Spinal Cord Injury

• Caused by trauma or damage to the spinal cord resulting in either a temporary or permanent alteration in the function of the spinal cord

  Spinal Cord Injury
• Young adult men between ages _ and _ years have the greatest risk

  16 and 30 years
• Most common cause of SCI

  Motor vehicles

  falls

  violence

  sports injuries

  Others
• Percentage of Motor vehicle collisions

  42 percent
• Motor vehicle crashes, Falls ,Acts of Violence and sports injuries can cause what kind of Injury

  Traumatic Injury
• Case of cancer, Infection, Intervertebral disc disease, Vertebral Injury , Spinal cord vascular disease, Osteoporosis/arthritis can cause what kind of injury

  Non traumatic Injury
• Can be due to cord compression by bone displacement, interruption of blood supply to the cord, or traction resulting from pulling on the cord 


  Primary Injuries
• Refers to the initial mechanical disruption of axons as a result of stretch or laceration


  primary Injuries
• Refers to the ongoing, progressive damage that occurs after the primary injury

  Secondary Injuries
• what is Apoptosis


  Cell death
• Complete cord damage in severe trauma

  related to auto destruction of the cord
• Hemorrhagic areas in the center of the spinal cord appear within

  1 hour
• Vasoactive substances causes


  vasospasm and hypoxia
• The extent of the injury and prognosis for recovery are most accurately determined at least

  72 hours or more
• actual physical disruption of axons

  Primary Injuries
• Ischemia, hypoxia, hemorrhage, and edema

  Secondary Injuries
• Spinal shock It is characterized by

  Loss of reflexes

  Loss of sensation

  Flaccid Paralysis
• Due to the loss of vasomotor tone caused by injury

  Neurogenic Shock
• Loss of sympathetic nervous system innervation causes

  Peripheral vasodilation

  Venous Pooling

  Decreased cardiac output
• Classification of Spinal Cord Injury

  Mechanism of Injury

  Level of Injury

  Degree of Injury
• Type of mechanism of Injury in which it ruptures the posterior ligaments

  Flexion Injury
• Type of mechanism of Injury that ruptures the anterior ligaments

  Hyperextension injury
• Type of Mechanism injury in which it crushes the vertebrae and force bony fragments into the spinal canal

  Compression injury
• Type of mechanism injury in which the cervical spine often results in tearing of ligaments structures that normally stabilize the spine

  Flexion- rotation injury
• The most unstable because ligamentous structures that stabilize the spine are torn; most often implicated in severe neurologic deficits

  Flexion- rotation
• Type of level of injury in which the vertebral level where there is the most damage to vertebral bones and ligaments

  Skeletal level of injury
• Type of level of injury in which the lowest segment of the spinal cord with normal sensory and motor function on both sides of the body

  Neurologic Level
• Most common level of injuries because these levels are associated with the greatest flexibility and movement

  Cervical and lumbar Injuries
• Is involved paralysis of all four extremities ( tetraplegia)

  Cervical cord
• damage of the lumbar, thoracic and sacral spinal cord can cause

  Paraplegia ( loss of sensation of the legs)
• Tetraplegia results in a complete paralysis below the neck

  C4 injury
• Results in partial paralysis of hands and arms as well as lower body

  C6 injury
• Paraplegia results in paralysis below the chest

  T6 injury
• Paraplegia results in paralysis below the waist

  L1 injury
• What kind of degree of injury results in total loss of sensory and motor function below the level of injury

  Complete cord involvement
• What kind of degree of injury results in a mixed loss of voluntary motor activity and sensation and leave some tracts intact

  Incomplete cord involvement
• What is the ASIA impairment scale of Motor and sensory function are normal

  E = Normal
• What is the ASIA of Motor function is preserved below the neurologic level and at least half of key muscles below the neurologic level have a muscle grade of 3 or more

  D = Incomplete
• What is the ASIA when the motor function is preserved below the neurologic level and more than half of key muscles below the neurologic level have a muscle grade less than 3

  C = Incomplete
• What is the ASIA when the sensory but not motor function is preserved below the neurologic level and includes the sacral segments S4-5

  B = Incomplete