Spinal cord injury and disease

9 Spinal cord injury and disease





Part 1 Spinal cord injury (SCI)


This is clearly a devastating event which can have a major effect on the quality of the future existence of the patient. A complex neural network involved in transmitting, coordinating and modifying the sensory, motor and autonomic signals is abruptly disrupted.






Diagnosis and prognosis


Diagnosis is dependent upon the completeness of the lesion and must take into account the infinite variations of this. Prognosis is irretrievably linked with this. The most useful current classification is the American Spinal Injuries Association (ASIA) Impairment Scale (Table 9.1). This scale is reasonably predictive of diagnosis and makes for a logical subclassification of incomplete spinal column injuries into clinical syndromes:






Table 9.1 American Spinal Injuries Association (ASIA) impairment scale


















A Complete: no motor or sensory function is preserved in the sacral segments S4–S5
B Incomplete: sensory but not motor function is preserved below the neurological level and extends through the sacral segments
C Incomplete: motor function is preserved below the neurological level, and the majority of key muscles below this level have a muscle grade less than 3
D Incomplete: motor function is preserved below the neurological level, and the majority of key muscles below this level have a muscle grade greater than or equal to 3
E Normal: motor and sensory function is normal


May 25, 2016 | Posted by in NEUROLOGY | Comments Off on Spinal cord injury and disease

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