Types of Spinal Cord Injuries

Spinal cord dysfunction is catastrophic by nature, and can occur due to a trauma or disease. When it occurs by trauma, it is usually called a Spinal Cord Injury (SCI). But spinal cord dysfunction can also be the result of disease and the resulting degeneration of nerve fibers, resulting in the inability transmit signals to and from the brain. Sometimes, the disease process is started by trauma. Among the diseases include:

• Arachnoiditis: A pain disorder caused by swelling of the arachnoid — one of the membranes that surrounds and protects the spine. Causes of the swelling can be chemical, infection or the result of trauma to the spine by direct injury. Scar tissue can form causing spinal nerves to stick together. If the condition interferes with the function of one or more of the nerves, the result can include paralysis of the legs[1].
• Cauda Equina Syndrome: This occurs when the nerve roots are compressed, cutting off sensation and movement. It affects the bundle of nerve roots at the lower end of the spinal cord that receives data from the brain and sends it to the pelvic organs and legs. An individual who suffers from this condition requires immediate acute care[2].
• Brown-Sequard Syndrome: While rare, this is a very serious condition requiring ongoing neurorehabilitation. It can result from trauma, such as a puncture wound to the back or neck[3]. It can also result from a lesion or tumor to the spine.

Keeping in mind despite the dichotomy in terminology, SCI can be of two broad types, complete and incomplete. These are generally differentiated in this way:

• A complete SCI can result from a lesion, a fracture, such as from a motor vehicle collision, sports injury or some other kind of trauma. A complete SCI causes a total and permanent loss of ability to send and to receive sensory and motor nerve impulses yet, despite its severity, the spinal cord is usually not entirely transected[4]. For that reason, it normally results in the complete and permanent loss of function to the part(s) of the body below the level of the Spinal Cord Injury. The extent of this kind of injury, that is, its “completeness” is often unknown for some number of weeks until after the injury. This is because the spinal cord enters “spinal shock” after damage, and is accompanied by swelling. The swelling and subsequent fluid built up can mask the true extent of the SCI, thereby preventing full diagnosis by X-Rays, MRIs and CT scans.

• An incomplete SCI is one in which the individual may retain some residual ability to send and to receive sensory and motor nerve impulses below the level of the SCI. In turn, an incomplete SCI can be further broken down into several patterns:

1. Anterior cord syndrome. Results from trauma to the motor and sensory pathways in the anterior part of the spinal cord. The usual result is that the individual can continue to feel some generalized sensation via the intact pathways of the posterior part of the spinal cord; however, true movement and the ability to apprehend detailed sensation are lost because of this type of Spinal Cord Injury.
2. Central cord syndrome. Often results from direct trauma to the spinal cord that causes damages to the large nerve fibers that function to carry information directly from the cerebral cortex of the brain to the spinal cord. Representative symptoms of this type of trauma may include:
3. Paralysis or loss of fine motor control in the arms and/or hands, with less leg impairment;
4. Sensory loss below the location of the SCI and loss of bladder control; and/or
5. Other types of functional dysfunction requiring rehabilitation and specialized rehabilitation that is consistent with the severity of the trauma.
6. Injuries to a specific nerve root. This may occur either separately or as part of an SCI. A nerve root is one of two bundles of nerve fibers (posterior and anterior roots) that join to form a single segmental (mixed) spinal nerve[5]. These injuries may occur either by themselves or together with an SCI. Because each nerve root supplies motor and sensory function to a different part of the body, the symptoms produced by this type of injury depend upon the pattern of distribution of the specific nerve root involved. As such, it presents an extremely challenging and difficult diagnosis.
7. Spinal concussions. This is essentially a contusion to the spinal cord and can be complete or incomplete. When this type of injury occurs, the resulting dysfunction is usually transient and ordinarily responds fairly quickly to specialized rehabilitation. Trauma of this type is often suffered by football players and other athletes, and may also result in neurologic problems such as numbness, tingling, electric-shock sensations and burning feeling in the affected extremities.

Regardless of the causation or type of SCI, once the individual becomes a Client of NeuLife Rehab in Mount Dora, Florida, he or she undergoes a comprehensive assessment with a Client Goal Plan meeting established for review by the Client, family members, nurse case manager and other appropriate parties, if applicable, at an initial Client Goal Plan Conference scheduled less than one week following admission. Each Client Goal Plan includes clinical needs for rehabilitation and covers personal goals and preferences of the Client. Therapies are provided by NeuLife full-time staff members who are Florida licensed and/or certified professionals. The professionals include but are not limited to:

• Board Certified Neurologist
• Board Certified Behavior Analyst
• Board Certified Physiatrist
• Neuropsychologist
• Psychologist
• Board Certified Psychiatrist
• Speech Language Pathologist/Cognitive Therapist
• Physical Therapist
• Occupational Therapist
• Nurses
• Certified Rehab Counselor

They and all other members of the NeuLife Rehab multidisciplinary team are devoted to their calling to helping individuals with catastrophic injuries in this highly specialized program. This is fully in keeping with NeuLife’s dedication to consistently provide the highest standard of care in the delivery of clinically relevant services. NeuLife Rehab strives to achieve successful, sustained outcomes and exceed the expectations of all persons served.

Proper and timely post-acute rehabilitation that may determine the difference between disability and independence is what NeuLife refers to as the “platinum post-acute period” — the crucial window following acute care that is needed to nurture the whole person to health with specialized, clinically relevant services.

NeuLife’s philosophy is that healing, wellness and personal fulfillment are best achieved in a positive and uplifting therapeutic environment where caring staff encourages, assists and supports each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to achieve function and independence.

NeuLife, in Mount Dora, Florida, is an accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with Traumatic Brain Injury (TBI), Spinal Cord Injury (SCI), Amputations, Burns and other Catastrophic Injuries and Challenging Diagnoses.

2725 Robie Avenue

Mount Dora, Florida 32757

[1] http://www.ninds.nih.gov/disorders/arachnoiditis/arachnoiditis.htm

[2] http://orthoinfo.aaos.org/topic.cfm?topic=a00362

[3] http://www.ninds.nih.gov/disorders/brown_sequard/brown-sequard.htm

[4] American Association of Neurological Surgeons, http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Spinal%20Cord%20Injury.aspx

[5] http://www.medilexicon.com/medicaldictionary.php?t=78937