Spinal cord injury is a low incidence, high cost disability requiring tremendous changes in an individual’s lifestyle Tetraplegia - lesion Paraplegia - lesion

1. Spinal Cord Injury
Dr. Maheshwari Harishchandre
Assistant Professor
M.P.Th (Neurosciences)
DVVPF College of Physiotherapy,
Ahmednagar

2. Objectives
• Able to classify the spinal cord injury
• Identify the level of injury
• Application of ASIA scale on SCI patients

3. Contents
Definition
Etiology
ASIA
Classification
Level of lesion
Clinical Syndrome

4. Definition / Introduction
• Spinal cord injury is a low incidence, high
cost disability requiring tremendous changes
in an individual’s lifestyle.

5. Etiology
SCI
Non Traumatic SCI Traumatic SCI
Infection RTA
Inflammation Occupation related
Degeneration Fall from height
Demyelination
Congenital
Neoplasm
Vascular injury

7. Statistics
National Spinal Cord Injury Database
{ USA Stats }
• AVM 44.5%
• Falls 18.1%
• Violence 16.6%
• Sports 12.7%
• 55% cases occur in 16 – 30yrs of age
• 81.6% are male!

8. Classification
• Tetraplegia - lesion
• Paraplegia - lesion

10. Level
• Neurological level …e.g-
• Motor level … e.g –
• Sensory level … e.g -
• Vertebral & cord level –
Lower cervical vert - +1
Thoracic 1-6 - +2
Thoracic 7-9 - +3
T10 – L1,2
T11 – L3,4
T12 – L5
L1 – cauda equina

11. ASIA

12. Type of Injury

15. Anterior Cord Syndrome
Mechanism- Flexion injury – damage- cord &
Ant.spinal
artery.
-Compression of ant cord from fracture,
dislocation or disc protrusion.
C/C- loss of motor function(corticospinal tract
damage), loss of pain & temp (spinothalamic
tract damage).

16. Posterior Cord Syndrome
Any injury to post column.
Preservation of motor function, pain & light
touch.
- loss of proprioception, 2 pt descrimination,
graphasthesia, stereognosis.
-Stappage gait pattern.
- tabes dorsalis.

17. Brown- Sequard Syndrome
• Mechanism-Hemisection of spinal cord
involvement.
• Penetration of wound i.e- gunshot.
• Assymetrical feacture
• Ipsilat- loss of sensation(lat column),
decreased reflexes, lack of sup reflexes,
clonus,+ve babinski sign. Also proprio. Kines
sensation loss
• Contralat – loss of pain & temp
• (spinothalamic tract)

18. Central Cord Syndrome
• Mechanism –
• C/C-

19. Cauda – Equina Injury
• Is a serious neurologic condition in which
damage to the cauda equina causes loss
of function of the lumbar plexus, nerve roots
of the spinal canal below the termination
(conus medullaris) of the spinal cord.

20. • The spinal cord tapers distally to form the conus
• medullaris at the lower border of the first lumbar
vertebra.
• Although some anatomical variations exist, this
is
• the typical termination point of the spinal cord.
Below
• this level is the collection of long nerve roots
known as
• the cauda equina. Complete transections in this

21. Summary
• Defnition
• Classification of SCI
• Levels of SCI
• Types of SCI
• Syndromes of SCI

23. References
• Physical rehabilitation / [edited by] Susan
B. O’Sullivan, Thomas J. Schmitz, George
D. Fulk. — 6th edition.