SPINAL CORD

INJURY
DIMA, NOR-SAFINAH S.
SPINAL CORD
The three primary roles of the
spinal cord are:
•To send motor commands
from the brain to the body,
•Send sensory information
from the body to the brain,
•coordinate reflexes.
SPINAL CORD INJURY (SCI)
an injury to the spinal cord, May result to:
vertebral column, supporting soft •Paraplegia (paralysis of the lower
tissue, or intervertebral discs body) and
caused by trauma is a major
health disorder. •tetraplegia (paralysis of all four
extremities; formerly called
common causes are motor vehicle quadriplegia)
crashes, falls, violence
(predominantly gunshot wounds),
and sports-related injuries.
RISK FACTORS
•GENDER- MALE> FEMALE (80:20)
•AGE- 16 TO 30 YEARS AND OLDER THAN 65 YEARS
•HAVING A BONE OR JOINT DISORDER
PATHOPHYSIOLOGY
Primary injury typically involves a sudden, traumatic impact on the spine that fractures or
dislocates vertebrae, causing compression on the spinal cord.
Following the primary injury, secondary injury causes additional damage. The acute phase of the
secondary injury begins immediately after the spinal injury, and includes bleeding, ischemia, and
swelling at the site of the injury. As time passes, additional neuronal cell death can be caused by
oxidative stress, neurotransmitter accumulation, and demyelination of surviving axons.
Eventually, specialized glial cells begin to form a scar at the site of injury, which creates a barrier
across the injured tissue that prevents the spread of neuronal damage. Unfortunately, since
neurons have limited regenerative capacity, these injuries tend to yield permanent damage to
the spinal cord.
CLINICAL MANIFESTATION
Manifestations of SCI depend on the type and
level of injury.
•A complete spinal cord lesion signifies loss of
both sensory and voluntary motor
communication from the brain to the
periphery, resulting in paraplegia or tetraplegia.
•Incomplete spinal cord lesion denotes that the
ability of the spinal cord to relay messages to
and from the brain is not completely absent.
ASSESSMENT AND DIAGNOSTIC
FINDINGS
•DETAILED NEUROLOGIC EXAM
•CT and MRI
•Cervical X-ray
•CT angiogram
EMERGENCY MANAGEMENT
•Initial care must include a rapid becoming complete.
assessment, immobilization,
extrication, and stabilization or control
of life-threatening injuries, and
transportation to the most appropriate
medical facility.
•At the scene of the injury, the patient
must be immobilized on a spinal (back)
board, with the head and neck
maintained in a neutral position, to
prevent an incomplete injury from
SURGICAL MANAGEMENT
Surgery is indicated in any of the following situations:
•Compression of the cord is evident.
•The injury results in a fragmented or unstable vertebral body.
•The injury involves a wound that penetrates the cord.
•Bony fragments are in the spinal canal.
•The patient’s neurologic status is deteriorating.
 Skeletal Fracture Reduction and Traction
Cervical fractures can be reduced, and
the cervical spine aligned with some form
of skeletal traction, such as with skeletal
tongs or with the use of the halo device.
Traction is applied to the skeletal traction
device by weights (ensuring the weights
are unencumbered);
The traction is then gradually increased
by adding more weights. As the amount
of traction is increased, the spaces
between the intervertebral discs widen
and the vertebrae are given a chance to
slip back into position.
A spinal cord injury refers to any damage to the spinal cord, or the bundle of nerves, called cauda equina, that protrude from the bottom
of the spinal cord.

Now, spinal cord injuries can have different causes. In younger patients, most spinal cord injuries are caused by motor vehicle crashes; or
recreational injuries, like those caused by impact sports. In older patients, though, spinal cord injuries are often caused by falls, as well as
medical conditions, like degenerative diseases of the spine.

Risk factors for developing a spinal cord injury include engaging in high-risk behaviors, such as speeding when driving or not wearing
safety equipment when playing sports. Lastly, patients with a history of bone or joint disorders are also at a higher risk, since even minor
trauma could damage the weakened bones and injure the spinal cord.

Okay, so the pathology of a spinal cord injury involves primary and secondary injuryAlright, now clinical manifestations of spinal cord
injuries depend on the severity and location of the injury and may include partial or complete loss of sensation and motor function below
the level of injury.

Upper cervical lesions lead to quadriplegia, so there’s loss of function of the limbs and trunk, and a ventilator is needed to maintain
respiration.

On the other hand, lower cervical lesions can still lead to a complete loss of trunk and lower limb function; however, some movements of
the upper limbs may remain intact, allowing for functions such as feeding or using a wheelchair.