Spinal Cord Injury
Potential Causes of Spinal Cord Dysfunction
- Injuries that narrow the space for the spinal cord: broken bones in your back or neck and torn ligaments that cause vertebrae to move in different directions.
- Diseases that affect the bones and joints and compress the cord: arthritis, osteoporosis, stenosis, spondylolisthesis, and cancer.
- Tumors near the spine that compress the spinal cord.
- Blocked blood supply to the spinal cord which causes death of the tissue.
- Motor vehicle accidents (36.5%)
- Acts of violence (14.3%): gunshot wounds, stab wounds, and fragments from explosions.
- Falls (28.5%)
- Sports (9.2%)
- Gender: majority (up to 80.7%) are male.
- Average Onset: 42.6
Types and Levels of Injury
Tetraplegia (Formally referred to as Quadriplegia)
- Spinal cord injury that is at the cervical level, C1-C8 (in the neck).
- The cervical nerve roots supply messages to the arms and hands and muscles that control breathing.
- Numbness and weakness occurs in the arm and hands, breathing may be more difficult.
- Everything below the level of the injury is effected including the trunk and legs.
- Spinal cord injury that is at a thoracic, lumbar, or sacral level.
- These levels supply messages to the trunk and legs.
- Arm function is spared.
- Numbness and weakness or loss of movement and sensation occurs below the level of injury.
- No voluntary movement and no feeling exists below the level of injury.
- Absent sensory and motor function in the lowest sacral segment (S5 the peri-anal area).
- Only partial damage occurred to the spinal cord allowing some nerve fibers to still be intact.
- Some voluntary movement and feeling is present below the level of injury and in the lowest sacral segment (S5).
Anterior Cord Syndrome
- Injury to the motor and sensory pathways in the anterior portion of the spinal cord.
- Loss of ability to feel pain and changes in temperature.
Central Cord Syndrome
- Damage to the large nerve fibers that carry information directly from the cerebral cortex (brain) to the spinal cord.
- May cause paralysis and/or loss of fine control of movements in the arms and hands with less impairment of the legs.
- Sensory loss below the site of injury and loss of bladder control may occur.
- Amount and type of functional loss is related to the severity of damage to the nerves of the spinal cord.
Posterior Cord Syndrome
- Typically occur with presence of a tumor or spinal artery infarct.
- Loss of motor function.
- Loss of proprioception, vibration, and two point discrimination.
- This type of injury is very rare.
- Damage to the right or left half of the spinal cord that causes paralysis on the same side of the injury.
- Loss of pain and temperature on the opposite side of the injury.
- Loss of ability to sense position, loss of deep touch and vibration on side of injury.
- Injury at the terminal end of the spinal cord and lumbar nerve roots below the L1 vertebrae.
- Sacral segments may show preserved reflexes.
- Bowel and bladder function may be spastic or flaccid based on the nerves injured.
- Injury that occurs in the lumbosacral nerve roots.
- Areflexic bowel, bladder, and legs.
Upper Motor Neuron Injury
- Occurs with complete injuries.
- Connection between the brain and the body below the level of injury is disrupted.
- LMNs remain intact and continue to carry out reflex actions (without limits set by brain) so spasticity occurs.
Lower Motor Neuron Injury
- At the lower tip of the spinal cord (cauda equina).
- Causes impaired reflex actions.
- Muscles no longer have nerve contact to stimulate them so spasticity does not occur.
- Caused by a sudden, violent jolt that injures the tissues around the spinal cord.
- Can be complete or incomplete Generally resolves within one or two days.
Spinal Contusion (Bruise)
- Bleeding occurs in the spinal column which can cause death of the neurons.
- May produce symptoms including: numbness, tingling, electric shock-like sensations, and burning in the arms and legs.
- Symptoms may or may not resolve.