Spinal Cord Injury (GMED3009)

Comprehensive vocabulary flashcards covering the pathophysiology, clinical syndromes, classification scales, complications, and medical management of spinal cord injuries.

Spinal cord injury (SCI)

Damage to the spinal cord resulting in a loss of function such as mobility or feeling, commonly occurring from compression or bruising while the cord remains structurally intact.

Quadriplegia

Dysfunction of the arms, legs, bowel, and bladder resulting from a spinal cord injury located in the cervical region.

Paraplegia

Dysfunction of the lower body, bowel, and bladder resulting from a spinal cord injury located in the thoracic, lumbar, or sacral region.

Spinal shock

A temporary areflexic state marked by autonomic dysfunction and complete loss of all neurologic function (including reflexes and rectal tone) below the level of injury, lasting from hours up to six weeks post-injury.

Neurogenic shock

A hemodynamic triad consisting of hypotension, bradycardia, and peripheral vasodilation caused by severe autonomic dysfunction and disruption of sympathetic nervous system control, typically seen in injuries at or above $T6$.

Primary injury (SCI)

Damage occurring at the exact time of the traumatic insult, characterized by microscopic haemorrhage in the grey matter and oedema in the white matter of the spinal cord.

Secondary injury (SCI)

Pathological processes developing over hours to days after initial trauma, mediated by inflammation, intracellular calcium shifts, vasoactive amines, vasospasm, and ischemia that expand the area of spinal cord necrosis.

Complete spinal cord injury

A spinal cord lesion where motor and sensory neural pathways are completely interrupted, causing total loss of all motor and sensory function below the level of injury.

Incomplete spinal cord injury

A spinal cord lesion where motor and sensory pathways are partially preserved, resulting in variable degrees of motor or sensory function below the level of injury.

Central syndrome

An incomplete cord injury syndrome caused by hyperextension or cord transection in the cervical region, resulting in spastic paralysis of the upper extremities greater than the lower extremities, alongside variable bowel, bladder, and sexual dysfunction.

Anterior syndrome

An incomplete cord syndrome caused by hyperflexion or injury/infarction of the anterior spinal artery affecting the anterior two-thirds of the cord, manifesting as bilateral paralysis and loss of pain and temperature sensation below the lesion.

Posterior syndrome

An incomplete cord syndrome caused by vertebral dislocation, herniated disc, or compression affecting nerve roots, presenting with weakness in isolated muscle groups, pain, tingling, decreased/absent reflexes, and bowel/bladder dysfunction.

Brown-Séquard syndrome

An incomplete cord syndrome caused by penetrating trauma resulting in cord hemisection, characterized by ipsilateral paralysis, ipsilateral loss of proprioception, and contralateral loss of pain and temperature sensation below the lesion.

Homer's syndrome

A syndrome resulting from incomplete cord transection affecting the cervical sympathetic nerves, causing ipsilateral ptosis of the eyelid, constricted pupil, and facial anhidrosis.

Autonomic dysreflexia

A condition in patients with injuries at or above $T6$ characterized by an exaggerated autonomic response to noxious stimuli below the lesion, producing sudden severe hypertension, bradycardia, and pounding headache.

ASIA Impairment Scale Grade A

Complete impairment where no motor or sensory function is preserved in the lowest sacral segments ($S4–S5$).

ASIA Impairment Scale Grade B

Incomplete impairment where sensory but not motor function is preserved below the neurologic level and extends into sacral segments $S4–S5$.

ASIA Impairment Scale Grade C

Incomplete impairment where motor function is preserved below the neurologic level, and more than half of key muscle groups below the level have a muscle grade less than $3$.

ASIA Impairment Scale Grade D

Incomplete impairment where motor function is preserved below the neurologic level, and at least half of key muscle groups below the level have a muscle grade of $3$ or greater.

ASIA Impairment Scale Grade E

Category indicating that sensory and motor functions are completely normal.

Axial loading

A compressive injury mechanism occurring when direct vertical force is exerted along the spine (such as diving into shallow water), compressing the vertebral body and the spinal cord.

Decompression laminectomy

A surgical procedure to relieve pressure on the spinal cord by removing compressive bone fragments, disc herniations, fluid, or foreign tissue.