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Spinal Injury - Coggle Diagram
Spinal Injury
Spinal Cord Disorders
Vascular: AV malformation, dural AV fistula
Inflammatory: Transverse myelitis, MS
Trauma: Fracture, Pathologic
Autoimmune: Rhematoid Arthritis, Ankylosing spondylitis
Metabolic: Osteoporosis, osteomalacia
Infection: Discitis, epidural abscess
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Congenital: Achondroplasia, Klippel-Feil
Degenerative: Spondylosis, spinal stenosis, Disc Herniation Deformity, Kyphosis, Scoliosis
Major Syndromes
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Anterior Cord syndrom
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Usually d/t acute anterior compression (disc, AA repiar)
Posterior Cord syndrome
Rare, existence is questionable
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Brown-Sequard Syndrome
Lateral cord damage with ipsilateral motor loss, ipsilateral proprioceptive loss, contralateral pain and temperature
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Burning Hands Syndrome
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Resolves in 48 hrs, and resolves in 48 hrs
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Spinal Cord Concussion
Transient motor/sensory loss, recovery within minutes, max within hours
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Emergency Management
ABCs and Stabilization
Obtain airway with C-Spine immobilization, maintain oxygenation, and maintain blood pressure
Motor Score
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Zone of partial preservation: Dematomes/myotomes caudal to neurological level that are partially innervated
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Imaging
Cervical spine, thoracic lumbar
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MRI to assess hemorrhage, extent of cord edema/injury
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DEcompressive surgery
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Early surgery may result in shorter hospital stay, earlier mobilization, fewer medical complications
Complication Prevention
Pressure ulcers, UTI, DVT
Regenerative
Matrices: Neurogel, collagen, fibrin, matrigel, methylcellulose, Mogo inhibitors
Neurotrophic Facotrs: BDNF, NT3, FGF1, GDNH,NGF
Tissue Transplant
Olffactory ensheating, schwann cells, macrophages, stem cells, genetically modified cells, Fetal Cells
Spinal Shock
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Tests
Bulbocavernossu, anal wink, Withdrawal reflex: Withdrawal and relaxation with noxious stimulants
Epidemiology
Most from traffic accidents, then work accidents, then sports accidents, then falls
Clinical Cervical -> Thoracic, Thoraco-lumbar, Lumbo-sacral
Chronic
Causes
Neurological (Syringomyelia, instability), Systemic (DCT, UTI, Pneumonia, autonomic dysreflexia)