WEEK 8 SCI

Question 1

What is the global prevalence of spinal cord injury (SCI)?

Answer 1

Over 15 million people are living with SCI globally

WHO, 2024

Question 2

How many people with SCI are living in the UK?

Answer 2

Approximately 105,000 people

SIA 2024

Question 3

What are the yearly new cases of SCI in the UK?

Answer 3

Approx. 4,400 individuals

SIA 2024

Question 4

What demographic was previously predominant in SCI cases?

Answer 4

Young, male individuals with a 1.5: 1 male to female ratio

Question 5

What are the three mechanisms of traumatic SCI?

Answer 5

• Destruction from direct trauma
• Compression by bone fragment, hematoma, or disc material
• Ischemia from damage or impingement on the spinal arteries

Question 6

What is the leading cause of SCI in the UK?

Answer 6

Falls (40%) followed by road traffic accidents (RTA) at 37%

Question 7

Define complete SCI.

Answer 7

Complete loss of function below the injury including motor, sensory, and autonomic dysfunction

Question 8

What is incomplete SCI?

Answer 8

Some sparing of neural activity below the level of the lesion

Question 9

What are the four main types of incomplete SCI?

Answer 9

• Central cord syndrome
• Anterior cord syndrome
• Brown-Sequard syndrome
• Posterior cord syndrome

Question 10

What is tetraplegia?

Answer 10

Impairment at cervical segments affecting all four limbs

Question 11

What is paraplegia?

Answer 11

Impairment at thoracic, lumbar, or sacral segments involving lower limbs

Question 12

What are the vulnerable areas of the vertebral column for SCI?

Answer 12

• Cervical spine, typically C5-7
• Thoracolumbar, typically T12

Question 13

What characterizes central cord syndrome?

Answer 13

Motor dysfunction in upper limbs and bladder dysfunction

Question 14

What is the effect of Brown-Sequard syndrome?

Answer 14

Motor deficit and numbness to touch and vibration on the same side, loss of pain and temperature sensation on the opposite side

Question 15

What is posterior cord syndrome?

Answer 15

Sensory disturbance with less motor loss due to compression of the posterior/sensory section of the spinal cord

Question 16

What is cauda equina syndrome?

Answer 16

Lower motor neuron lesion with motor and sensory loss in lower limbs and saddle anaesthesia

Question 17

What is the immediate medical management following trauma in SCI?

Answer 17

Stabilisation, ensuring normal oxygenation, perfusion, and acid/base balance

Question 18

What complications must be managed post-acute SCI?

Answer 18

• Urinary and bowel management
• Skin integrity (pressure sores)
• DVT
• Autonomic dysreflexia
• Orthostatic hypotension

Question 19

What is the ASIA classification used for?

Answer 19

To define the level of injury based on the first spinal segmental level showing abnormal neurological loss

Question 20

What differentiates anterior cord syndrome?

Answer 20

Motor paralysis below the lesion, loss of pain and temperature sense, retained proprioception and vibration

Question 21

What are some examples of other pathologies leading to sensorimotor loss?

Answer 21

• Stroke
• Multiple sclerosis
• Guillain-Barré syndrome
• Transverse myelitis
• Myasthenia gravis
• Botulism
• Hypoglycemia
• Diabetic neuropathy

Question 22

What is the role of a thorough clinical assessment in SCI diagnosis?

Answer 22

Essential for differentiating SCI from other pathologies with similar presentations

Question 23

Fill in the blank: The ASIA Impairment Scale is used for ______.

Answer 23

[classifying the severity of spinal cord injuries]