Spinal Cord Injuries (SCI) by Dr. Sanobar Khan

Spinal Cord Injuries (SCI)

• A spinal cord injury is damage to the spinal cord, a bundle of nerves that runs down the back, resulting in loss of sensation, movement, or function below the level of the injury.

Types of Spinal Cord Injuries

• Complete spinal cord injury: Results in complete loss of sensation and movement below the level of the injury.

  • Tetraplegia: Affects arms, hands, trunk, legs, and pelvic organs.
  • Paraplegia: Affects legs, trunk, and pelvic organs.

• Incomplete spinal cord injury: Results in partial loss of sensation and movement below the level of the injury.

  • Central cord syndrome: Affects the central part of the spinal cord, causing loss of sensation and movement in the arms.
  • Anterior cord syndrome: Affects the front of the spinal cord, causing loss of pain and temperature sensation.
  • Posterior cord syndrome: Affects the back of the spinal cord, causing loss of proprioception (position and movement).
  • Brown-Sequard syndrome: Affects one side of the spinal cord, causing loss of sensation and movement on the opposite side.
  • Conus medullaris syndrome: Affects the lower part of the spinal cord, causing loss of sensation and movement in the legs and pelvic organs.
  • Cauda equina syndrome: Affects the nerve roots at the base of the spine, causing loss of sensation and movement in the legs.

Clinical Evaluation

• Assessment:
  • Complete blood count (CBC)
  • X-ray
  • CT scan
  • MRI
  • Myelography
  • Physical Examination

Treatment

• Surgical treatment:

  • Compressed spinal cord decompression
  • Surgical stabilization of the spine
  • Fixation of spine
  • Artificial disc implantation

• Non-surgical treatment:

  • Epidural steroid injection
  • Intradiscal thermoplasty
  • Nucleoplasty
  • Facet injection
  • Radio frequency rhizotomy

Physiotherapy

• Management of muscle spasticity:
  • Range of motion exercises
  • Positioning techniques
  • Weight bearing exercises
  • Electrical stimulation

Rehabilitation Therapies

• Cognitive rehabilitation therapy
• Speech therapy
• Occupational therapy