Spinal Cord

Spinal Cord

SPINAL CORD INJURY


TYPES/CLASSIFICATIONS:

Determined by Mechanism of injury
Level of injury
Degree of injury


Mechanisms:
• Hyperflexion- as when chin makes contact with the chest
• Flexion with rotation- chin makes contact with chest and head or body is turned
• Hyperextension- head is tilted all the way back
• Axial loading- impact on the top of the head
• Compression- patient falls and lands on feet or buttocks- the injury fractures the vertebrae and the cord is compressed

Level of injury:
• Cervical spine injury- Quadriplegia = Tetraplegia C1-C7
• Thoracic and lumbar spine injury- Paraplegia T1-L5

Degree of injury:
• Complete cord involvement- Total loss of sensory and motor function below the level of injury
• Incomplete cord involvement- Mixed motor and sensory loss and some tracts will be intact. Degree depends on level of injury
Spasticity due to damage to CNS
Flaccidity due to damage to peripheral nerves

3 syndromes associated with incomplete spinal cord injury: (SEE HANDOUT WITH PICTURES)
➢ Central cord syndrome
Common with hyperextension-hyperflexion injuries

Produces more weakness in bilateral upper extremities than bilateral lower extremities

Bowel and bladder dysfunction is variable
Weakness is secondary to edema and hemorrhage in central area of the cord, which has mostly nerve tracts to hands and arms (usually with cervical area injury)
➢ Anterior cord syndrome = Anterior artery syndrome
May be caused by acute disc herniation or hyperflexion injuries associated with fracture-dislocation of the vertebra. May also occur as a result of injury to the anterior spinal artery, which supplies the anterior two-thirds of the spinal cord
Concussion of the cord resolves itself
Loss of pain, temperature and motor function noted below the level of injury
Light touch, position and vibration sensation remain intact
Client makes a complete recovery...

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