DRG Category: 53
Mean LOS: 4.0 days
Description MEDICAL: Spinal Disorders and Injuries without CC or Major CC
Spinal cord injury (SCI), trauma to the spinal cord, affects approximately 12,000 Americans every year. Half of the injuries produce paraplegia and half quadriplegia. A physiological cascade of events occurs at the time of an SCI and leads to neuronal damage and neurological deficit.
The initial injury causes a release of glutamate, which causes cellular damage and petechial hemorrhages at the injury site. Calcium influx into the neuron is caused by thrombus formation. This alteration in calcium triggers the arachidonic acid cascade to be initiated, leading to free radical formation, lactic acidosis, and lipid peroxidation. This final series of events hastens ischemia of the white matter and microvasculature destruction, with resultant neuronal damage and permanent neurological deficit. This series of physiological and chemical events associated with acute SCI lead to the permanent neurological deficit. With aggressive medical interventions and nursing management, approximately 90% of patients with acute SCI survive.
SCI can be classified by a variety of methods: complete and incomplete cord injury, mechanism of injury, and the level of injury. In a complete SCI, the patient loses all function below the neurological injury level (the lowest neurological segment with intact motor and sensory function). In an incomplete SCI, some motor or sensory function below the neurological injury level remains intact (Table 3).
Types of Incomplete Spinal Cord Injury
|INJURY||MECHANISM||DESCRIPTION||FUNCTIONS PRESERVED||FUNCTIONS IMPAIRED|
|Brown-Séquard syndrome||Penetrating trauma||One side of the cord is affected||Opposite-side pain and temperature sensation||Opposite-side movement, proprioception, light touch|
|Same-side movement, proprioception, light touch||Same-side pain and temperature sensation|
|Posterior cord syndrome||Extension||Loss of posterior column sensory function; motor paralysis|
|Anterior cord syndrome||Flexion||Hypalgesia; hypesthesia, motor paralysis, posterior column sensory function preserved||Light touch, proprioception, vibratory sensation||Pain sensation, motor function, temperature sensation|
|Central cord syndrome||Flexion or extension||Injury to central gray matter||Motor functions of lower extremities||Motor functions of upper extremities|
Spinal Cord Injury has been found in Diseases and Disorders
If you are a registered user, please login below.
If not, learn more about gaining full access.
- Try and Buy
- Nursing Central puts five fully integrated references at your fingertips on mobile devices and the web. See how Nursing Central works by clicking the sample entries below or purchase a subscription for the web and your mobile device.
View these free topics online now.