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Alfacip (Alphadol)

Early in the hospital stay, doctors examine the injured person’s neurological functions to determine the severity of the spinal cord injury. They determine the level at which the spinal cord is injured, whether the injury is complete or incomplete, and whether there is any injury to the bones and ligaments that protect the spinal cord.
What makes up this complex part of our body, the spinal cord? Composed of a delicate bundle of nerve fibers, it connects the brain to the rest of the body. It is surrounded by a long, tubular structure of bones, cartilage, and ligaments called the vertebral column. (The vertebral column is also known as the spine. It is important to understand that the spine is a bony structure surrounding the spinal cord.) The vertebral column consists of a series of small bones called vertebrae, which form a column extending from the lower back to the base of the skull. The vertebrae are cushioned and separated by small gelatinous blocks of cartilage called intervertebral disks.
The vertebrae are named by region of the body, with seven cervical (C) vertebrae in the neck, twelve thoracic (T) vertebrae in the upper back, five lumbar (L) vertebrae in the lower back, and a fused block of vertebrae, called the sacrum (S), at the base of the spine. The vertebrae are also numbered from top to bottom within each of these regions: the lowest cervical (neck) vertebra, C7, sits atop the highest thoracic (upper back) vertebra, T1.
Most people with a spinal cord injury also have an injury of the vertebral column, such as a fracture or dislocation of a vertebra. A spinal fracture is a broken vertebra, and a dislocation of the spine is movement of one vertebra out of its normal alignment. When any vertebrae are fractured or dislocated, there is a high risk of spinal cord injury. Ligaments hold the bones together. If ligaments are destroyed, bones can move out of proper alignment and compress the spinal cord. The forces often involved in serious accidents—car accidents, for example—can tear or stretch vital ligaments. Some people need bracing until ligaments heal; others require surgery. Ensuring the stability of the vertebral column is essential in the care of individuals with spinal cord injury.
The spinal cord, like the vertebral column, has segments from cervical to sacral. Two pairs of nerve roots (bundles of nerve fibers) connect with the spinal cord at every level. Each pair of nerve roots consists of a sensory (or dorsal) root and a motor (or ventral) root, which join to form a mixed spinal nerve. These spinal nerves pass through the vertebral column between the vertebrae, carrying sensory information from and motor information to the arms, legs, and trunk.
When we are born, the spinal cord is the same length as the vertebral column, so the L4 level of the spinal cord lies next to the L4 vertebra, for example. During childhood, the skeleton grows tremendously, but the spinal cord grows only a little longer. By the time we reach adulthood, the spinal cord is much shorter than the vertebral column. Because the top of the spinal cord is still attached to the brain, the CI level of the spinal cord lies next to the CI vertebra. But the S3 level of the spinal cord is near the LI vertebra, only about two-thirds of the way down the back. This means that the level of a vertebral injury may be quite different from the level of the spinal cord injury it causes. For example, when the TIO (middle back) vertebra is fractured, it may result in L3 (lower back) spinal cord injury. Injuries of the lower lumbar and sacral parts of the vertebral column are below the bottom of the spinal cord, because the cord extends only to about LI. Thus lower injuries may cause damage to the nerve roots in the lower back (called the cauda equina) but do not affect the spinal cord itself.

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