Spinal cord injuries/conditions



Given its crucial role in transmitting afferent (sensory) and efferent (motor) neuronal signals, unimpaired spinal cord function is critical. When impaired by trauma or metabolic disease, function on an organismal level may be significantly impaired.

Spinal cord injuries/conditions typically lead to life changing physical, medical, psychosocial, and economic consequences.


Though sensorimotor impairment is a most common sequela of spinal cord injuries/conditions, other complications include spasticity, bowel and bladder dysfunction, sexual dysfunction, hypotension, hypothermia, bradycardia, and respiratory dysfunction.

Management of spinal cord injuries/conditions require a multidisciplinary approach characterized by keen assessment and customized intervention.

Certainly, the physical therapist assistant’s role in managing the diverse sequelae associated with spinal cord injuries/conditions is significant.


Common Causes of Death

Pneumonia and influenza

Septicemia (Infections Decubiti, UTI, etc.) Cardiovascular Disease

Suicide







Spinal cord injuries/conditions may be complex. Oftentimes, signs and symptoms may demonstrate incomplete lesions. This can result in a variety of manifestations that do not fully correlate with the level of injury.

It is crucial that a comprehensive, objecttive, and standardized assessment is performed.

The International Spinal Cord Society (ISCoS), American Spinal Injury Association (ASIA), and other organizations have agreed on International Standards for Neurological Classification of Spinal Cord Injury. You may click/tap on the picture below to view the assessment/classification tool.





Non Traumatic Spinal Cord Injuries







Transverse Myelitis

Inflammation in a segment of the spinal cord, resulting in demyelination. Symptoms include pain, muscle weakness or paralysis, and bladder or bowel dysfunction. Common triggers include viral or bacterial infections, autoimmune disorders, or other myelin disorders like multiple sclerosis. Management includes corticosteroids, plasmapheresis, rehabilitation. Most recover with residual impairment/disability.

Friedreich’s Ataxia

Friedreich's ataxia (FA) is a rare, autosomal recessive, progressive disorder that causes nerve damage, affecting balance, coordination, and muscle control, along with potential heart, vision, and hearing problems. The condition is caused by a mutation in the FXN gene resulting in an abnormal mitochondrial protein called frataxin.


Symptoms typically begin in childhood or adolescence, with a loss of coordination and walking difficulty, progressing to wheelchair use within 10-20 years. While there is no cure, treatments can help manage symptoms and improve quality of life.

Spina Bifida

Spina bifida is a congenital neural tube defect occurring in the first month of pregnancy when the fetal spinal column fails to close completely, causing nerve damage. It results in varying degrees of paralysis, bowel/bladder dysfunction, and hydrocephalus.

The exact cause is unknown, but it is a combination of genetic, nutritional, and environmental factors, with inadequate folic acid intake before and during early pregnancy being a primary risk factor.


Types

Myelomeningocele: The most severe type the spinal cord and nerves protrude through an opening in the back, resulting in moderate to severe disabilities.


Meningocele: A less common, milder form where the protective sac around the spinal cord pushes through, but the spinal cord itself does not.


Spina bifida occulta: The mildest, most common form ("hidden") where a small gap exists in the vertebrae, usually causing no symptoms or disabilities.