SPINAL CORD INJURY

DR.HAMAD MASKARY
M.B.CH.B
ANATOMY
 ANATOMY
Spinal Cord is the major bundle of nerves that carry impulses to/from
the brain to the rest of the body.

Spinal Cord is surrounded by rings of bone-vertebra.

They function to protect the spinal cord.
 SCI ( SPINAL CORD INJURY )
Spinal Cord Injury is damage to the spinal cord that results in a loss of
function such as mobility or feeling. Frequent causes of damage are trauma
and disease.
Causes of SCI :-
Traumatic injury
• Motor vehicle crashes
• Falls
• Acts of violence
• Sports injuries
Non-traumatic injury
• Case of cancer
• Infection
• Intervertebral disc disease
• Vertebral injury
• Spinal cord vascular disease
 SCI
Spinal cord injury symptoms
depend on two factors :-

1) The location of the injury :- In general, injuries that are higher in

your spinal cord produce more paralysis. For example, a spinal cord
injury at the neck level may cause paralysis in both arms and legs
and make it impossible to breathe without a respirator, while a lower
injury may affect only your legs and lower parts of your body.
2) The severity of the injury :- Spinal cord injuries are classified as
partial or complete, depending on how much of the cord width is
damaged.
TYPE OF SCI INJURY :-
1) Complete or incomplete (depending on
2) how much of the cord width is damaged )
3) Stable or unstable
Complete
• A person loss all ability to feel and
voluntarily move below the level of the injury
Incomplete
• There is some functioning below the level of the injury

• Vertebral column fractures are usually stable in open injury

• Vertebral fractures in closed injury are usually is unstable type
SYMPTOMS:
• Pain or an intense stinging sensation caused by damage to the
nerve fibers in your spinal cord
• Loss of movement
• Loss of sensation, including the ability to feel heat, cold and
touch
• Loss of bowel or bladder control
• Exaggerated reflex activities or spasms Changes in sexual
function, sexual sensitivity and fertility
• Difficulty breathing, coughing or clearing secretions from your
lungs
C.SPINE ( CERVICAL )

• Quadriparesis

• Loss of sensation below (sensory level)

• Respiratory(due to phrenic n.paralysis)
• sphincteric(i.e urine retention)
• Neurogenic shock (hypotension,bradycardia)
LUMBARSPINE
• Paraplegia
• Loss of sensation below (sensory level)
• sphincteric(i.e urine retention)
INVESTIGATIONS
• X-ray
Informative in cervical and lumbar spine
• CT
Is very imp and fast tool
• MRI
Is the definite tool
 TREATMENT
-ABCDE
-Immobilization :-
Philadelphia neck collar for c.spine
Thoracolumbar jacket
Clinitron bed
Tilt bed
 TREATMENT
Medical :-
• IVF and antibiotics
• ABO , CBC and foley catheter
• Never forget to look for other injuries
• In neurogenic shock we give IV fluid and drugs drugs
• We give steroids ( within 8 hours )
SURGERY :-
remove fragments of bones, foreign objects, herniated disks or
fractured vertebrae that appear to be compressing the spine.
Surgery may also be needed to stabilize the spine to prevent future
pain or deformity.
POSTOPERATVE FOLLOW UP IN
NEUROSURGICAL WARD
1) chart used for every surgical patient
• Vital signs
• Fluid input and output
• If there are drains ,amount of fluid
2) in addition
• GCS
• Pupils size, symmetry and reaction to light
• Other focal neurological signs i.e
babinski,motor weaknes
• In shunt surgery the bowel sounds shd be
monitored
THANK YOU