Materiały źródłowe

• #1 Spinal cord injury – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/diagnosis-treatment/drc-20377895

  Healthcare professionals in the emergency room do an exam, test for sensory function and movement, and ask questions about the accident. They may be able to rule out a spinal cord injury based on this evaluation. […] But emergency diagnostic tests may be needed. They should be done if the injured person has neck pain, isn’t fully awake, or has obvious weakness or neurological injury. […] A few days after the injury, when some of the swelling might have gone down, a more comprehensive neurological exam may be done. The exam looks at the level and completeness of the injury. This involves testing muscle strength and your ability to sense light touch and pinprick sensations. […] X-rays can reveal damage to the bone surrounding the spinal cord, known as the vertebrae. They also can find tumors, fractures or changes in the spine.

• #1

  https://www.aurorahealthcare.org/services/aurora-spine-services/spinal-cord-injury

  Diagnosing a spinal cord injury involves a combination of a physical exam and imaging tests to pinpoint the location and extent of the injury. […] To diagnose your injury, your doctor will use a standardized neurological exam, which includes testing your motor and sensory skills, as well as an anal muscle test to determine whether the injury has affected the base of your spine. […] Your provider may also order digital imaging tests, such as: MRI or CT scan: These tests allow your doctor to assess nerve and spinal column damage, blood clots or masses. […] Accurate and timely diagnosis is crucial for getting the proper treatment and optimizing recovery. Schedule an appointment with your doctor right away if you suspect a spinal cord injury.

• #1 How is SCI diagnosed? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/spinalinjury/conditioninfo/diagnosed

  SCIs are not always immediately recognizable. The following injuries should be assessed for possible damage to the spinal cord: Head injuries, particularly those with trauma to the face; Pelvic fractures; Penetrating injuries in the area of the spine; Injuries from falling from heights. […] If any of these injuries occur together with any of the symptoms mentioned above (acute head, neck, or back pain; decline of feeling in the extremities; loss of control over part of the body; urinary or bowel problems; walking difficulty; pain or pressure bands in the chest area; difficulty breathing; head or spine lumps), then SCI may be implicated. […] A person suspected of having an SCI must be carefully transported to an emergency room or trauma center. A doctor will question the person to determine the nature of the accident, and the medical staff may test the patient for sensory function and movement. If the injured person complains of neck pain, is not fully awake, or has obvious signs of weakness or neurological injury, diagnostic tests will be performed.

• #1 Spinal Cord Injury | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/spinal-cord-injury

  After an injury or accident, an emergency room doctor will check for movement or sensation at or below a suspected SCI. They will also check for proper breathing, responsiveness, and weakness. […] Medical tests for SCI include: […] Magnetic resonance imaging (MRI) can show brain and spinal trauma from injury, herniated discs (problems with the cartilage located between the vertebrae), vascular (blood vessel) irregularities, bleeding, inflammation that might compress the spine and spinal cord, and injury to the ligaments that support the cervical spine. […] Computerized tomography (CT) can detect bone fractures, bleeding, and spinal stenosis (narrowing of the spinal canal). […] X-rays can show vertebrae misalignment and fractures within minutes of injury. […] Doctors are now able to predict with reasonable accuracy the likely long-term outcome of an SCI. This helps people experiencing spinal cord injuries to set achievable goals for themselves and gives families and loved ones a realistic set of expectations for the future.

• #1 How is SCI diagnosed? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/spinalinjury/conditioninfo/diagnosed

  These tests may include: A CT („cat”) scan. This approach uses computers to form a series of cross-sectional images that may show the location and extent of the damage and reveal problems such as blood clots (hematomas). An MRI (magnetic resonance imaging) scan. An MRI machine „takes a picture” of the injured area using a strong magnetic field and radio waves. A computer creates an image of the spine to reveal herniated disks and other abnormalities. A myelogram. This is an X-ray of the spine taken after a dye is injected. Somatosensory evoked potential (SSEP) testing or magnetic stimulation. Performing these tests may show if nerve signals can pass through the spinal cord. Spine X-rays. These may show fracture or damage to the bones of the spine. […] On about the third day after the injury, doctors give patients a complete neurological examination to diagnose the severity of the injury and predict the likely extent of recovery. This involves testing the patient’s muscle strength and ability to sense light touch and a pinprick. Doctors use the standard ASIA (American Spinal Injury Association) Impairment Scale for this diagnosis. X-rays, MRIs, or more advanced imaging techniques are also used to visualize the entire length of the spine.

