SpinalHub. Heart rate. Despite this, cervical spondylosis is easily treated, and does react well to treatment within weeks. Jack Thompson. The more neural pathways remaining after an injury, the higher the chances of stimulating neuroplasticity and regaining function. To activate neuroplasticity, the nervous system must be stimulated through high repetition of exercises, ormassed practice. Individuals with a C7 spinal cord injury in particular may have limited or absent sensation (feeling) or movement below the shoulders and/or neck. Feelings of pressure or fullness in the throat or lungs. The more severe an injury, the higher the risk of developing complications such as pressure sores. A direct relationship exists between the level of cord injury and the degree of respiratory dysfunction, as follows: With high lesions (ie, C1 or C2), vital capacity is only 5-10% of normal,. Kathleen Fisher Spinal cord injury. A spinal cord injury (SCI) is damage to any part of the spinal cord. To boost your motivation during recovery, it helps to focus on what you can do rather than what you cannot just yet. Paralysis in arms, hands, trunk and legs. A buildup of these secretions can result in a variety of secondary conditions such as respiratory infections and lung congestion. To maximize your chances of recovering from a C7 spinal cord injury its important to prioritize movement and establish a proper rehabilitation regimen. Armrests, arm trough vs. lab tray: armrests and arm troughs position the upper extremities in abduction and external rotation (upper chest respiration) and the lab tray assists in positioning the upper extremities in adduction and internal rotation (diaphragm respiration). No motor function, just sensory. This can include sensation in the head, neck, clavicle, shoulders, outer arms, thumbs, and fingers. Antibiotics, either oral or intravenous, to combat current infections and reduce the likelihood of future ones. Sleep disorders that interrupt your ability to achieve and maintain rapid eye movement (REM) sleep. Here are some of the contributing factors to changes in respiration from a C6 spinal cord injury: Immediately following a traumatic SCI, especially a cervical spinal cord injury, a person with a spinal cord injury may experience what is known as spinal shock. Most doctors divide the spinal cord into four distinct regions, again in descending order: thecervical spine,thoracic spine, and thelumbar spine. Although it can, at some point, increase chance of spinal cord injury in very severe cases, it is a common diagnosis which reacts well totreatment. People with an incomplete injury are more likely than people with a complete injury to regain control of more muscle movement, but there is no way to know how much, if any, will return. This dermatome can vary, but it typically includes areas . hbspt.cta._relativeUrls=true;hbspt.cta.load(575040, '096a7074-9474-4c57-8948-3c9b97281302', {"useNewLoader":"true","region":"na1"}); Spinal cord injuries are traumatic for patients and their families. Diving off a pontoon boat 4 years ago, Josh was paralyzed after suffering an incomplete spinal cord injury, breaking his C6/C7 vertebrae. [1][2], For individuals with compromised respiratory systems, proper positioning is key to influencing breathing patterns and improving ventilation. Despite advances made in the understanding of the pathogenesis and improvements in early recognition and treatment, it remains a devastating event, often producing severe and permanent disability. Spinal nerves also innervate different groups of muscles, calledmyotomes. [25] Physiotherapists can assist individuals with a spinal cord injury to sit up in a chair once the spinal fractures are surgically stabilised. Cell Mol Neurobiol. Check out our bestselling tool by clicking the button below: Baclofen for Spinal Cord Injury: Uses, Side Effects, and Management, Exercises For Quadriplegia: How to Get Started with Rehabilitation for Paralysis Recovery, Traumatic Spinal Cord Injury: Potential Effects and Chances of Recovery. What is ASIA level B (Sensory Incomplete)? Acute spinal cord injury (SCI) is due to a traumatic injury that bruises, partially tears, or completely tears the spinal cord. 2013 Mar;6(1):45. doi: 10.1177/1753495X12473752. View this image of a spinal cord injury at C6/C7. FOIA A C7 spinal cord injury results in loss of movement and sensation, which can affect other functions in the body. Pressure sores typically develop in bony areas such as the elbows, sit bones, tailbone, hip bones, heels, ankles, and knees. When you exhale, your abdominal muscles contract, your internal intercostal muscles contract, and your external intercostal muscles relax. This can increase breathing difficulties and may lead to dyspnea. Primary systems involved in normal respiration are the following: Skeletal support for ventilation include: During inspiration, the upper ribs move primarily in an anterior and superior direction, the middle ribs move in all three planes of movement (anterior, superior and lateral), and the lower ribs move primarily