Spinal Cord Conditions and Injuries

Multiple Sclerosis (MS) disease course

Chronic disease with periods of remission and exacerbation.

MS life expectancy

Can have normal life expectancy if effects are managed effectively.

MS physical pathology

Demyelination and plaques in the white matter of the CNS.

MS cause factors

Complex; involves multiple immune, genetic, and/or infectious factors.

MS climate prevalence

Seen more frequently in colder climates.

MS history assessment changes

Vision, mobility, and sensory perception changes.

MS physical symptoms

Muscle weakness, spasticity, tremors, dysmetria, dysesthesia, and dysphagia.

MS vision and cognitive symptoms

Nystagmus, scotomas, memory loss, impaired judgment, and decreased problem-solving.

MS psychosocial reaction

Anger and frustration at length of time to obtain diagnosis.

MS cerebrospinal fluid (CSF) findings

Elevated proteins and increased white blood cells (WBCs).

MS diagnostic imaging

MRI of brain and spinal cord showing myeloid plaques.

MS drug therapy categories

Steroids or immunomodulators.

MS common symptom: Depression

A frequent symptom experienced by patients with MS.

MS common symptom: Vertigo

A frequent symptom experienced by patients with MS.

MS common symptom: Vision problems

A frequent symptom experienced by patients with MS.

MS common symptom: Fatigue

A frequent symptom experienced by patients with MS.

MS common symptom: Cognitive dysfunction

A frequent symptom experienced by patients with MS.

MS common symptom: Sexual dysfunction

A frequent symptom experienced by patients with MS.

MS common symptom: Muscle-related issues

A frequent symptom experienced by patients with MS.

MS common symptom: Bowel and bladder issues

A frequent symptom experienced by patients with MS.

Acute lower back pain duration

Less than 4 weeks; usually self-limiting.

Subacute lower back pain duration

Between 4 and 12 weeks.

Chronic persistent lower back pain duration

More than 12 weeks.

Lower back pain risk factor: Weight

Being overweight increases risk.

Lower back pain risk factor: Muscle tone

Poor muscle tone increases risk.

Lower back pain risk factor: Stress and posture

Poor posture and stress increase risk.

Lower back pain risk factor: Lifestyle and history

Smoking and a history of spinal problems.

Lower back pain risk factor: Life stages

Pregnancy and aging.

Lower back pain prevention methods

Proper positioning, exercise, and ergonomics.

Lower back pain assessment imaging

CT, x-rays, MRI, bone scan, and myelogram.

Lower back pain nonpharmacologic interventions

Massage, spinal manipulation, heat, acupuncture, and physical therapy.

Lower back pain minimally invasive surgeries

Microdiscectomy, laser thermodiscectomy, and laser-assisted laparoscopic lumbar discectomy.

Lower back pain open surgical procedures

Discectomy, laminectomy, and spinal fusion.

Minimally invasive back surgery postop stay

Go home the same day or the following day.

Conventional back surgery postop inpatient stay

Usually inpatient for 24 to 48 hours.

Minimally invasive surgery activity restrictions

A few days up to 3 weeks.

Conventional spine surgery activity restrictions

Activity restrictions for 4 to 6 weeks.

Primary postoperative back surgery considerations

Meningeal tear or cerebrospinal fluid (CSF) leak.

Early postoperative care focus in spine surgery

Preventing complications.

Complete spinal cord injury definition

Eliminates all innervation below the level of the injury.

Incomplete spinal cord injury definition

Allows some function or movement below the level of the injury.

Leading cause of spinal cord injury

Motor vehicle accidents (37.6%).

Second leading cause of spinal cord injury

Falls (31.5%).

Hyperflexion injury mechanism

Sudden, forceful acceleration of the head forward.

Hyperextension injury mechanism

Sudden acceleration then deceleration causing forced extension.

Vertical compression injury mechanism

Heavy downward or upward force crushing the vertebrae.

Excessive rotation injury mechanism

Turning the head beyond its normal range.

Spinal cord injury physical assessment priorities

ABCs, neurovascular assessment, and level of consciousness.

Spinal shock definition

Complete but temporary loss of motor, sensory, reflex, and autonomic function.

Spinal shock duration

Often lasts less than 48 hours but may continue for weeks.

Spinal shock physical signs

Decreased heart rate, low blood pressure, and pale or flushed skin.

Spinal cord injury complication: Blood pressure

Blood pressure instability and issues.

Spinal cord injury complication: Clots

Thromboses and emboli.

Spinal cord injury complication: Breathing

Respiratory issues.

Spinal cord injury complication: Temperature

Poikilothermia.

Spinal cord injury complication: Elimination

Bowel and bladder issues.

Spinal cord injury complication: Muscle tone

Spasticity and contractures.

Spinal cord injury complication: Sexual function

Sexual dysfunction.

Spinal cord injury teaching: Mobility

Self-management education on mobility skills.

Spinal cord injury teaching: Skin care

Pressure injury prevention education.

Autonomic dysreflexia key symptom

Severe and rapid increase in blood pressure.

Autonomic dysreflexia physical signs

Flushed face, headache, distended neck veins, and decreased heart rate.

Autonomic dysreflexia trigger level

Triggered by sustained stimuli at T-6 or below.

Autonomic dysreflexia common triggers

Restrictive clothing, pressure areas, full bladder, or fecal impaction.

Autonomic dysreflexia immediate intervention

Raise head above heart and loosen restrictive clothing.

Autonomic dysreflexia assessment steps

Assess for a full bladder, bowel issues, and skin condition.