Spinal Cord Injury

Spinal Cord Injury (SCI)

Damage to the spinal cord resulting in loss or impairment of motor, sensory, and/or autonomic function below the level of the lesion.

Traumatic SCI

Spinal cord injury caused by external force such as motor vehicle accidents, falls, violence, or sports-related trauma.

Nontraumatic SCI

Spinal cord damage caused by disease or pathological processes such as vascular dysfunction, stenosis, neoplasms, infection, or neurologic disease.

Tetraplegia (Quadriplegia)

Motor and/or sensory impairment of all four extremities and trunk, including respiratory muscles, due to cervical spinal cord lesions.

Paraplegia

Motor and/or sensory impairment of the trunk and both lower extremities due to thoracic, lumbar, or cauda equina lesions.

Conus Medullaris

Terminal segment of the spinal cord, typically ending at the L1 vertebral level.

Cauda Equina

Bundle of lumbar and sacral nerve roots below the conus medullaris, resembling a horse’s tail.

Ascending Sensory Tracts

Spinal cord pathways that transmit sensory information from the body to the brain.

Descending Motor Tracts

Spinal cord pathways that transmit motor commands from the brain to the body.

Lateral Corticospinal Tract

Descending motor tract responsible for voluntary movement of distal muscles.

Anterior Corticospinal Tract

Descending motor tract responsible for voluntary control of axial muscles; minimal functional significance due to small size.

Gray Matter (H-shaped)

Central spinal cord region containing sensory neurons dorsally, interneurons centrally, and motor neurons ventrally.

ISNCSCI

Standardized neurological examination developed by ASIA to classify motor and sensory impairment after SCI.

Motor Level

Lowest spinal segment with key muscle strength of at least 3/5, provided segments above are 5/5.

Sensory Level

Lowest dermatome with normal light touch and pinprick sensation.

AIS (ASIA Impairment Scale)

Classification system grading SCI completeness from A (complete) to E (normal).

Head–Hips Relationship

Movement principle where head movement in one direction facilitates hip movement in the opposite direction.

Momentum

Use of force and velocity to assist movement of denervated body segments.

Muscle Substitution

Use of intact muscles to compensate for lost muscle function.

Task Modification

Altering task demands to make activities easier while promoting progression and confidence.

Controlled Mobility

Ability to move a body segment while maintaining postural stability.

Rolling

Fundamental bed mobility skill and prerequisite for other mobility tasks.

Supine-to-Sit Transfer

Transition from lying to sitting at the edge of the bed, required for independent mobility.

Jackknifing

Sudden forward trunk flexion when the center of mass shifts anterior to the hips during standing or gait.

Static Standing Balance

Ability to maintain upright standing posture with hips in hyperextension and trunk posterior to pelvis.

Weight Shifting

Controlled transfer of body weight to maintain balance or initiate movement.

Swing-Through Gait

Gait pattern in which both lower extremities swing forward together past assistive devices.

Four-Point Gait

Slower, safer gait pattern where three points of contact are always maintained.

Vital Capacity (VC)

Maximum volume of air exhaled after maximal inhalation.

Functional Cough

Loud, forceful cough capable of producing two or more expulsions per breath.

Weak Functional Cough

Soft, single cough per exhalation without true expulsive force.

Glossopharyngeal Breathing

Method of breathing using lips, tongue, and pharyngeal muscles to gulp air in high-level SCI.

Orthostatic Hypotension

Drop in blood pressure upon upright positioning due to impaired autonomic regulation.

Virchow Triad

Three factors contributing to thrombosis: venous stasis, hypercoagulability, and endothelial injury.

Neuropathic Pain

Pain resulting from damage to the central or peripheral nervous system.

Allodynia

Pain response to normally non-painful stimuli.

Hyperalgesia

Increased sensitivity to painful stimuli.

Musculoskeletal (Nociceptive) Pain

Pain arising from tissue or bone damage such as overuse or fractures.

Spasticity

Velocity-dependent increase in muscle tone accompanied by hyperreflexia and involuntary contractions.

Ashworth Scale

Ordinal scale used to grade the severity of spasticity.

Modified Ashworth Scale

Refined version of the Ashworth Scale for spasticity assessment.

Intrathecal Baclofen

Direct delivery of baclofen into the spinal canal for severe generalized spasticity.

Contracture

Fixed shortening of tissues around a joint resulting in limitation of motion.

Heterotopic Ossification (HO)

Formation of true bone within soft tissues, usually near joints below the level of injury.

Osteoporosis

Loss of bone mineral density increasing fracture risk after SCI.

Functional Independence Measure (FIM)

Generic assessment tool measuring level of disability and assistance required.

Spinal Cord Independence Measure (SCIM)

SCI-specific functional outcome measure sensitive to small functional changes.

Quadriplegic Index of Function (QIF)

Functional assessment tool specific to individuals with tetraplegia.

Walking Index for SCI (WISCI)

Scale ranking walking ability based on assistance, devices, and bracing required.

Locomotor Training (LT)

Task-specific walking practice using repetitive stepping with body-weight support.