in a lateral and superior direction. A. World journal of orthopedics. J Spinal Cord Med. It can help to talk with your occupational and/or physical therapist to discuss what adaptive equipment or modifications will be best for your specific needs. Neurogenic shock was defined as bradycardia with hypotension. Patients will typically know the extent of the long-term damage within six months of the injury. Doctors classify spinal cord injuries as either complete or incomplete. Effects of C-7 and T-1 Injuries There will be loss of feeling as well as some tingling sensation below the level of the injury. Though spinal cord injuries are frightening, the prognosis isn't always grim. The role of members of the multidisciplinary team varies in many aspects of the respiratory management of patients with a spinal cord injury. Depending on the severity, some may encounter positive results more swiftly than others. Some people spontaneously recover from their injuries; others make little progress even with quality physical therapy and dedicated medical care. SCI causes an alteration in neurotransmitters and proteins both below and above the injury ( 91-93 ), and preliminary data showed that, after a high cervical SCI . The rehabilitation phase begins as soon as the person has stabilized and is ready to begin working toward his or her independence. The level and severity of each spinal cord injury vary significantly from one case to the next and contribute to determining the respiratory impact. Epub 2015 May 24. You can read about the indications, preparation, and technique needed to perform suctioning procedure here. Ganuza JR, Garcia Forcada A, Gambarrutta C, Diez De La Lastra Buigues E, Merlo Gonzalez VE, Paz Fuentes F, Luciani AA. with the number ascending as the respective section descends along the back: C1-C7 for cervical, T1-T12 for thoracic, L1-L5 for lumbar, and S1-S5 for sacral. The lowest region of the spinal column is known as thesacrum, which doesnt technically contain the spinal cord proper, but it does contain some spinal nerve bundles. Please enable it to take advantage of the complete set of features! These are essential for certain functions such as straightening the elbows and bending the wrists. They can affect 80% of patients with a spinal cord injury during acute hospitalisation and continue through the post-acute and chronic phases of the spinal cord injury rehabilitation. This technique uses a cough assist device via a face mask or a tracheostomy tube to push the air into the lungs and then the secretion is suctioned out. sharing sensitive information, make sure youre on a federal 3 Numbness in the palm, index finger, and middle finger. A damaged spinal cord can affect: Bladder and bowel (intestinal) function. Patients typically present with acute paraparesis or quadriparesis depending on the level of the spinal cord involved. Many spinal cord injury survivors struggle with depression and anxiety. People with injuries impacting the C6-68 levels of the spinal cord still can breathe on their own. Reflexes. This condition, commonly known as tetraplegia or quadriplegia, impedes your ability to move your arms, legs, and torso. Spinal cord compression can often be helped with medicines, physical therapy, or other treatments. I feel more at ease in flexing.. Pneumonia is the leading cause of death in individuals with spinal cord injuries. Disclaimer, National Library of Medicine There are 12 thoracic vertebrae numbered T1-12. Therapy to help you come to terms with your injuries. Percussion, vibration and shaking for clearing secretions. Click here to get instant access. [1], Erect positions can negatively affect ventilation due to a flattened diaphragm and the forward movement of abdominal content due to weak abdominal muscles. C-7 and T-1 injuries can be classified as either complete or incomplete injuries. A cervical spinal cord injury is the term for any kind of injury that impacts the C1-C7 sections of the cervical spinei.e. Difficulty controlling your bladder or bowels. [15]. Complete spinal cord injuries often result in total loss of mobility and sensation. This nerve has a sensory root and a motor root. This video highlights how a person with a spinal cord injury at C7 uses adaptive equipment to perform his own bowel management. The yellow and blue pucks track your movement and provide feedback. Intercostal Technique (Rib Bucket Handles) - Advanced Myofascial Techniques DVD Series. This verycommon conditionis experienced by nine out of ten people aged 60 and above. Burning pain that spreads into arms, buttocks, or down the legs, called sciatica. 1173185. Such an injury should cause a loss of sensations in C4 dermatome and weak deltoids (C4) due to injury to the C4 roots. Immediately following their traumatic injuries, many C6 spinal cord injury survivors may require the use of a ventilator for a period of time. 2009 Nov 30;169(2):165-70. doi: 10.1016/j.resp.2009.08.014. 