• #1 NYC Spinal Trauma Treatments & Diagnosis | Spinal Cord Injury Treatments

  https://comprehensivespine.weillcornell.org/conditions-we-treat/spinal-trauma/diagnosing-and-treating-spinal-cord-injuries/

  Hospital emergency teams are typically the first health care providers to see a patient with a spine injury. The emergency room providers will perform diagnostic tests to determine the location and extent of the injury, including: […] An accurate diagnosis of the injury is critical to treatment planning. […] X-rays will show which bones, if any, have fractured. […] Computerized tomography (CT) shows more detail than an X-ray, and can identify damage to the nerves and spinal cord. […] Magnetic resonance imaging (MRI) reveals fine details of the spine, including nerves, bone detail, and unstable areas.

• #1 Spinal cord injury – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/diagnosis-treatment/drc-20377895

  A CT scan can provide a clearer image compared with an X-ray. This scan uses computers to form a series of cross-sectional images that can define bone, disk and other changes. […] MRI uses a strong magnetic field and radio waves to produce computer-generated images. This test is helpful for looking at the spinal cord to find herniated disks, blood clots or other masses that might compress the spinal cord.

• #1 Spinal Cord Injury Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/spinal-cord-injury

  Computed tomography scan (also called a CT scan): a diagnostic procedure that uses a combination of X-rays and computer technology to produce detailed images of any part of the body, including the bones, muscles, fat, and organs. […] Magnetic resonance imaging (MRI): a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. MRIs are the most helpful scan for visualizing the spinal cord.

• #1 Spinal Cord Injury: Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/12098-spinal-cord-injury

  A healthcare provider can usually diagnose a spinal cord injury using multiple methods, including: […] Imaging scans. Examples include computed tomography (CT) and magnetic resonance imaging (MRI) scans. CT scans are faster and show your provider bone-related injuries or problems. MRI scans take longer but provide ultra-detailed images of bones, soft tissues, nerves, etc. […] Diagnostic tests. Examples of these include electromyography and nerve conduction tests. They measure electrical signals reaching your muscles, which can help locate nerve or spinal cord damage interfering with signals.

• #1 How is SCI diagnosed? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/spinalinjury/conditioninfo/diagnosed

  The ASIA Impairment Scale has five classification levels, ranging from complete loss of neural function in the affected area to completely normal: A: The impairment is complete. There is no motor or sensory function left below the level of injury. B: The impairment is incomplete. Sensory function, but not motor function, is preserved below the neurologic level (the first normal level above the level of injury) and some sensation is preserved in the sacral segments S4 and S5. C: The impairment is incomplete. Motor function is preserved below the neurologic level, but more than half of the key muscles below the neurologic level have a muscle grade less than 3 (i.e., they are not strong enough to move against gravity). D: The impairment is incomplete. Motor function is preserved below the neurologic level, and at least half of the key muscles below the neurologic level have a muscle grade of 3 or more (i.e., the joints can be moved against gravity). E: The patient’s functions are normal. All motor and sensory functions are unhindered.

• #1 Spinal cord injury – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/syc-20377890

  A spinal cord injury involves damage to any part of the spinal cord. […] Your healthcare team performs a series of tests to determine the neurological level and completeness of your injury. […] The ability to control your arms or legs after a spinal cord injury depends on two factors. One factor is where the injury occurred on the spinal cord. The other factor is how bad the injury is. […] The lowest part of the spinal cord not damaged after an injury is known as the neurological level of the injury. „The completeness” of the injury refers to how much feeling, known as sensation, is lost. Completeness is classified as: […] A serious spinal injury is not always immediately obvious. If a spinal injury occurs but it is not known, worse injury may occur. […] The time between injury and treatment can be critical. Learning the level of the injury can help determine the possible recovery.

