SCI- Spinal Cord Injuries

SCI Life expectancy

• Below Normal

• lifetime of disability

• Causes of death may be:

- pneumonia

- pulmonary emboli

- septicemia (infection in blood)

Tetraplegia

• AKA quadriplegia

• Involves cervical spine injuries

• UE’s, LE’s and trunk are all impaired

Paraplegia

• Involves injuries to thoracic spine

• UE function is available

• Varying degrees of LE and trunk involvement

• Both loss of sesnory and motor information below level of lesion

Mechanisms of Injury

• Traumatic impact including compression, penetrating injuries, hyperextension, and hyperflexion

• Vertebral subluxations, compression fractures, and fractures that encroach spinal cord. 

• May produce partial or complete transection of spinal cord 

Mechanisms of Injury causes

• Flexion and rotation injuries from MVA rear-end accidents

• Hyperflexion injuries from head on collisions

• Hyperextension injuries from fall

• Compression injuries from osteoporosis, degenerative changes, diving injuries, falls from elevated surfaces

SCI medical intervention

• pt immobilized

• Meds administered o limit effects of injury

• Surgery for spinal stabilization

• Skeletal traction to help bony alignmet

• Immobilization through various immobilizers (aspen cervical collar, jewit bracem TLSO, LSO, clamshell)

SCI in the clinic

Treatment:

• is highly variable and depends on level of injury

• May have abnormal tone or spasticity

How to name level of SCI

1. Identify bony segment involved (C for cervical, T for thoracic, L for lumbar)

2. Neurological level is most caudal segment of cord with intact sensory and 3/5 grade muscle strength

Example: C5 Spinal cord injury will have sensation and innervation to muscles with a C5 nerve root and MMT of at least 3/5.

If a muscle is innervated by more than one nerve root_________.

• it may result in weakness and not full paralysis

Example: C5 spinal cord injury

• Subscapularis is innervated by C5, 6, & 7

• Will result in weakness due to 2/3 of the nerve roots being impacted by the injury

• Must have at least a 3/5 strength to be named at the C5 level

SCI: types of lesions

• Complete

• Incomplete

Brown Sequard syndrome

Anterior cord syndrome

Central cord syndrome

Dorsal column syndrome

Cauda equina injuries

Complete injuries