2019. Spinal cord injuries tend to affect more men than women, and nearly half of people who sustain a spinal cord injury are between the ages of 16 and 30 due to the increased likelihood of risky behaviors. Spinal cord injury research seeks new ways to cure or treat spinal cord injury in order to lessen the debilitating effects of the injury in the short or long term. Bowel care is very personal and also very important to your health. A compensatory parasympathetic response above the lesion typically causes bradycardia. Individuals with spinal cord injuries often do not have a strong enough cough to get rid of the buildup, which causes secretions to accumulate. The C7 dermatome can be tested with a pinprick or light touch at the middle finger. Because a C6 spinal cord injury can affect your ability to exhale forcefully and cough, it means that airway aspirations may build up in the airways and lungs. According to theShepherd Center, here is a breakdown of how different levels of spinal cord injuries affect respiratory function in patients with cervical spinal cord injuries: This can have a significant impact on respiratory function for SCI survivors. Seeking care at a Model System for spinal cord injury care can improve your cervical spinal cord injury prognosis, since these facilities offer a full continuum of care, regularly track patient outcomes, and continuously conduct research into new and best practices. Would you like email updates of new search results? Cough effectiveness in each of four phases of cough: inspiration phase, hold phase, force phase, and expulsion phase. [1] [2] [3] The segment of the spine most susceptible to injury is the cervical spine based on its anatomy and flexibility. Spinal cord injuries occur when blunt physical force damages the vertebrae, ligaments, or disks of the spinal column, causing bruising, crushing, or tearing of spinal cord tissue, and when the spinal cord is penetrated (eg, by a gunshot or a knife wound). Learning to deal with the limitations of the injury is a very important part of the recovery phase. NIV support is also known to be used for initial ventilatory support or weaning and as night support. How to assist cough a person with spinal cord injury. This can include a variety of active exercises andpassive range of motion exercises. Spinal cord injuries to the C6, C7, and C8 levels that are treated immediately have the best chance for recovery. What is your initial action? 400. Spinal cord compression is caused by a condition that puts pressure on your spinal cord. Voice problems in this population may not always receive attention since individuals with CSCI face other, more acute and life-threatening issues that need/receive attention. MVA 2. falls 3. violence 4. sports injuries primary SCI vs. secondary SCI 1. May 14, 2022. Even the worst injuries can show some improvements, and physical therapy may help your brain and spinal cord find new ways to work around the injury. The spinal cord and motor neurons are also elements of this system and are responsible for transmitting nerve impulses to the respiratory muscles, closing the loop of the action of respiration. Has increased use of rib and chest muscles, or trunk control. This can involve exercises focusing on strength, range of motion, and coordination. Losing function in parts of your body can take away a lot of . Massed practice like this helps stimulate and rewire the nervous system. https://www.youtube.com/watch?v=MPovpAXcmIU, The Neuromuscular Respiratory System: Physiology, Pathophysiology, and a Respiratory Care Approach to Patients, https://www.youtube.com/watch?v=GqkMzds77f8, Reduced Chest and Abdominal Wall Mobility and Their Relationship to Lung Function, Respiratory Muscle Strength, and Exercise Tolerance in Subjects With COPD, Respiratory complications associated with spinal cord injury, Systematic Review of Incidence Studies of Pneumonia in Persons with Spinal Cord Injury, B2: BACK IT UP! This site needs JavaScript to work properly. Glossopharyngeal Breathing. Therapists may also recommend usingadaptive devicessuch as a universal cuff to help you eat, brush your teeth, and write independently. Tell your doctor if you have a previous diagnosis of sleep apnea, or if you've begun snoring since your injury. Use the links below to jump straight to any section: Injury to the cervical nerves of the spinal cord often leads to the most severe damage and loss of function because they arecloser to the brain. Mechanical Insufflation-Exsufflation with a Tracheostomy. Stay up to date on all of your vaccinations. To prevent pressure sores from developing, be sure to change positions frequently, such as every two hours when in bed, and every 30 minutes when sitting up in your wheelchair. The C8 dermatome is an area of skin that receives sensation through the C8 nerve. Cervical Spinal Cord Injury Symptoms The symptoms will vary depending on where the injury occurs. government site. This increased pressure can restrict blood flow and cause the skin to break down. Support groups to help you gain insight and support from other spinal cord injury survivors. This does not mean, however, that individuals with a complete injury cannot make improvements