury without proper stabilization of the injured spinal bone.
2. Undue delay in choosing the proper health care facility which can  investigate and treat such injuries based on protocol at the earliest.

Public awareness about spinal fracture and spinal cord injury is very crucial.

Spinal cord injury needs early surgery to stabilize the fractured spinal segment and decompress the spinal cord. Decompression and stabilization surgeries done withing 24 hours have the best prognosis in terms of recovery.

A. D12 unstable Burst fracture / B. Long segment pedicle screw fixation with decompression.

Cervical spine injuries if not identified, properly stabilized and operated if essential early can have devastating long term consequences. At field level public awareness measures can greatly contribute to avoid such scenarios

Prudent measures while suspecting spine injuries

1. Don’t remove helmet or rotate the patient without help with 2 people at the site of injury.
2. Suspect spine injury in all head injury patients.
3. Always inform ambulances services from hospitals which can investigate and treat such injuries at the earliest. Involving nearby hospitals will be prudent if the person involved in accident is found totally unconscious, not breathing and bleeding actively.
4. Don’t shift injured patients in two wheelers or three wheelers even if they are conscious.
5. Get investigated completely using CT scan or MRI scan whenever there is a suspicion.
6. Don’t sprinkle water or give water to a injured person at the site where are injured.
7. Try to hold and support the patient from changing position if they can communicate and tell that they feel weak / numb in any of the limbss.
8. Try to provide life saving cardio pulmonary resuscitation if anyone if trained in the crowd.