Spinal Cord injury
Trauma to Spinal Cord Causes
o Disruption of the Nerve Tracts & Neurons
o Edema develops, resulting in: Loss of Motor Function, Sensation, Reflex Activity, Bladder
& Bowel Control
o Cervical – C 5, 6, 7
o Thoracic – T12 and above
o Lumbar- L1 and above
Spinal Cord Injury
Causes
o 50% MVA’s
o 24% Falls
o 11% Violence
In large urban areas, gunshot wounds may surpass falls
o 9% Sport injuries
o 6% Other miscellaneous
Types of injuries
Flexion- forceable mvmt forward with a posterior injury of spinal cord
Hyperextension- force is upward and forward causing injury to anterior spinal cord
Compression- ex) driving into pools
Flexion-rotation- displacement of the vertebrae
Complete Transection of the Cord
Partial Transection of the Cord
Complete Involvement- results in total loss of sensory and motor function below the level of
injury
Incomplete Involvement (6 Syndromes)- mixed loss of voluntary motor activity and sensation
and level some tracts intact
o Central Cord Syndrome
o Anterior Cord Syndrome
o Brown-Sequard Syndrome
o Posterior Cord Syndrome
o Conus Medullaris Syndrome
o Cauda Equina Syndrome
Tetraplegia (Quadriplegia)
Paraplegia
,
Spinal Shock
Complete but temporary loss of motor, sensory, reflex & autonomic function
Occurs immediately after injury
o Flaccid paralysis, loss of reflex activity, bradycardia, hypotension, paralytic ileus (caused
secondary to flaccid paralysis- consider bowel program)
o Loss of deep tendon and sphincter reflexes, loss of sensation, and flaccid paralysis below
the level of injury
o Loss of bowel and bladder control
Lasts less than 48 hours
Neurogenic shock
Most common in injuries above T6
Unopposed parasympathetic response due to loss of SNS innervation, causes peripheral
vasodilation, venous pooling, and decrease CO
Manifestations: significant hypotension <90 mmHg, bradycardia, and temperature dysregulation
o Poor perfusion and oxygenation to spinal cord and worsen spinal cord ischemia
Massive Vasodilation Occurs
o Results in Tissue Hypoperfusion
o Hypotension and bradycardia, loss of body temp control (seen with extreme
hyperthermia temp greater than 103- consider cooling techniques)
Trauma to Spinal Cord Causes
o Disruption of the Nerve Tracts & Neurons
o Edema develops, resulting in: Loss of Motor Function, Sensation, Reflex Activity, Bladder
& Bowel Control
o Cervical – C 5, 6, 7
o Thoracic – T12 and above
o Lumbar- L1 and above
Spinal Cord Injury
Causes
o 50% MVA’s
o 24% Falls
o 11% Violence
In large urban areas, gunshot wounds may surpass falls
o 9% Sport injuries
o 6% Other miscellaneous
Types of injuries
Flexion- forceable mvmt forward with a posterior injury of spinal cord
Hyperextension- force is upward and forward causing injury to anterior spinal cord
Compression- ex) driving into pools
Flexion-rotation- displacement of the vertebrae
Complete Transection of the Cord
Partial Transection of the Cord
Complete Involvement- results in total loss of sensory and motor function below the level of
injury
Incomplete Involvement (6 Syndromes)- mixed loss of voluntary motor activity and sensation
and level some tracts intact
o Central Cord Syndrome
o Anterior Cord Syndrome
o Brown-Sequard Syndrome
o Posterior Cord Syndrome
o Conus Medullaris Syndrome
o Cauda Equina Syndrome
Tetraplegia (Quadriplegia)
Paraplegia
,
Spinal Shock
Complete but temporary loss of motor, sensory, reflex & autonomic function
Occurs immediately after injury
o Flaccid paralysis, loss of reflex activity, bradycardia, hypotension, paralytic ileus (caused
secondary to flaccid paralysis- consider bowel program)
o Loss of deep tendon and sphincter reflexes, loss of sensation, and flaccid paralysis below
the level of injury
o Loss of bowel and bladder control
Lasts less than 48 hours
Neurogenic shock
Most common in injuries above T6
Unopposed parasympathetic response due to loss of SNS innervation, causes peripheral
vasodilation, venous pooling, and decrease CO
Manifestations: significant hypotension <90 mmHg, bradycardia, and temperature dysregulation
o Poor perfusion and oxygenation to spinal cord and worsen spinal cord ischemia
Massive Vasodilation Occurs
o Results in Tissue Hypoperfusion
o Hypotension and bradycardia, loss of body temp control (seen with extreme
hyperthermia temp greater than 103- consider cooling techniques)