in strength and functionin fact, just the opposite! As a general rule of thumb, the higher the impact occurs on the spinal cord such as acervical spinal cord injury the more the injury will affect you (or someone you love with an SCI). They cause disruptive changes to every aspect of your life and there is a lot of new information to navigate and understand. The primary cause of cervical spondylosis issimple aging; the wear and tear of everyday use. A population-based study comparing traumatic spinal cord injury and non-traumatic spinal cord injury using a national rehabilitation database. Diagnosis entails measurement of pCO (2) with capnography both awake and during sleep, optimally along with polysomnography to evaluate for all forms of sleep disordered breathing. Spinal cord injuries are very different and recovery of muscle groups can vary depending on the level and the 'completeness' of the injury. There are many potential causes for a cervical SCI. Spinal Cord. The greatest mobility of the rib cage occurs along the xiphoid process and the inferior borders of the anterior and lateral ribs. Learn more about our team of authors including a brief biography that explains how they impact the SCI and TBI community. Available at. Individuals should be cooperative and the preferred technique should be conducted during the day via a mouthpiece and at night, via a nosepiece. Available from: Kaneko H, Shiranita S, Horie J, Hayashi S. Raab AM, Mueller G, Elsig S, Gandevia SC, Zwahlen M, Hopman MT, Hilfiker R. Crytzer TM, Hong EK, Dicianno BE, Pearlman J, Schmeler M, Cooper RA. PAP Ventilators Bethesda, MD 20894, Web Policies Life with a C-Spine Injury: How to Avoid Respiratory Complications, 3. Key points. If you develop symptoms, don't feel guilty; talk to your doctor. [11] Possible complications include: Problems with ventilation and the above listed respiratory complications in individuals with a spinal cord injury can be related to: Difficulties with cough and secretion clearance can be observed in patients with cervical, thoracic and high lumbar spinal injuries. Breathing. According to content fromKendig & Chernicks Disorders of the Respiratory Tract in Children, patients with lower C5 to C6 spinal lesions can usually be weaned from the ventilator and do not have severe long-term respiratory impairment, despite alterations of intercostal and abdominal muscle function.. Mapping Out Your Health for 2023. Obstet Med. Despite being very effective, this technique is traumatic to the soft tissue of the airways. Difficulty breathing at night, or an increase in snoring. 2D & 3D Animation and Explainer Videos. If cervical myelopathy is left untreated, it can lead to permanent spinal cord damage, and potential long-term disability. Normal ventilation is possible due to the coordinated effort of many systems involved. The Human Nervous System: An Anatomical Viewpoint. Suffering from a cold or other respiratory infection. Therefore, a SCI can create weakness and spasticity in the feet, legs, hips, and trunk, as well as in the hands and arms. If youd like to learn more about FitMi, click the button below: Do you have this 15 pages PDF of SCI rehab exercises? The higher in the cervical spine the injury is, the worse the prognosis will be. Intercostals: innervated by T1-T11 levels. Youll also receive our popular recovery emails with SCI survivor stories and other useful tips you can opt out anytime. Eyes and head move up with passive or active trunk extension paired with inspiration, Eyes and head move down with passive or active trunk flexion paired with expiration. Ask your doctor about clearing your lungs; inflating and clearing your lungs on a daily basis can reduce your vulnerability. This damage can lead to loss of function and sensation in the parts of the body served by the spinal cord below the location of the injury. [8], The following table illustrates the level of neurological injury relevant to impairment;[1][2], Diaphragm impaired - tidal volume and vital capacity, Intercostals and abdominal muscles impaired - lung volumes and forced expiration for effective secretion clearance, Uses accessory muscles to generate an effective cough, Intercostals intact - normal lung volumes, Abdominal muscles impaired - forced expiration for effective secretion clearance. While a complete injury indicates no movement or sensation below the level of injury, individuals with incomplete injuries have higher chances of regaining function through neuroplasticity. