Spinal Cord Injury Flashcards
What is the definintion for spinal cord injury (SCI)?
It is the loss of motor and sensory function due to damage to the spinal cord (or disease)
Briefly list the demographics for SCI
5/100000; occurs more in males; the typical age is considered 16-30 but now rising to 40 yrs
Describe the aetiology or SCI
Motor vehicle accidents, falls, violence, gunshos, and sports injuries
Disease e.g. infections and cancer
Describe the main signs and symptoms, and different paralysis types
Sensory and motor impairments; injuries to cervical, thoracic, lumbosacral areas.
Paralysis: above the T1 is tetraplegia (either incomplete or complete); below T1 is paraplegia (either incomplete or complete)
What are the five main pathophysiology components for SCI?
- destruction - trauma
- compression - trauma
- tumour
- ischemia/hemorrhage
- spial schock - a transient physiologic reflex depression of cord function below the level of injury
What are the five classifications of SCI?
- mechanism
- level
- degree of injury
- syndrome
- ASIA
What are the components surrounding mechanism of SCI?
- flexion
- hyper-extension
- rotation
- compression
What are the components surrounding level and degree of injury for SCI?
Level:
- cervical
- thoracic
- lumbar
- sacral
Degree:
- complete
- incomplete/ partial
List the various syndromes of SCI and what they encompass
- cauda equina syndrome: fracture, dislocation, disc herniation; groin numbness; back pain, sciatica
- conus medullaris syndrome:
- brown-sequard syndrome: damage to one half of cord; trauma, tumour, infection; hemiparalysis
- anterior cord syndrome: flexion injury; sudden/complete motor paralysis; touch, position, vibration sensation intact; decreased pain and temperature sensation
- central cord syndrome: cervical cord; haemorrhage, ischemia; hands/arms more affected
- posterior cord syndrome: cervical hyperextension injury; dorsal column damaged resulting in loss proprioception
What are the five steps to determine the classification of individuals w/SCI
- determine sensory levels for right and left sides. 2 determine motor levels for right and left sides. 3. determine the single neurological level. 4. determine whether the injury is complete or incomplete. 5. determine ASIA impairment scale (incomplete/complete)
Discuss the ASIA impairment scale
A = complete with no motor or sensory function is preserved in sacral segments. B = incomplete: sens, but no motory function is preserved below neuro level. C = incomplete: motor func is preserved below neuro level, more than half of key muscles have muscle grade 3. E = complete: motor/sensory normal
Discuss the muscle grading scale
0 = total paralysis; 1 = palpable or visible; 2=?; 3 = full range of motion, against gravity; 4 = active movement, full range of motion, against gravity and provides some resistance; 5= muscle able to exert, sufficient resistance to be considered normal if identifiable
List the conventional therapies for SCI
surgical decompression; spine stabilization; physical and occupational therapy; treatment of co-morbidities