• #1 Spinal Cord Injuries: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/793582-overview

  One of the goals of the physician is to classify the pattern of the neurologic deficit into one of the cord syndromes. Spinal cord syndromes may be complete or incomplete. […] A complete cord syndrome is characterized clinically as complete loss of motor and sensory function below the level of the traumatic lesion. Incomplete cord syndromes have variable neurologic findings with partial loss of sensory and/or motor function below the level of injury. […] Providing an accurate prognosis for the patient with an acute SCI usually is not possible in the emergency department (ED) and is best avoided.

• #1 Understanding And Responding To A Spinal Cord Injury Diagnosis

  https://winstonbriggslaw.com/understanding-and-responding-to-a-spinal-cord-injury-diagnosis/

  The severity of a spinal cord injury determines the how an individual will be affected. According to the Mayo Clinic, an SCI will be classified in one of two ways: complete or incomplete. In a complete injury, the person loses most or all sensation and motor function below the site of the injury. In an incomplete injury, the person retains some motor or sensory functions below the injury. […] In terms of paralysis, there are also two main categories: tetraplegia/quadriplegia and paraplegia. With tetraplegia/quadriplegia, the person’s arms and legs, trunk and pelvic organs will all be affected. With paraplegia, paralysis affects the legs, a portion of the trunk and the pelvic organs. Spinal cord injuries at the cervical (neck) area often result in tetraplegia/quadriplegia while injuries at the thoracic (upper back) area and below result in paraplegia.

• #1 Spinal Cord Injuries Differential Diagnoses

  https://emedicine.medscape.com/article/793582-differential

  Attributing hypotension to neurogenic shock in the setting of spinal cord injury (SCI) is a potentially devastating error. […] The presence of vital sign confusion in acute SCI coupled with the limitations of the physical examination can make the diagnosis of hemorrhage from associated injuries challenging. […] Also consider other conditions in patients with suspected SCI, such as transverse myelitis, acute inflammatory demyelinating polyradiculopathy (AIDP), myasthenia gravis exacerbation, and extradural spinal cord compression from abscess, hematoma, or tumor.

• #1 Spinal cord injury and normal neuroimaging. Aetiology, diagnosis and medico-legal issues | Spanish Journal of Legal Medicine

  https://www.elsevier.es/en-revista-spanish-journal-legal-medicine-446-articulo-spinal-cord-injury-normal-neuroimaging–S2445424917300432

  The objective demonstration of minor spinal and spinal-cord lesions following accidents is a classic discussion issue in both Clinical and Forensic Medicine. Particular problems are the patients with symptomatic spinal cord damage and normal neuroimaging. These situations are usually named with acronyms: SCIWORA (spinal cord injury without radiographic abnormality), SCIWNA (spinal cord injury without neuroimaging abnormality), and SCIWORET (spinal cord injury without radiological evidence of trauma). […] The most suitable diagnostic tool for these cases is MRI. It must include sequences such as: Spin-echo T1 (T1 SE), gradient-echo T2 (T2-weighted GRE) and STIR (short-term T1 inversion recovery). […] One important issue is that often the appropriate sequences are not carried out. In this regard, it has been reported that the STIR sequence is the most suitable for screening traumatic lesions in the rachis, since it saturates fat and boosts the signal in tissues with long relaxation times in T2, increasing sensitivity in the detection of bone marrow and soft tissue oedema.

• #1 Spinal cord injury and normal neuroimaging. Aetiology, diagnosis and medico-legal issues | Spanish Journal of Legal Medicine

  https://www.elsevier.es/en-revista-spanish-journal-legal-medicine-446-articulo-spinal-cord-injury-normal-neuroimaging–S2445424917300432

  The normality of neuroimaging tests does not exclude the possibility of spinal cord damage. […] The classification of a case as SCIWORET does not prejudge the non-existence of traumatic effects on the spinal cord owing to, for example, a previous state. In these cases, a highly detailed analysis of causality and co-causality is required, along with a precise understanding of the meaning of the radiological terms which may appear in the neuroimaging reports.

