Spinal cord injury

2,079 views
1,895 views

Published on

THIS IS AREVIEW ABOUT SPINAL CORD INJURY

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
2,079
On SlideShare
0
From Embeds
0
Number of Embeds
9
Actions
Shares
0
Downloads
56
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Spinal cord injury

  1. 1. بسم الله الرحمن الرحيم
  2. 2. Spinal Cord Injury By: Dr- Mohamed El Hady Neurosurgeon King Saud Hospital
  3. 3. Approximately 2 per100,000 of population per year sustain spine injury <ul><li>--- 50% Cervical . </li></ul><ul><li>--- 64% TL . </li></ul><ul><li>--- 70% T12-L1 . </li></ul><ul><li>In children uncommon du to ligamentous </li></ul><ul><li>Laxity and immaturity of para spinal </li></ul><ul><li>Muscles </li></ul>
  4. 5. Care accident considered to be the main cause of spinal cord injury+ spinal cord diseases
  5. 6. Classification of injuries <ul><li>1) Soft tissue lesion 2) Bony lesion. </li></ul><ul><li>INCOMPLETE LESION. </li></ul><ul><li>Any residual motor or sensory function more </li></ul><ul><li>Than 3 segment below the level of injury </li></ul><ul><li>Signs of preserved long tract function. </li></ul><ul><li>Sensation including position sense or voluntary movement in the les </li></ul><ul><li>Sacral sparing: sensation around anus </li></ul><ul><li>Voluntary rectal sphincter control or . </li></ul><ul><li>Voluntary toe flexion. </li></ul>
  6. 7. Types of incomplete lesion <ul><li>1- Central cord syndrome. </li></ul><ul><li>It may occur with or without cervical fracture </li></ul><ul><li>Or dislocation may occur also in rheumatoid </li></ul><ul><li>Arthritis. </li></ul><ul><li>Presentation similar to that seen in (synringomyelia ) </li></ul><ul><li>1 .motor: weakness upper extremities with </li></ul><ul><li>Less in lower. </li></ul><ul><li>2 . Sensory: varying below level of lesion </li></ul><ul><li>3. myelopathic: sphincteric function usually </li></ul><ul><li>Urinary retension. </li></ul>
  7. 9. 2- Brown-sequard syndrome( cord hemi section) <ul><li>Usually a result of penetrating trauma it is seen. </li></ul><ul><li>In 2-4% of spine injury also may occur with spinal epidural hematoma. </li></ul><ul><ul><li>cervical disc herniation </li></ul></ul><ul><ul><li>spinal cord tumor </li></ul></ul><ul><ul><li>spinal AVMs or spondylosis </li></ul></ul>
  8. 10. Classical presentation <ul><li>Contra lateral </li></ul><ul><ul><li>loss of pain and temperature 1-2 segment below the lesion </li></ul></ul><ul><ul><li>Preserved light touch. </li></ul></ul><ul><li>Ipsilateral </li></ul><ul><ul><li>loss of proprioception and vibratory sense </li></ul></ul><ul><li>(posterior colum function ) </li></ul><ul><ul><li>- motor paralysis below lesion </li></ul></ul><ul><li>( corticospinal tract ) </li></ul><ul><li>Prognosis : 90% improves. . </li></ul>
  9. 11. 2 –Anterior cord or anterior spinal artery syndrome . <ul><li>Presentation </li></ul><ul><ul><li>Paraplegia or if higher than C7 quadriplegia. </li></ul></ul><ul><ul><li>Dissociated sensory loss below the lesion. </li></ul></ul><ul><li>A) Loss of pain and temperature sensation. </li></ul><ul><ul><li>( spinothalamic tract ) </li></ul></ul><ul><li>B) Preserved two pair discrimination </li></ul><ul><ul><li>Position of sense, deep pressure sensation. </li></ul></ul><ul><ul><li>Posterior column </li></ul></ul>
  10. 12. Complete Lesion <ul><li>No preservation of any motor or sensory </li></ul><ul><li>Function more than 3 segments below the </li></ul><ul><li>Level of injury. </li></ul><ul><li>There may be priapism,hypotension and </li></ul><ul><li>Bradycardia (spinal shock ) </li></ul>
  11. 13. Bony Lesion <ul><li>Denis classified vertebral column into : </li></ul><ul><li>A) anterior column . </li></ul><ul><li>Ant. Half of disc and V B +ALL. </li></ul><ul><li>B) middle column. </li></ul><ul><li>Pos. half of disc and V B +PLL. </li></ul><ul><li>C) posterior column. </li></ul><ul><li>Bony complex arch( facet joint and capsule </li></ul><ul><li>Supraspinous and infraspinous ligement+LF </li></ul>

×