PATHOPHYSIOLOGY OF SPINAL CORD INJURY

Predisposing Factor Etiology Precipitating Factor

 Age (16-35 y/o) > vehicular accidents > lifestyle (fond of driving)
 Gender (male) > falls, sport activities > work (driver)
> Disease
(bone cancer, osteoporosis, arthritis)

Can result to any of the following:

 Hyperextension
 Hyperflexion
 Rotational movement
 Compression
 Lateral flexion

Fracture and dislocation of vertebral disc

Excessive force is exerted on spinal cord

If L4 & L5 is affected or damage can lead to:

L4- controls bowel & bladder elimination > Ischemia
 Urinary Retention > Hemorrhage
 Loss of bowel reflex
  Low back pain
L5 – controls lower limb or extremities
 Muscle weakness

 Absence of withdrawal reflex

 Absence of Patellar reflex
 Muscle Paralysis
In gray matter in white matter

Increase in size rapidly lead to massive edema

Necrosis frequently spreads to involve surrounding

segment
Scaring

Shrinkage of axonal and

Myelin sheath

Rapid loss of axonal conduction

Result to production of free radicals

- normally found in the body but
quickly controlled by antioxidant
enzyme tissue

When antioxidant is overwhelmed

Free radicals damage tissue

Dilation of arterioles in injured area inflammatory process (lumbar area)

Result capillary bed close Increase capillary permeability

Increase blood flow of injured tissue lead to loss of protein rich fluid in
at injured site extravascular tissue

Bleeding pain hematoma

Decrease extravascular Increase intravascular

osmotic pressure osmotic pressure

Fluid shift

Edema

fever (compensatory mechanism)