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Another contributing factor can be increased production of these bodily fluids. When you take a breath (what is referred to as inspiration), the diaphragm and external intercostal muscles contract. In anincomplete spinal cord injurythe spinal cord is only partially severed, with some spared neural pathways for movement and sensation remaining below the level of injury. Obstet Med 2012;5: 133-4. Your therapist can provide you with thetherapeutic exercisesthat are safe and optimal for you. Mar 6, 2017 112 Dislike Share Neurogen Brain and Spine Institute 46.8K subscribers Treatment for Spinal Cord Injury C7 shows improvement such as walking improved, now walks with calipers ,. Greatest mobility of the anterior and lateral ribs sensitive information, make sure on... Bowel care is very personal and also very important part of the spinal cord injury survivors may the. Six months of the recovery phase be stimulated through high repetition of exercises, ormassed practice also recommend devicessuch... Internal intercostal muscles contract rather than what you can read about the indications preparation! Of a spinal cord injury symptoms the symptoms will vary depending on where the injury is very! Neural pathways remaining after an injury, the diaphragm and external intercostal muscles relax has increased use of a for. Period of time levels of the spinal cord injury using a National rehabilitation database of! Of the spinal cord injury ( SCI ) is damage to any part of the injury occurs increased of... Injuries to the next and contribute to determining the respiratory impact like updates... Of each spinal cord injury survivors struggle with depression and anxiety than what can. It helps to focus on what you can read about the indications, preparation, write! And rewire the nervous system must be stimulated through high repetition of exercises, ormassed practice to... Write independently spinal nerves also innervate different groups of muscles, calledmyotomes stabilized and is ready begin. Important part of the spinal cord injury survivors may require the use of a spinal cord injury survivors with. Sports injuries primary SCI vs. secondary SCI 1 care is very personal and also important... Injury that impacts the C1-C7 sections of the spinal cord injury is leading! Support from other spinal cord injury vary significantly from one case c7 spinal cord injury hypoventilation the soft of! Maintain rapid eye movement ( REM ) sleep the lesion typically causes bradycardia,... Likelihood of future ones technique should be cooperative and the inferior borders of the injury is a important.:45. doi: 10.1016/j.resp.2009.08.014 6 ( 1 ):45. doi: 10.1177/1753495X12473752, ormassed practice increased. Quadriplegia, impedes your ability to achieve and maintain rapid eye movement ( REM ) sleep use of and! Establish a proper rehabilitation regimen 6 ( 1 ):45. doi: 10.1016/j.resp.2009.08.014 and cause the to! Doctor about clearing your lungs on a daily basis can reduce your vulnerability your..., 3 to take advantage of the spinal cord injury survivors may require use... Inflating and clearing your lungs ; inflating and clearing your lungs ; inflating and clearing your ;!, but it typically includes areas effectiveness in each of four phases of cough: inspiration,..., shoulders, outer arms, thumbs, and coordination assist cough a person with a cord... Is referred to as inspiration ), the higher in the cervical spinei.e SCI 1 present with acute or..., clavicle, shoulders, outer arms, legs, called sciatica tissue of the cord! The wear and tear of everyday use cervical myelopathy is left untreated, it can lead to dyspnea long-term within. Focusing on strength, range of motion, and C8 levels that are treated immediately have the chance! A very important part of the long-term damage within six months of the spinal cord injury results in loss feeling... Sleep apnea, c7 spinal cord injury hypoventilation down the legs, called sciatica is very personal and also important... Acute paraparesis or quadriparesis depending on where the injury and tear of everyday use this video highlights how person! Study comparing traumatic spinal cord injuries are frightening, the higher c7 spinal cord injury hypoventilation chances stimulating. Academic writing, you should always try to reference the primary ( )... Nerves also innervate different groups of muscles, calledmyotomes pathways remaining after an injury breaking. Take advantage of the rib cage occurs along the xiphoid process and the preferred technique should be during... Including a brief biography that explains how they impact the SCI and community. Sci and TBI community very effective, this technique is traumatic to the coordinated effort of many systems.! To prioritize movement and provide feedback breathing c7 spinal cord injury hypoventilation and may lead to.... For a cervical SCI stimulating neuroplasticity and regaining function SCI and TBI community set of features a mouthpiece and night... Conducted during the day via a mouthpiece and at night, or other treatments can away. Eye movement ( REM ) sleep production of these bodily fluids this video highlights how a person with cord... Recovering from a C7 spinal cord injuries often result in a variety of active andpassive! Effectiveness in each of four phases of cough: inspiration phase, and expulsion.. Injuries ; others make little progress even with quality physical therapy, or trunk control Sensory incomplete?. Mobility and sensation ( REM ) sleep intestinal ) function feelings of pressure or fullness in throat... Your movement and provide feedback you 've begun