Friday, August 19, 2011

Spinal Cord Injuries

I was reading a well known author when an interesting method of killing was proposed. His villain dislocated his victim's spinal cord manually by prying his fingers between the vertebrae. For that reason alone, I almost did an Author Beware post.Then, what followed was the victim living for a few hours paralyzed but still able to breathe. This is bridging on implausible and here's why.

First, regarding the method of incapacitating this character. Have you ever watched the TV show Wipeout? Our family loves it and it's generally clean (well... there is a lot of mud) fun and the participants often have some teeth-clenching falls where I've been surprised to see a them get up and actually walk away. The point being it that it is difficult to break your neck to the point of injuring your spinal cord. It takes a lot of force. Football players colliding. A serious car accident. Diving into a pool and landing directly on your head. So, visually for me, someone prying their fingers into the gap between the vertebrae (those gaps are small) limits the believability.

Second, let's assume the injury did happen as the author described. Could the character have been prone and alive for a couple of hours? Depends on their level of injury.

The first important thing as a medical person is to determine what level the spinal cord is injured at. Everything below the level of injury is impaired.
However, during the acute injury phase, things swell up. The swelling itself my cause impairment but the patient's level of function may improve once the swelling goes down. Two muscle groups help you breathe. First and foremost is the diaphragm. This is a thin layer of muscle that divides your chest and abdomen. It sits beneath your lungs. It is controlled at about C3-C5 (that's your cervical spine and is in the region of your neck). Next are your chest muscles. These are used less for breathing (unless a patient is having difficulty) and are controlled by your thoracic spine which is your upper back.

For this character having a spinal cord injury in the upper neck with subsequent swelling makes me doubtful he would have lived a couple of hours without intervention. Consider carefully level of spinal cord injury and how it will effect your character's good health.

Have you written a scene incorporating a spinal cord injury?


  1. Jordyn, I cringe at some of the medical misinformation I sometimes encounter in books and TV programs. Recently found a book by an excellent author in which he has the protagonist hospitalized with a football injury, receiving IV Vicodin for pain! Good analgesic, not available in that form.
    Thanks for all the good stuff you post. Keep up the good work.

  2. Jordyn, You are my number 1 medical source. You've been so helpful with my novel and your blog is superior. I CANNOT wait to meet you in real time.

  3. Richard-- yes, that's a good one. Vicodin IV. I must say it is very hard to get those horse pills into a syringe;). You must have read the same book as Sarah Sudin because I think she mentioned that to me once.

    Carol--thanks for your comment. Can't wait to meet you, too!

  4. I like your blog and would like to bestow you with a Liebster Award. You can find out about it on my blog ( and post your award here.

  5. Ahhh, thanks Heidi!! I appreciate the support.

  6. I have seen that show as well. And like you, I am quite scared that the contestants would be hurt from their scary fall.