• #1 Spinal Cord Injury in Children – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/spinal-trauma/spinal-cord-injury-in-children

  Spinal cord injury should be suspected in any child who has been in a motor vehicle crash, has fallen from a height 3 meters, or has had a submersion injury. […] Spinal cord injury without evidence of radiologic abnormality (SCIWORA) is suspected in children who have even transient symptoms of neurologic dysfunction or lancinating pains down the spine or extremities and a mechanism of injury compatible with spinal cord injury. […] Do MRI in all patients who had neurologic symptoms, neurologic deficits on examination, or spinal injury detected on other imaging studies.

• #1 Association between Cerebrospinal Fluid and Serum Biomarker Levels and Diagnosis, Injury Severity, and Short-Term Outcomes in Patients with Acute Traumatic Spinal Cord Injury

  https://www.mdpi.com/2075-4418/13/10/1814

  Acute traumatic spinal cord injury (SCI) is recognized as a global problem that can lead to a range of acute and secondary complications impacting morbidity and mortality. […] The aim of this prospective controlled study was to determine the cerebral spinal fluid (CSF) and serum profiles of 10 biomarkers as indicators of SCI diagnosis, severity, and prognosis to aid in assessing appropriate treatment modalities. […] This study demonstrated a strong correlation between biomarker levels in the diagnosis and injury severity of SCI but no association with short-term outcomes. […] In patients with suspected spinal trauma, a correct diagnosis should be made in a timely manner to reduce the occurrence of secondary medical issues that could worsen long-term outcomes. […] Timely neuroprotective interventions including early surgery following the rapid localization and classification of neurological injuries can have critical benefits and affect the long-term neurological recovery of patients.

• #1 Association between Cerebrospinal Fluid and Serum Biomarker Levels and Diagnosis, Injury Severity, and Short-Term Outcomes in Patients with Acute Traumatic Spinal Cord Injury

  https://www.mdpi.com/2075-4418/13/10/1814

  For this reason, current international guidelines suggest reducing the time from injury to surgery, and support the concept of “time is spine.” […] The identification of surrogate biomarkers through rapid diagnostic tests holds promise for the earlier diagnosis of injury severity, decreases the therapeutic window for surgical interventions, and helps identify patients that may require specialized interventions. […] The severity of the primary injury is often used against the AIS benchmark. […] The identification and critical measurement of these surrogate markers, including advanced imaging strategies as well as biofluid-based biomarkers reflecting the severity of neurological injury, would have great potential as predictive prognostic markers of SCI. […] Elevated concentrations of biomarkers have been observed in both the serum and CSF after TBI and SCI.

• #1

  https://link.springer.com/article/10.1007/s40719-015-0020-0

  Although SCI largely remains a clinical diagnosis, imaging is essential to confirm and localize the level of injury. […] The role of MRI in acute trauma remains unclear, but guidelines recommend MRI within 48 h in obtunded patients to rule out cervical injury and allow collar removal. […] The authors suggest that patients with unexplained neurological deficits should have an MRI study performed urgently since CT is inadequate to assess for ongoing cord compression and timely surgical decompression improves outcomes. […] Once the diagnosis of SCI is made, the primary goal of management is avoidance of secondary injury. […] A proposed algorithm for optimal care is presented. […] The spinal cord frequently faces ongoing mechanical compression following SCI, in which case a decompressive procedure should be performed as quickly as possible.

• #1

  https://www.who.int/news-room/fact-sheets/detail/spinal-cord-injury

  The term spinal cord injury (SCI) refers to damage to the spinal cord resulting from trauma (e.g. from falls and road traffic injuries) or non-traumatic causes like tumors, degenerative and vascular conditions, infections, toxins or birth defects. […] The extent of SCI related impairment depends on injury severity and location in the spinal cord. […] Inappropriate management of SCI related impairments and secondary conditions often causes premature mortality. […] The prevention, early diagnosis and treatment of SCI related secondary conditions are essential to increase life expectancy. […] Timely access to prehospital management, emergency and acute care and rehabilitation is essential to ensure survival and restore optimal levels of functioning, aimed at minimizing long-term disability.

