Spinal Cord Injury (SCI): Aftermath and Diagnosis
The physical and emotional consequences from a spinal cord injury (SCI) can be devastating. Loss of spinal cord function can affect activities that are autonomous (e.g. breathing) as well as thought-driven actions (e.g. driving). Both motor and sensory functions may be lost.
According to the National Spinal Cord Injury Association (NSCIA), not every spinal cord injury results from a motor vehicle accident (42%), violence (24%), falling (22%), or sports (8%). Occasionally SCIs are caused by diseases such as polio. Spinal cord injuries are usually described using the following terms:
Paraparesis: A slight degree of paralysis affecting the lower extremities
Paraplegia: Complete paralysis of both lower extremities and usually the lower trunk. The upper extremities are not involved.
Quadriparesis: Partial paralysis of all four limbs (arms, legs)
Quadriplegia (or Tetraplegia: Complete paralysis of all four limbs
Other terms used to describe neural dysfunction include:
Paresis: Partial paralysis
Paralysis: Partial or complete loss of motor function
Paresthesias: Abnormal sensation such as burning or tingling
The spinal cord does not have to be severed for function to be lost. Most people with spinal cord dysfunction present with the cord intact. Cord injuries usually fall into one of the following categories:
Contusions, or bruising of the spinal cord
Compression injuries that place pressure on the cord
Lacerations or tearing (e.g., from a bullet)
Central Cord Syndrome
Complete severing (rare) W
When injury occurs and for a time period following, the spinal cord swells. Loss of function occurs below the level of the injury and may be permanent or temporary. Much depends on the severity of the injury.
|Spinal Region||Location||Area Effected||Spinal Levels|
|Cervical||Neck||Neck, arms, hands||C1 thru C7|
|Thoracic||Chest||Torso, parts of the arms||T1 thru T12|
|Lumbar||Low Back||Hips, legs||T12 thru L5|
|Sacral||Pelvis||Groin, toes, parts of the leg||S1 thru S5|
Symptoms may include loss of motor function, sensation or proprioception. The nerves responsible for these functions transmit their messages through the muscles, tendons, joints and other organs.
Destruction of sensory nerve fibers may lead to loss of sensation such as touch, pressure, and temperature. Reflexes may become exaggerated, bladder and bowel control may be lost, even the ability to breath normally may be compromised.
When spinal cord injury is suspected (e.g., spinal fracture) immediate medical attention is required. Spinal cord injury (SCI) is usually first diagnosed when the patient presents with a loss of function below the level of injury.
The initial evaluation includes x-rays, a CT scan, and possibly a MRI. Fractures are demonstrated on plain radiographs. CT scanning and MRI studies are used to evaluate the soft tissues in the spinal column. In addition, a myelogram may be performed to identify and evaluate spinal cord lesions caused by trauma or disease.
The neurologic evaluation includes assessment of the patient's symptoms, which might include loss of motor or sensory function. Other neurologic symptoms may include pain, numbness, paresthesias (e.g., tingling), muscle spasm, weakness, and bowel/bladder changes.