Different types of spinal cord injuries include: Cervical Spinal Cord Injury: Affects vertebrae C1-C8 and causes paralysis or weakness in both arms and legs. This is also known as quadriplegia or tetraplegia.
Thoracic Spinal Cord Injury: Affects vertebrae T1-T12. These injuries can cause paralysis or weakness of the legs along with loss of physical sensation, bowel, bladder and sexual function.
Lumbar Spinal Cord Injury: Injury : Affects vertebrae L1-L5 and result in weakness or paralysis of the legs. This is also known as paraplegia.
Sacral Spinal Cord Injury: Affects vertebrae S1-S5. Sacral level injuries mainly cause loss of bowel and bladder function as well as sexual dysfunction. They can also cause weakness of paralysis of the hips and legs.
Injuries can also be complete or incomplete. Complete incomplete. Complete injuries are indicated by a total lack of sensory and motor function below the level of injury, whereas incomplete incomplete injuries are marked by some remaining sensation and movement.While much is taken, often much remains. Many people with spinal cord injuries surmount extreme adversity to lead productive lives. Jim Langevin became a quadriplegic at 16, and is now a Congressman from Rhode Island. Brooke Ellison has been a vent-dependent vent-dependent quad since age 11, but graduated from Harvard with honors. While these are exceptional people, they illustrate the fact that a useful life is still possible after spinal cord injury.
Actions of the spinal nerves edit
Level
Motor Function
C1-C6
Neck flexors
C1-T1
Neck extensors
C3, C4, C5
C5, C6
Supply diaphragm (mostly C4)
Shoulder movement, raise arm(deltoid); flexion of elbow (biceps); C6 externally rotates the arm (supinates)
C6, C7
Extends elbow and wrist (tricepsand wrist extensors); pronateswrist
C7, T1
Flexes wrist; supply small muscles of the hand
T1 -T6
Intercostals and trunk above thewaist
T7-L1
Abdominal muscles
L1, L2, L3,L4 Thigh flexion
L2, L3, L4
L4, L5, S1
Thigh adduction; Extension of legat the knee (quadriceps femoris)
Thigh abduction; Flexion of leg at the knee (hamstrings);Dorsiflexion of foot (tibialis anterior ); Extension of toes
L5, S1, S2
Extension of leg at the hip(gluteus maximus); Plantarflexion of foot and flexion of toes
ANTERIOR CORD SYNDROME Damage to the anterior (front) of the spinal cord is usually caused by a compression fracture, or by a flexion-rotation force on the spine producing an anterior dislocation. There is often anterior spinal artery compression so that the corticospinal (between spinal cord and brain cortex) and spinothalamic (between spinal cord and thalamus) tracts are damaged by a combination of direct trauma and inadequate blood flow. This results in l oss of power as well as reduced pain and temperature sensation below the lesion. BROWN-SEQUARD SYNDROME
The signs of Brown-Sequard syndrome are hemisection (cutting) of the spinal cord resulting from stab injuries but also common in lateral mass fractures of the vertebrae. Power is reduced or absent but pain and temperature sensation are relatively normal on the side of the injury because the spinothalamic tract crosses over to the opposite side of the cord. The uninjured side therefore has good power but reduced or absent sensation to pin prick and temperature. CENTRAL CORD SYNDROME
The most common spinal cord syndrome, an incomplete spinal cord injury is also known as, “inverse paraplegia” because the hands and arms are paralyzed while the legs and lower extremities work correctly. Typically seen in older patients with cervical spondylosis central cord syndrome is a hyperextension injury often from relatively minor trauma to the cervical regions of the spinal cord. The more centrally situated cervical tracts supplying the arms suffer the brunt of the injury resulting in a flaccid (lower motor neurone) weakness of the arms and relatively strong but spastic (upper motor neurone) leg function. Sacral sensation and bladder and bowel function are often partial. The abil ity to walk is regained in most cases with some residual disability. CONUS MEDULLARIS SYNDROME
Resulting from injury to the tip of the spinal cord, located at vertebra L1 the effect of injury to the sacral cord (conus medullaris) and lumbar nerve roots is usually loss of bladder, bowel and lower limb reflexes. Lesions high in the conus may occasionally represent upper motor neurone defects and function may then be preserved in the sacral reflexes, for example the bulbospongiosus and micturition reflexes.
POSTERIOR CORD SYNDROME
This syndrome is most commonly seen in hyperextension injuries with fractures of t he posterior (rear) elements of the vertebrae. Contusion of the posterior columns may cause the p atient to have good power, pain and temperature sensations, but poor perception of movement and spatial orientation, making walking very difficult. TETHERED SPINAL CORD SYNDROME
Tethered spinal cord syndrome (also known as occult spinal dysraphism) is a condition arising from an abnormally stretched spinal cord. The sensory and motor symptoms of lower back pain and leg weakness can usually be relieved by surgery that may involve the cutti ng of spinal cord nerve roots. Tethered spinal cord damage affecting bowel or bladder function however is typically non-treatable and permanent. CONCLUSION
Spinal cord injuries resulting in paraplegia and quadriplegia (tetraplegia) are permanent debilitating conditions of paralysis involving much more than loss of limb function and sensation. Thorough primary and secondary hospital examinations are essential in forming an accurate early diagnosis and long term prognosis of spinal cord injury classification and outcomes. Given the same neurological examination and findings, neurologists and physiatrists may not assign the same spinal cord injury level. For example, a patient with fractured C5 vertebrae who has normal C4 sensation and absent C5, a physiatrist may call a C4 level injury whereas a neurologist or neurosurgeon may call it C5. Most orthopedic surgeons will refer to t he bony level of injury C5 as the level of injury. Outside of clinical environments it matters little if C4 or C5. Both require use of a wheelchair for life. Many of the rights and opportunities afforded to able-bodied people are not afforded to wheelchair users with spinal cord injury.
