Spinal Chord Injuries

C4 & above

Quadriplegia and inability to breathe

C4-C8

Quadriplegia, possible functional ability of arms; may or may not be able to breathe spontaneously

T1-T5

Paraplegia of trunk and lower legs; can move arms

T6-T12

Paraplegia of lower legs with some trunk control; limited bowel/bladder control

Below L1

only partial lower extremity motor/sensory loss; bowel and bladder works

complete injury

total loss of motor and sensory function below the level lof injury

incomplete injury

some preserved function below the primary injury level

Central Cord Syndrome

• seen most often with older adults due to falls

• variable sensation loss

• Greater motor loss in arms than legs (more strength in legs than arms)

• can cause bladder dysfunction (urinary retention)> perform bladder scan, I/O, rigidity to assess

• e.g. Cervical hyperextension injury

Anterior Cord Syndrome

• due to crush or compression caused by MVC or trauma e.g. falling off deer stands

• loss of motor function, and ability to feel pain, temperature, and pressure sensation below injury level

• can cause bladder/bowel, and sexual dysfunction

• Patient is still aware of proprioception (positioning)

• e.g. Acute anterior compression, disk herniation

Posterior Cord Syndrome (least common)

• due to non-trauma such as ischemia or tumors

• Aware of pain and temperature

• loss of proprioception, fine touch, & pressure>asses perfusion, cap refill, pulses, and skin temp

• however, pt here is aware of pain and temperature

• e.g. acute compression

Brown Sequard Syndrome

• hemisection of cord caused by a penetrating injury> gunshot, stabbing

• causes paralysis or weakness

• ipsilateral- loss of motor and proprioception on the same side of the injury

• contralateral- loss of pain and temperature on the opposite side of the injury