Ask the Doc: Understanding Spinal Cord Injuries

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by JOSHUA ZAVERTNIK|PT, DPT, FMS, OCS, FAAOMPT
Get Ogar Strong here: http://kevinogar.com/ 
The CrossFit world has been rocked by the recent tragic event that took place at the OC Throwdown early in January. Kevin Ogar, a well-respected and seasoned veteran of the sport, suffered an unthinkable injury during the competition. In true CrossFit fashion, the sport and community he loved has turned to support him during his time of need. I don’t know him personally, but his story has touched me and I wanted to help our community better understand spinal cord injuries, common mechanisms of injury, and treatment. This article is intended to be general and is in no way speaking directly about Kevin’s situation, but I would hope with a better appreciation of the how’s and what’s, we can continue to strengthen our support for him.

Components and Function of the Spine

The spinal column

397708466The spinal column consists of 24 vertebrae: 7 in the cervical spine, 12 in the thoracic spine and 5 in the lumbar spine. The sacrum is a series of 5 fused vertebrae, and the coccyx — or tail bone — consists of 3-5 fused vertebrae. Between each of the vertebrae are the intervertebral discs. The vertebrae are boney structures that are uniquely shaped based upon where in the body they are located. Typically we see the most movement in the spine at the cervical level and progressively less in the lumbar region comparatively. Each vertebra has an opening known as the spinal canal. The spinal canal runs through the middle of each vertebrae which allows for the spinal cord to pass through and also protects it.

The spinal cord

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The spinal cord along with the brain is often referred to as the central nervous system (CNS). The cord itself is comprised of neural tissue that is surrounded by three layers of tissue: dura mater, arachnoid mater and pia mater. Between the arachnoid and pia mater is the cerebral spinal fluid (CSF). The spinal cord is housed with the spinal column and extends from the foremen magnum (the opening at the base of the skull) and runs the length of the spinal column and usually ends at the level of L1 or L2; this tapered lower end of the cord is known as the conus medullaris. The cord itself ends there, but the lower spinal nerves continue to traverse the rest of the spinal column to the sacrum in a tight cluster of hair-like fibers known as the cauda equine — the horse’s tail. The spinal cord consists of 31 segments, and each has a pair of spinal nerves that extend to the left and the right.

Peripheral Nervous System

Spinal nerves carry different levels of responsibility based upon their location. Once the spinal nerve extends beyond the vertebral body, it is classified as a peripheral nervous system. The peripheral system can be broken into two sub-classifications: the autonomic nervous system (ANS) and the somatic nervous system. The somatic nervous system is responsible for the voluntary motor control that we have over our bodies, while the ANS works with systems such as digestion, breathing and heart rate — things that are more automated and regulated by the body.

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