• #1

  https://link.springer.com/article/10.1007/s40719-015-0020-0

  The diagnosis and management of spinal cord injury (SCI) have continuously evolved over decades of clinical experience. […] Future advances in SCI diagnosis will likely utilize novel MRI techniques that characterize spinal cord microstructure and functional connectivity. […] The acute management of SCI is likely to undergo a radical transformation, with numerous potential treatments used in combination, such as neuroprotective and regenerative pharmaceuticals, cellular transplantation, and implantation of structural scaffolds. […] The mechanism involved in traumatic SCI often determines the injury pattern, severity of neurological impairment, and potential for recovery. […] As a result, it is ideal that these patients are efficiently transferred to tertiary care centers with highly specialized teams.

• #2 Spinal Cord Injuries: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/793582-overview

  After a suspected SCI, the goals are to establish the diagnosis and initiate treatment to prevent further neurologic injury from either mechanical instability secondary to injury from the deleterious effects of cardiovascular instability or respiratory insufficiency. […] The International Standards for Neurological and Functional Classification of Spinal Cord Injury (ISNCSCI) is a widely accepted system describing the level and extent of injury based on a systematic motor and sensory examination of neurologic function. […] Spinal cord injuries may be primary or secondary. Primary SCI arises from mechanical disruption, transection, or distraction of neural elements. Secondary SCIs are potentially modifiable injuries that occur hours to days after the initial trauma. […] Anoxic or hypoxic effects can compound the extent of SCI.

• #2 How is SCI diagnosed? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/spinalinjury/conditioninfo/diagnosed

  SCIs are not always immediately recognizable. The following injuries should be assessed for possible damage to the spinal cord: Head injuries, particularly those with trauma to the face; Pelvic fractures; Penetrating injuries in the area of the spine; Injuries from falling from heights. […] If any of these injuries occur together with any of the symptoms mentioned above (acute head, neck, or back pain; decline of feeling in the extremities; loss of control over part of the body; urinary or bowel problems; walking difficulty; pain or pressure bands in the chest area; difficulty breathing; head or spine lumps), then SCI may be implicated. […] A person suspected of having an SCI must be carefully transported to an emergency room or trauma center. A doctor will question the person to determine the nature of the accident, and the medical staff may test the patient for sensory function and movement. If the injured person complains of neck pain, is not fully awake, or has obvious signs of weakness or neurological injury, diagnostic tests will be performed.

• #2 Spinal Cord Injury Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/spinal-cord-injury

  Acute spinal cord injury (SCI) is caused by a trauma to the cervical or thoracic spine, where the spinal cord is located. SCI can disrupt movement, sensation, and body organ function below the level of the injury. […] After a trauma, doctors will ask questions about what happened and conduct a careful examination. If patients are conscious, doctors may test patients ability to move different parts of the body, and their ability to feel strong or light sensations in different parts of the body. These tests help determine whether movement and sensation have been affected by the injury. Doctors will ask about any pain in the neck or back. […] If doctors cannot rule out a spinal cord injury, patients will need imaging tests like X-ray, CT scan, or MRI: […] X-ray (also known as plain films): test that uses invisible electromagnetic energy beams (X-rays) to produce images of bones.

• #2 Spinal Cord Injuries: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/793582-overview

  Spinal cord injury (SCI) is an insult to the spinal cord resulting in a change, either temporary or permanent, in the cords normal motor, sensory, or autonomic function. […] The following laboratory studies can be helpful in the evaluation of spinal cord injury: Arterial blood gas (ABG) measurements – May be useful to evaluate adequacy of oxygenation and ventilation. […] Imaging techniques in spinal cord injury include the following: Plain radiography – Radiographs are only as good as the first and last vertebrae seen, therefore, radiographs must adequately depict all vertebrae. […] Computed tomography (CT) scanning – Reserved for delineating bony abnormalities or fracture. CT imaging is the gold standard for detecting fractures and bony injury. […] Magnetic resonance imaging (MRI) – Used for suspected spinal cord lesions, ligamentous injuries, and other soft-tissue injuries or pathology.

