SCI Lecture ASIA (American Spinal Injury Association Classification)

Complete VS Incomplete
Common cause
1. Motor Vehicle Accidents (MVA)
2. Falls and acts of violence
3. Sports related (Diving most
common)
Assessment Protocol
 2 sensory exams
o Pinprick
o Light touch
 1 Motor exam
o MMT
 Classification framework (impairment scale)

- Neurological level: Lowest segment of the SC that has normal sensory and motor function
o All level above must be normal
- Motor level: Most caudal (lowest) segment of the cord with normal function
o Determined by myotome
- Sensory level: most caudal segment of the cord with normal sensory function
o Determined by dermatome
Location Motor Sensory Common Cause
Central Cord Center of More paralysis in UE More sensory loss in Hyperextension to
Syndrome cord than LE UE than LE neck
Brown Sequard One side Ipsi: Paralysis below Ipsi: Proprioception GSW
Syndrome ½ injury Con: pain temp touch Stabbing
Anterior Cord Anterior Paralysis Bi: Pain, temp, touch
Syndrome aspect Proprioception intact
Cauda Equina Peripheral Varies Varies Direct trauma from
(better prognosis nerves not LMN type fracture of
due to nerve regen) SC Areflexic bladder/bowel vertebrae
Acute Care: Decompress, realign, stabilize
 Harrington Rods – Internal stabilization
 Halo – Cervical stabilization
 Jewett Brace – 3 point Post-op brace to decompress and stabilize
 Steroid – Reduce swelling
Complications
Skin Integrity (Decubiti)
 Stage 1
o Non-blanched
o Skin intact
o Sunburn
 Stage 2
o Partial thickness
o Skin loss involving epidermis
 Stage 3
o Full thickness
o Skin loss involving damage or necrosis of subcutaneous tissue
 o May extend to fascia
 Stage 4
o Full thickness
o Skin loss extensive destruction, tissue necrosis or damage to muscle, bone or supporting
structures
Deep Venous Thrombus (DVT)
 Pulmonary Embolism
o Skin Warm
o Discolored
o Do not move leg
o Call MD