Degree of Spinal Cord Injuries (Nursing)

by Rhonda Lawes, PhD, RN

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      Slides Spinal Cord Injury Classification.pdf
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      Review Sheet Spinal Cord Injury Assessment Treatment Nursing.pdf
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    00:01 Now the third criteria is degree of injury.

    00:05 So it's either a complete spinal cord injury or an incomplete spinal cord injury.

    00:10 With the complete spinal cord injury, you have a total loss of feeling and motion below the site of the injury.

    00:16 With incomplete, there might be some sensation or motion below the injury.

    00:21 Remember, it's unique and individualized to each person and each injury.

    00:26 Now we're talking about incomplete spinal cord injuries here.

    00:29 I'm gonna give you four examples, but we're gonna start with the central cord syndrome.

    00:35 Now, this is the most common incomplete cord syndrome that's why we start with it.

    00:39 It's called the central cord syndrome because the damage is in the center of the cord.

    00:45 You frequently find this in elderly.

    00:47 With that, they probably have some type of underlying spondylosis or younger people with severe extension injuries.

    00:54 Now remember as we're going through this, use your own neck to recall what an extension injury would look like, what motion that would involve.

    01:03 Now, another unusual thing about central cord syndrome is the upper extremity deficit is greater than the lower extremity deficit.

    01:13 Sometimes we refer to that as walking paraplegia for just that reason.

    01:17 It's more impacted in the upper extremities than it is in the legs.

    01:22 Now let's look at anterior cord syndrome.

    01:26 Central cord syndrome was in the center.

    01:28 Anterior cord syndrome is from injury in the anterior portion of the spinal cord.

    01:33 Now you see that in flexion injuries, like a burst fracture, a flexion tear, a drop fracture or herniated disc.

    01:40 This shows you immediate paralysis because those corticospinal tracts are located in the anterior aspect of the spinal cord.

    01:49 So we've talked about central cord syndrome in the center.

    01:52 Now we're talking about anterior cord syndrome and that's in the anterior portion of the spinal cord.

    01:59 Now third, I wanna talk about Brown-Sequard. This one is really unusual.

    02:04 You have spinal cord damage on one side. And on that same side of the damage, you have motor weakness.

    02:11 On the opposite side, you have sensory deficits.

    02:14 So if I have a spinal cord injury on the right side, then I have motor weakness on the same side, on the right.

    02:22 On the opposite side or the contralateral side, I would have sensory deficit on my left side due to a hemisection of the spinal cord.

    02:31 So, Brown-Sequard syndrome may result from a rotational injury such as a fracture dislocation or from a penetrating trauma like a stab wound.

    02:40 Okay. So the first two were location; central cord syndrome, anterior cord syndrome.

    02:47 Brown-Sequard comes from some type of penetrating trauma or stab wound.

    02:52 But remember on the same side of the injury, I have motor loss.

    02:57 On the opposite side, I'm gonna have sensory loss.

    03:02 Now, the last one is a posterior cord syndrome.

    03:06 And I put this one last even though it's all about location because this is really uncommon, right? This is an unusual syndrome that you have but it can happen.

    03:15 It's due to an extension injury.

    03:18 So, the patient has kind of a loss of positioning sense cuz you've disrupted the dorsal columns.

    03:24 So they have a good prognosis, but they're really gonna have to work with some physical therapy after the injury.

    About the Lecture

    The lecture Degree of Spinal Cord Injuries (Nursing) by Rhonda Lawes, PhD, RN is from the course Spinal Cord Injuries and Syndromes (Nursing) .

    Included Quiz Questions

    1. Complete spinal cord injury
    2. Incomplete spinal cord injury
    3. Total spinal cord injury
    4. Limited spinal cord injury
    1. Central cord syndrome
    2. Anterior cord syndrome
    3. Brown-Sequard syndrome
    4. Posterior cord syndrome

    Author of lecture Degree of Spinal Cord Injuries (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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