• #2 Diagnosing an SCI: Identification and Paralysis Types – Myolyn

  https://myolyn.com/diagnosing-spinal-cord-injuries-and-paralysis-types/

  A physical exam also helps detect damage to the vertebrae. […] Neurological exams are performed a few days after the injury occurs, giving the swelling time to go down, and therefore, making diagnosis easier. […] A CT scan creates cross-sectional images that allow doctors to pinpoint exactly where damage exists on the spine and to what extent. […] Using magnetic and radio waves, a computer shows the spine in great detail, allowing a doctor to identify any present herniated disks, blood clots, mass formations, and other abnormalities. […] A radiologist may run a myelogram using contrast dye or a spine x-ray to show damage or fracture to the spinal bones. […] SSEP Testing assesses how well signals pass through the arms and legs to the spinal cord and brain. Doctors can measure how long it takes a mild electrical stimulus to pass through electrodes attached to the wrist and back of the knee to electrodes on the scalp.

• #2 Spinal cord injury: From diagnosis to rehabilitation | Top Doctors

  https://www.topdoctors.co.uk/medical-articles/spinal-cord-injury-an-expert-guide-to-diagnosis-treatment-and-rehabilitation

  The diagnosis of a spinal cord injury typically involves a combination of medical history, physical examination, and a range of diagnostic tests. […] Common methods of diagnosis include: Medical history: A doctor will take a detailed medical history, including the circumstances and timing of the injury, as well as any symptoms a patient is experiencing. […] Physical examination: A doctor will perform a physical examination to assess neurological function, including strength, sensation, and reflexes. […] Imaging tests: Imaging tests such as X-rays, CT scans, or MRI scans may be used to visualise the spinal cord and surrounding structures, and to identify any fractures, dislocations, or other abnormalities. […] Electromyography (EMG): An EMG may be used to assess nerve and muscle function, and to identify any damage to the nerves that control the muscles.

• #2 Diagnosing an SCI: Identification and Paralysis Types – Myolyn

  https://myolyn.com/diagnosing-spinal-cord-injuries-and-paralysis-types/

  A few days following the SCI, healthcare providers perform a complete neurological exam, including those evaluating muscle strength and sensitivity to touch, which helps determine the injury severity and rehabilitation or recovery odds. […] The ASIA (American Spinal Injury Association) Impairment Scale and the FIM (Functional Independence Measure) Assessment are the most commonly used tools. […] The ASIA Impairment Scale classifies spinal cord damage from A-E, with A being complete neural loss and E being normal function. […] The FIM Assessment quantifies if a person with paralysis can live independently. […] The higher the SCI or the closer the injury is to the brain, the more of the body the paralysis will affect. […] Paraplegia leads to paralysis in the lower limbs and can affect the legs, hips, sexual function, and other processes, resulting in movement loss. This type of paralysis results when the thoracic or lumbar spinal areas are injured.

• #2 Spinal cord injury – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/syc-20377890

  Spinal cord injuries can cause the following symptoms: […] Your healthcare team performs a series of tests to determine the neurological level and completeness of your injury. […] Whether the cause is traumatic or nontraumatic, spinal cord damage affects the nerve fibers passing through the injured area. This can impair part of or all the muscles and nerves below the injury site. […] A spinal cord injury usually results from an accident and can happen to anyone. But certain factors can increase the risk of having a spinal cord injury, including: […] A spinal cord injury can lead to many complications. Your rehabilitation team helps you develop tools to address these complications. […] The neurological level of injury determines what kind of breathing problems you may have. If the injury affects your neck and chest, you might have an increased risk of pneumonia or other lung conditions. […] Your healthcare team performs a series of tests to determine the neurological level and completeness of your injury.

• #2 Understanding And Responding To A Spinal Cord Injury Diagnosis

  https://winstonbriggslaw.com/understanding-and-responding-to-a-spinal-cord-injury-diagnosis/

  The severity of a spinal cord injury determines the how an individual will be affected. According to the Mayo Clinic, an SCI will be classified in one of two ways: complete or incomplete. In a complete injury, the person loses most or all sensation and motor function below the site of the injury. In an incomplete injury, the person retains some motor or sensory functions below the injury. […] In terms of paralysis, there are also two main categories: tetraplegia/quadriplegia and paraplegia. With tetraplegia/quadriplegia, the person’s arms and legs, trunk and pelvic organs will all be affected. With paraplegia, paralysis affects the legs, a portion of the trunk and the pelvic organs. Spinal cord injuries at the cervical (neck) area often result in tetraplegia/quadriplegia while injuries at the thoracic (upper back) area and below result in paraplegia.

