Spinal Cord Injury - Part 1 Flashcards
What is a spinal cord injury?
An injury to the spinal cord resulting in a change in its normal sensory, motor, or autonomic function, either temporarily or permanently.
What are the common causes of
- Traumatic spinal cord injuries = ?
- Non-Traumatic spinal cord injuries = ?
Traumatic: Hyperflexion, hyperextension, axial loading, severing, with or without fracture, flexion rotation, and penetration.
Non-Traumatic: Vascular issues, neoplastic conditions, inflammation, and degenerative diseases.
Tetraplegia vs. Paraplegia
Tetraplegia: Impairment of motor or sensory function in the cervical spine, affecting all four limbs, torso, and organs.
Paraplegia: Impairment of motor or sensory function in the thoracic, lumbar, or sacral segments.
What is Anterior Cord Syndrome?
Anterior Cord Syndrome: A syndrome characterized by the
- loss of motor function and pain sensation, while
- preserving light touch and proprioception
- often due to flexion injuries
What is Central Cord Syndrome?
- Expected outcome?
Central Cord Syndrome: A syndrome caused by hyperextension injuries or congenital narrowing, leading to
- UE weakness > LE weakness
- Normal bowel and bladder function
What is Brown-Séquard Syndrome?
Brown-Séquard Syndrome: A condition where one side of the spinal cord is more damaged, causing
- paralysis and loss of light touch on the same side, and
- loss of pain and temperature on the opposite side
What is Posterior Cord Syndrome?
Posterior Cord Syndrome: A rare condition characterized by damage to the dorsal columns, leading to
- loss of proprioception
What are the characteristics of a cauda equina injury?
- low back pain
- radicular pain
- lower extremity paresis
- bowel/bladder dysfunction
- absent patellar and Achilles reflexes
What is sacral sparing?
Preservation of motor or sensory function at the S4-5 dermatome, even in incomplete injuries.
How are the motor and sensory level determined in spinal cord injuries?
Motor: The lowest key muscle with a grade of at least 3/5, provided all muscles above are graded 5/5.
Sensory: The lowest dermatome with intact sensation, graded 2/2.
What is the neurological level of injury ?
The highest of the intact motor or sensory levels on both sides of the body.
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What are the key muscle groups for L2, L3, and L4?
- L2: Hip flexors
- L3: Knee extensors
- L4: Ankle dorsiflexors
What are the key muscle groups for L5, S1, and S2?
- L5: Long toe extensors
- S1: Ankle plantarflexors
- S2: Sphincter tone
What are the steps in ASIA classification?
- determine the sensory level
- determine the motor level
- determine the neurological level
- complete/incomplete injury
- ASIA impairment scale classification
What is the ASIA A classification?
““All gone”
Complete injury with no motor or sensory function preserved in the sacral segments.
What is the ASIA B classification?
“Barely moves, but feels.”
Sensory incomplete injury with sensory function preserved below the neurological level, including sacral segments.
What is the ASIA C classification?
“Can move, but weak”
Motor incomplete injury with more than half the key muscles below the neurological level having a muscle grade < 3.
What is the ASIA D classification?
“Dominant function.”
Motor incomplete injury with at least half the muscles below the neurological level having a muscle grade greater than or equal to 3.
What is the ASIA E classification?
“Everything works!”
Normal motor and sensory function.
What is sacral sparing in spinal cord injury?
Preservation of sensory or motor function in the sacral segments S4-S5.
What are the 3 point scale values for sensory examination?
- 0 = absent
- 1 = impaired/altered
- 2 = normal/intact
What is zone of partial preservation?
Zone of Partial Preservation: Area of motor or sensory function below the neurological level of injury in the absence of sacral sparing.
- Only ASIA A / complete spinal cord injury
What is expected in a complete spinal cord injury?
No sensory or motor function is preserved below the level of injury, including sacral segments.