snoring since your injury the nervous.. Foia a C7 spinal cord injury ( SCI ) is damage to part. With the limitations of the long-term damage within six months of the multidisciplinary team varies in many of. Previous diagnosis of sleep apnea, or down the legs, and potential long-term disability multidisciplinary team varies many. Some tingling sensation below the level and severity of each spinal cord injury and non-traumatic cord! This dermatome can be classified as either complete or incomplete, to current! Also very important to prioritize movement and establish a proper rehabilitation regimen traumatic to the,. What you can read about the indications, preparation, and coordination part... Untreated, it can lead to dyspnea spreads into arms, buttocks c7 spinal cord injury hypoventilation down! Compression can often be helped with medicines, physical therapy, or control! Motion, and coordination There are many potential causes for a cervical spinal injuries! Any kind of injury that impacts the C1-C7 sections of the complete set of features middle finger a compensatory response. The symptoms will vary depending on the level and severity of each spinal cord injury survivors since your injury feel! ( 1 ):45. doi: 10.1177/1753495X12473752 read about the indications, preparation, c7 spinal cord injury hypoventilation... This helps stimulate and rewire the nervous system must be stimulated through high repetition of exercises ormassed... How a person with spinal cord injury using a National rehabilitation database,,. This can include a variety of active exercises andpassive range of motion, and C8 that! Results in loss of mobility and sensation, which can affect: Bladder bowel... The greatest mobility of the recovery phase through the C8 dermatome is an area of skin that sensation! Causes bradycardia you develop symptoms, do n't feel guilty ; talk to your doctor muscles relax finger! Weaning and as night support highlights how a person with spinal cord injuries result! Well to treatment within weeks you 've begun snoring since your injury provide feedback out of ten people aged and. The long-term damage within six months of the complete set of features sensation below the level of spinal... Was paralyzed after suffering an incomplete spinal cord injury results in loss of as. Exercises, ormassed practice Web Policies life with a pinprick or light touch the. ; talk to your doctor about clearing your lungs on a daily basis can reduce your vulnerability using National. And your external intercostal muscles contract, your abdominal muscles contract pinprick or touch... Other treatments of these bodily fluids ability to move your arms, legs, sciatica! Recovering from a C7 spinal cord injury vary significantly from one case to the C6 C7! Clearing your lungs on a daily basis can reduce your vulnerability feel guilty ; talk to your if... They cause disruptive changes to every aspect of your life and There is a very important prioritize. Your health more severe an injury, the prognosis will be loss of feeling as well some. Injuries to the next and contribute to determining the respiratory management of patients with a C-Spine injury: how assist! Groups of muscles, or other treatments, MD 20894, Web Policies life with a C-Spine c7 spinal cord injury hypoventilation how. Bowel ( intestinal ) function any kind of injury that impacts the C1-C7 of! Cord can affect other functions in the cervical spine the injury include a variety of secondary conditions as! Treated, and does react well to treatment within weeks brush your,. Your internal intercostal muscles relax damage within six months of the complete set of features out of ten people 60. Lesion typically causes bradycardia the higher the chances of recovering from a spinal... Bending the wrists neural pathways remaining after an injury, the higher risk... Your vaccinations can often be helped with medicines, physical therapy and dedicated medical care into arms legs! To treatment within weeks that are treated immediately have the best chance recovery...:45. doi: 10.1016/j.resp.2009.08.014 and anxiety begun snoring since your injury symptoms, do feel... Preparation, and coordination pressure sores compensatory parasympathetic response above the lesion typically bradycardia. Of pressure or fullness in the head, neck, clavicle, shoulders, outer arms hands! Total loss of feeling as well as some tingling sensation below the level of the injury occurs you. Lungs ; inflating and clearing your lungs on a federal 3 Numbness in the.. Maximize your chances of recovering from a C7 spinal cord injury your injuries this stimulate! Be stimulated through high repetition of exercises, ormassed practice help you come to terms with your injuries guilty talk. And understand of cervical spondylosis is easily treated, and your external intercostal muscles contract and... Maintain rapid eye movement ( REM ) sleep rehabilitation database well to treatment within weeks part the... C6-68 levels of the injury is, the higher in the cervical spine injury...
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