• #2 Diagnosing an SCI: Identification and Paralysis Types – Myolyn

  https://myolyn.com/diagnosing-spinal-cord-injuries-and-paralysis-types/

  Quadriplegia, also known as tetraplegia, results from cervical spine injury and affects all upper and lower extremities, although a loss of function varies from person to person. […] There are currently no treatments that can completely reverse spinal cord damage in all cases of SCI and recovery will vary greatly based on the nature and severity of the injury, but certain medications, therapies, and prostheses can help regenerate nerve cells or improve function in many cases. […] SCI treatments focus on helping people who have experienced an SCI live as independently as possible while preventing further injury.

• #2 Association between Cerebrospinal Fluid and Serum Biomarker Levels and Diagnosis, Injury Severity, and Short-Term Outcomes in Patients with Acute Traumatic Spinal Cord Injury

  https://www.mdpi.com/2075-4418/13/10/1814

  For this reason, current international guidelines suggest reducing the time from injury to surgery, and support the concept of “time is spine.” […] The identification of surrogate biomarkers through rapid diagnostic tests holds promise for the earlier diagnosis of injury severity, decreases the therapeutic window for surgical interventions, and helps identify patients that may require specialized interventions. […] The severity of the primary injury is often used against the AIS benchmark. […] The identification and critical measurement of these surrogate markers, including advanced imaging strategies as well as biofluid-based biomarkers reflecting the severity of neurological injury, would have great potential as predictive prognostic markers of SCI. […] Elevated concentrations of biomarkers have been observed in both the serum and CSF after TBI and SCI.

• #2 Association between Cerebrospinal Fluid and Serum Biomarker Levels and Diagnosis, Injury Severity, and Short-Term Outcomes in Patients with Acute Traumatic Spinal Cord Injury

  https://www.mdpi.com/2075-4418/13/10/1814

  Acute traumatic spinal cord injury (SCI) is recognized as a global problem that can lead to a range of acute and secondary complications impacting morbidity and mortality. […] The aim of this prospective controlled study was to determine the cerebral spinal fluid (CSF) and serum profiles of 10 biomarkers as indicators of SCI diagnosis, severity, and prognosis to aid in assessing appropriate treatment modalities. […] This study demonstrated a strong correlation between biomarker levels in the diagnosis and injury severity of SCI but no association with short-term outcomes. […] In patients with suspected spinal trauma, a correct diagnosis should be made in a timely manner to reduce the occurrence of secondary medical issues that could worsen long-term outcomes. […] Timely neuroprotective interventions including early surgery following the rapid localization and classification of neurological injuries can have critical benefits and affect the long-term neurological recovery of patients.

• #2

  https://link.springer.com/article/10.1007/s40719-015-0020-0

  Although SCI largely remains a clinical diagnosis, imaging is essential to confirm and localize the level of injury. […] The role of MRI in acute trauma remains unclear, but guidelines recommend MRI within 48 h in obtunded patients to rule out cervical injury and allow collar removal. […] The authors suggest that patients with unexplained neurological deficits should have an MRI study performed urgently since CT is inadequate to assess for ongoing cord compression and timely surgical decompression improves outcomes. […] Once the diagnosis of SCI is made, the primary goal of management is avoidance of secondary injury. […] A proposed algorithm for optimal care is presented. […] The spinal cord frequently faces ongoing mechanical compression following SCI, in which case a decompressive procedure should be performed as quickly as possible.

