Spinal Cord Injury

(SCI)
SPINAL CORD INJURY (SCI)
- traumatic insult to the
spinal cord that results in
alterations of normal
motor, sensory and
autonomic function.
 SIGNS AND SYMPTOMS
• Extreme back pain or pressure in your neck,
head or back
• Weakness, incoordination or paralysis in any
part of your body
• Numbness, tingling or loss of sensation in
your hands, fingers, feet or toes
• Loss of bladder or bowel control
• Difficulty with balance and walking
• Impaired breathing after injury
• An oddly positioned or twisted neck or back
 CAUSES
Traumatic
1. Fall
2. Motor vehicle crashes
3. Gunshot wound
4. Acts of violence
5. Sports injuries

Non-traumatic
-Results from a disease or
pathologic influence.
example: cancer
 Epidemiology
SCI primarily in young adult and
more than half occurring in persons
16-30 years old. Motor vehicle
accidents and falls have become the
most common reasons of injury. The
number of male patients were
significantly more than female.
 Classification
Complete Incomplete
•Complete
No motor and sensory function below
the level of lesion
There is complete transaction or
severe compression which cause an
impaired cord circulation
Areflexia
Diagnosis can be made 24-48 hrs
after injury and still with the absence
of sacral reflexes.
•Incomplete
With incomplete injuries, the cord
is only partially severed, allowing
the injured person to retain some
function. In these cases, the
degree of function depends on the
extent of the injuries.
Types of Incomplete Spinal Cord Injuries
Central cord syndrome (CCS) is the
most common form of cervical 
spinal cord injury. It is
characterized by loss of motion and
sensation in arms and hands. It
usually results from trauma which
causes damage to the neck, leading
to major injury to the central 
grey matter of the spinal cord. The
syndrome is more common in
people over the age of 50 because 
osteoarthritis in the neck region
causes weakening of the
vertebrae. 
• Brown-Sequard syndrome (BSS) is
a rare neurological condition
characterized by a lesion in the
spinal cord which results in
weakness or paralysis
(hemiparaplegia) on one side of
the body and a loss of sensation
(hemianesthesia) on the opposite
side. BSS may be caused by a
spinal cord tumor, trauma (such as
a puncture wound to the neck or
back), ischemia (obstruction of a
blood vessel), or infectious or
inflammatory diseases such as
tuberculosis, or multiple sclerosis.
•.
• Posterior cord syndrome
 This PCS causes the loss of
proprioception and sense of
vibration below the level of
injury while motor function and
sensation of pain, temperature,
and touch remain intact.  Tabes
dorsalis, due to injury to the
posterior part of the spinal cord
caused by syphilis, results in
loss of touch and
proprioceptive sensation.
Cauda equina syndrome (CES)
is a condition that occurs when
the bundle of nerves below the
end of the spinal cord known as
the cauda equina is
damaged. Signs and symptoms
include low back pain, 
pain that radiates down the leg,
numbness around the anus, and
loss of bowel or bladder control.
SACRAL SPARING

A degree of
intact sacral
segment
fractures
usually sparing
of central long
tract.
 Root escape
only the spinal cord is
damaged
Recovery of the nerve
root at or below the level
of the lesion
 Clinical Pictures
1.Spinal shock or concussion of the cord
2.Motor deficit
3.Spasticity
4.Impaired or absence sensation
5.Autonomic dysfunction
6.Respiratory dysfunction
7.Bladder dysfunction
8.Sexual dysfunction
SECONDARY COMPLICATION
1. Pressure sore
2. Autonomic dysreflexia
(hyperreflexia)
3. Postural hypotension
4. Heterotopic bone formation
5. Contractures
 DIAGNOSIS
Diagnostics tools that
doctors may use include:
1. CT scans
2. MRIs
3. X-rays of the spine
 TREATMENT
•Medications
•Immobilization
•Surgery
•Experimental
treatments
 PREVENTION
1. Vehicle-related SCI is prevented with measures
including societal and individual efforts:
• to reduce driving under the influence of drugs or
alcohol, distracted driving, and drowsy driving.
• To increase road safety (such as marking hazards
and adding lighting) and vehicle safety, both to
prevent accidents (such as routine maintenance
and antilock brakes) and to mitigate the damage of
crashes (such as head restraints, air bags, seat
belts, and child safety seats).
2. falls can be prevented by making changes to the
environment, such as nonslip materials and grab
bars in bathtubs and showers, railings for stairs, child
and safety gates for windows.
3. gun-related injuries with conflict resolution
 training, gun safety education campaigns, and
changes to the technology of guns (such as 
trigger locks) to improve their safety.
4. Sports injuries can be prevented with changes to
sports rules and equipment to increase safety, and
education campaigns to reduce risky practices such
as diving into water of unknown depth or 
head-first tackling in association football.
 CAREGIVER MANAGEMENT
• Provide care, helping the patient bathe, dress,
change position, and perform other activities
of daily living.
• Ensuring adequate ventilation and lung
function
• Preventing and promptly addressing infection
and other complications.
• Take care to maintain spinal alignment by
using a cervical collar, manual inline traction,
or both.
• Monitor the patient’s bowel sounds and abdominal
distention at least every 4 hours.
•  Turning the patient every 2 hours or more (depending
on risk assessment findings)
• Avoiding positioning the patient on bony prominences,
such as the trochanters, sacrum, and heels
• Inspecting the skin under braces and splints frequently
• Manage spasticity by range-of-motion exercises,
positioning techniques, weight-bearing
exercises, electrical stimulation, and orthoses or
splinting to prevent loss of muscle length and
contractures.