Spinal Cord Injuries Flashcards
What percentage of spinal injuries result in quad or paraplegia?
10%
What demographic group is most commonly affected? From what activity?
- Adolescent and young males
- Traffic accidents
What determines the type of vertebral damage and neurological damage?
Mechanism of injury
What are the most common injuries to cervical spine?
- Flexion and flexion-rotation injuries
- c5/c6
- unstable
Define unstable fracture?
When two parts of vertebra are broken (e.g. facets dislocated and ligamentous damage)
What are the main characteristics of a compression injury?
- loss of height of vertebral body
- wedge or comminuted with posterior aspect encroaching upon spinal cord
- c5/c6 most common
- usually stable because PLL intact
- when combined with rotation force in flexion – tear drop fx which is unstable.
What are main characteristics of hyperextension injury?
- older age group
- ALL injury
- central cervical cord syndrome
Where do thoracolumbar flexion-rotation injuries most frequently occur?
T12/L1
Result in anterior dislocation of T12 onto L1.
- PLL disruption
Are thoracolumbar flexion-rotation injuries at t12/l1 stable or unstable?
Unstable, usually result in complete neurological deficit of either the spinal cord, conus or cauda equina
Describe thoracolumbar compression injuries?
- Decreased vertebral height
- stable
- no neuro deficit
Describe thoracolumbar hyperextension injury?
- very uncommon
- rupture of ALL
- Intervertebral disk fracture through vertebrae body anteriorly
- unstable
What injury needs to be considered in patients in MVA wearing lap band?
- chance fractures
What is a chance fracture?
- hyperflexion distraction injury
- forward flexion injury
- two kinds injury
Chance fracture 1 ?
spinous process pedical and vertebral fracture
Chance fracture 2?
end plate fx and disruption of facet joint and ligamentous structures
What is spinal shock?
state of diminished excitability of the isolated spinal cord, duration is variable, 2/2 direct force applied to cord, ischemia, hemorrhage
What is a complete lesion?
- most severe consequence, complete transverse myelopathy all neuro fxn is lost below level
What characteristics describe UMN lesion?
- hyperreflexia
- spasticity/increased tone
- loss of voluntary movements
- weakness
- positive babinski
What characteristics describe LMN lesion?
- reduced muscular tone
- muscle wasting
- loss of reflexes
Describe the affect of T5 lesion on autonomics?
- Above T5, you get hypotension 2/2 interruption of sympathetic splanchnic vasomotor control
Incomplete lesions include?
- anterior cervical spinal cord sx
- central spinal cord sx
- brown sequard (hemisection)
- spinal cord concussion
Describe anterior cervical spinal cord sx?
- motor paralysis below lesion, pain/temp loss
Describe central spinal cord sx?
- hyperextension of c-spine with compression of spinal cord
- severe injury to upper limbs vs lower limbs
Describe brown sequard?
- ipsilateral paralysis of limbs below lesion with loss of pain, temp, touch on opposite side of body
