Spinal cord injury

  • What is it?
    • Spinal cord injury(SCI) is a non-progressive condition that results in a complete or incomprete loss of sensory, motor or autonomic function at the level of the lesion and distal to the lesion.
  • Anatomy
    • The spinal cord is surrounded and protected by the bony spinal column. The spinal column consists fo 33 veterbrae.
    • The Spinal cord has three membranes : pia mater, arachnoid mater, dura mater.
    • The spinal cord is made up gray matter and white matter
      • Gray matter
        • anterior(ventral) horns : contains lower moter neurons, descending tracts(from brain to spinal cord)
        • posterior(dorsal) horns : contain sensory neurons, ascending tracts(from spinal cord to brain)
        • lateral horns : sympathetic fibres from the autonomic nervous system(in the thoracic region)
    • There are 31 piars of spinal nerves
  • Cause of SCI
    • Direct Injury
      • Most common segements : C4 to C6, then T12 to L1
    • Indirect inhury
      • Spinal hematoma, infection, neoplasm interruption of the cord’s blood supply due to surgery, cardiac arrest, aortic aneurysm.. etc..
  • Symptoms
    • Loss of functions
      • Quadriplegia : affects the four limbs and the trunk and pelvic organs. damage from C1 to T1
      • Paraplegia : affects the lower limbs. damager from T2 and below.
    • Spinal shock
      • occurs almost immediaterly after spinal cord injury
      • There is a loss of voluntary motor control, sensory and autonomic function and spinal reflexes below the level of the lesion
      • Whithin the first 24 hours and over the next several weeks(up to 8 weeks)
    • Spasticity
    • hypertonicity
    • pain
    • heterotopic osscification
    • contractures
    • decubitus ulcers
    • deep vein thrombosis
    • Autonomic dysreflexia
    • Etc
  • Massage treatment
    • Be careful the risk of DVT, autonomic dysreflexia
    • Gentle and slow massage techniques
    • remedial exercise : stengthenig and stretching to prevent contracture and muscle weakness
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