Body-Weight Supported Treadmill Training

Gait training using a harness system to partially unload body weight during treadmill walking.

Functional Electrical Stimulation (FES)

Use of electrical currents to activate paralyzed muscles for exercise or functional tasks.

Tendon Transfer

Surgical procedure reattaching a functional tendon to restore lost movement.

Arthrodesis

Surgical fusion of a joint by removing cartilage and allowing bone ends to unite.

Tenodesis

Use of passive tension created by wrist motion to produce functional grasp.

Activity-Dependent Plasticity

Ability of neural circuits to reorganize in response to task-specific practice.

Incomplete SCI Prognosis

Greater likelihood of motor recovery and ambulation, especially when pinprick sensation is preserved.

Jefferson Fracture

Burst fracture of C1 (atlas) due to axial compression.

Hangman's Fracture

Traumatic spondylolisthesis of C2 caused by hyperextension and axial loading.

Odontoid Fracture

Fracture of the dens (C2) classified as Type I-III from hyperflexion, hyperextension, or lateral bending.

Flexion Teardrop Fracture

Severe cervical flexion injury with anterior vertebral body fragment retropulsion; may cause anterior cord syndrome.

Clay-Shoveler's Fracture

Avulsion fracture of C6, C7, or T1 spinous process; usually neurologically stable.

Hyperextension Teardrop Fracture

Avulsion of anterior inferior vertebral body by anterior longitudinal ligament without canal retropulsion.

Chance Fracture

Horizontal fracture through vertebral body, pedicles, and spinous process; often seatbelt injury.

Denis' Three-Column Theory

Thoracolumbar fracture classification; instability if ≥2 columns disrupted (anterior, middle, posterior).

Lateral Mass Plating

Posterior cervical surgical stabilization with screws and bone graft.

Closed Reduction

Nonoperative realignment of cervical subluxation or fracture dislocation, often with skeletal traction.

Autologous Bone Graft

Spinal fusion graft harvested from patient (e.g., iliac crest).

Allograft

Bone graft from a donor or bone bank used in spinal fusion.

Syringo-Subarachnoid Shunt

Surgical treatment for post-traumatic syringomyelia to divert fluid from syrinx to subarachnoid space.

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Pushover Transfer

Sit-pivot transfer without sliding board assistance.

Pneumatic Compressive Devices

Mechanical prophylaxis for DVT prevention in acute SCI.

LMWH (Low Molecular Weight Heparin)

Pharmacologic prophylaxis for DVT/PE.

Vena Cava Filter (IVC Filter)

Device placed in IVC for DVT/PE prevention when anticoagulation fails or is contraindicated.

Erythema

Skin redness, early sign of HO or pressure-related injury.

Intramedullary Hemorrhage

Hemorrhage within the spinal cord, correlating with poor prognosis.

Brown-Séquard Plus Syndrome (BSPS)

Partial hemisection of the spinal cord; more common than complete hemisection.

Spinal Stenosis

Non-traumatic spinal canal narrowing causing cord compression.

Syringomyelia

Cyst formation within spinal cord parenchyma; may cause progressive deficits.

Airway Hyperreactivity

Increased airway sensitivity in SCI, responsive to bronchodilators.

Respiratory Rate

Number of breaths per minute; may rise to compensate for weak diaphragm.

Maximal Chest Excursion

Difference between maximal inhalation and exhalation, normally 2.5–3 inches.

Tracheostomy

Artificial airway into the trachea, often for mechanical ventilation in cervical SCI.

Intermittent Positive Pressure Ventilator (IPPV)

Ventilatory support device, often for injuries at/above C5.

Inspiratory Muscle Training

Exercises to strengthen diaphragm and inspiratory muscles.

Expiratory Muscle Training

Exercises to improve forceful exhalation, aiding cough.

Endurance Training

Aerobic exercise 3–5x/week at 50–80% peak HR to improve cardiovascular fitness.

Rating of Perceived Exertion (RPE)

Subjective scale (e.g., 13–17) to gauge exercise intensity when HR unreliable.

Rhythmic Stabilization

PNF technique to improve stability and strength of head, neck, shoulders, scapula.

Long Sitting Balance

Sitting with legs extended; requires ~90–100° straight leg raise ROM.

Tripod Position

Seated posture with hands forward of hips for stability during transfers.

Push-Up Pressure Relief

Manual pressure relief by lifting buttocks using elbow extension and scapular depression/protraction.

Suicide Rate

~5x higher in SCI population; highest risk 1–5 years postinjury.

Dual Diagnosis (TBI and SCI)

Co-occurrence of TBI with SCI, complicating rehabilitation.

Neuropsychological Evaluation

Assessment for cognitive and behavioral deficits in dual diagnosis patients.

Epidural Electrical Stimulation

Neuromodulation combined with locomotor training to restore motor function.

Neurodiagnostics

Tools like TMS to assess motor cortex-periphery connectivity and rehab effects.

Locomotor Neuroprostheses

Devices providing functional assistance or volitional control to paralyzed limbs.

Brain-Computer Interface Devices (BCIs)

Acquire brain signals and convert to commands for external devices.