Summary Spinal cord injury - Bruyninx

Spinal cord rehabilitation
Theoretical introduction
Definition

❗ A Spinal Cord Injury (SCI) is damage or trauma to the spinal cord that
results in a loss or impaired function causing reduced mobility or feeling.


→ Paraplegia: impaired function in trunk and lower limbs.
→ Tetraplegia: impaired function in upper limbs, trunk and lower limbs.




Etiology

❗ Spinal collum damaged which pushes on the spinal cord.




Incidence: 1-2/ 100 000.

→ Tendency toward tetra + incomplete!

Tetraplegia/ paraplegia: 50/50.

Complete/ incomplete: 50/50.



Traumatic (75%) versus atraumatic (25%).

Gender: make more traumatic.

Age: elderly more atraumatic.




Spinal cord rehabilitation 1

, Loss of function
Motor function




Sensibility


❗ Touch, pressure, temperature, pain, proprioception and vibration.




Autonomic function



Spinal cord rehabilitation 2

, Spinal cord anatomy


1. Complete or incomplete transaction

= complete loss of function.

= amount of damage depends on anatomy.

2. Posterior versus anterior blood supply problem:

Anterior = motor + pain + light sensation.

Posterior = proprioception + vibration + deep sensation.

3. Central cord problem:

Lost function below the lesion but more downwards it's better.

4. Cauda equina:

Lower motor neuron lesion.

→ Looks more like peripheral motor neuron problem.

Anatomy different than from spinal cord.




Consequences

1. Functionality.



2. Respiratory.



❗ More problems with expiration then with inspiration.



Inspiration:
→ Neck muscles: above C3.
→ Diaphragm: C3 - C5.

Expiration:
→ Intercostal muscles: T1 - T12.
→ Abdominal muscles: T7 - T12.


Spinal cord rehabilitation 3