• #3 Types & Levels of Spinal Cord Injuries | Shepherd Center

  https://shepherd.org/treatment/conditions/spinal-cord-injury/types-and-levels/

  A comprehensive neurological exam is typically performed a few days after the injury to allow swelling to subside. During this exam, doctors evaluate: Sensory functions: Assessing the ability to feel sensations such as hot, cold, touch, pain, pressure, and body position. Motor functions: Testing muscle strength and movement in areas like the arms, legs, hands, and chest. Reflex responses: Checking involuntary reflexes that protect the body through instinctive reactions. […] Once the assessment is complete, the results are classified using the American Spinal Cord Injury Association (ASIA) Impairment Scale, which helps determine the severity of the injury and guide treatment and rehabilitation: Grade A: Complete lack of motor and sensory function below the injury level, including the anal area. Grade B: Some sensation preserved below the injury level, including anal sensation. Grade C: Some muscle movement is spared below the injury level, but less than 50% of muscles cannot move against gravity. Grade D: Most muscles (more than 50%) below the injury level can move against gravity. Grade E: Full neurological function has returned.

• #3 Diagnosing an SCI: Identification and Paralysis Types – Myolyn

  https://myolyn.com/diagnosing-spinal-cord-injuries-and-paralysis-types/

  A few days following the SCI, healthcare providers perform a complete neurological exam, including those evaluating muscle strength and sensitivity to touch, which helps determine the injury severity and rehabilitation or recovery odds. […] The ASIA (American Spinal Injury Association) Impairment Scale and the FIM (Functional Independence Measure) Assessment are the most commonly used tools. […] The ASIA Impairment Scale classifies spinal cord damage from A-E, with A being complete neural loss and E being normal function. […] The FIM Assessment quantifies if a person with paralysis can live independently. […] The higher the SCI or the closer the injury is to the brain, the more of the body the paralysis will affect. […] Paraplegia leads to paralysis in the lower limbs and can affect the legs, hips, sexual function, and other processes, resulting in movement loss. This type of paralysis results when the thoracic or lumbar spinal areas are injured.

• #3 Association between Cerebrospinal Fluid and Serum Biomarker Levels and Diagnosis, Injury Severity, and Short-Term Outcomes in Patients with Acute Traumatic Spinal Cord Injury

  https://www.mdpi.com/2075-4418/13/10/1814

  For this reason, current international guidelines suggest reducing the time from injury to surgery, and support the concept of “time is spine.” […] The identification of surrogate biomarkers through rapid diagnostic tests holds promise for the earlier diagnosis of injury severity, decreases the therapeutic window for surgical interventions, and helps identify patients that may require specialized interventions. […] The severity of the primary injury is often used against the AIS benchmark. […] The identification and critical measurement of these surrogate markers, including advanced imaging strategies as well as biofluid-based biomarkers reflecting the severity of neurological injury, would have great potential as predictive prognostic markers of SCI. […] Elevated concentrations of biomarkers have been observed in both the serum and CSF after TBI and SCI.

• #3

  https://link.springer.com/article/10.1007/s40719-015-0020-0

  The optimal method of spinal stabilization may include anterior and/or posterior surgical approaches, halo-vest, external bracing, or rigid collar, depending on the pattern of bony and ligamentous injury. […] The concept of neuroprotection dates back to ancient Greece, where physicians treated cranial injuries by inducing hypothermia with ice baths. […] The optimal timing of neuroprotective therapies is generally as soon as possible. […] Regenerative approaches focus on inducing or amplifying repair mechanisms rather than halting secondary injury. […] The future of SCI therapeutics lies in combinatorial strategies that address each mechanism of secondary injury and the multiple roadblocks to successful regeneration. […] Scientific evidence has informed our current best practices in diagnosis and acute management of SCI, providing a foundation for clinical practice.

• #3 Association between Cerebrospinal Fluid and Serum Biomarker Levels and Diagnosis, Injury Severity, and Short-Term Outcomes in Patients with Acute Traumatic Spinal Cord Injury

  https://www.mdpi.com/2075-4418/13/10/1814

  In addition, a CSF analysis has the potential to identify blood biomarkers for the diagnosis, SCI severity, and prognosis. […] Based on the current biomarker information for clinical SCI, there is a great need for the rapid and reliable detection of injury-sensitive SCI biomarkers. […] The primary aim of this prospective controlled study was to determine the CSF and serum profiles of potential biomarkers for the diagnosis of SCI severity. […] The secondary aim was to determine whether these markers predict the neurological outcome with respect to AIS grade improvements at discharge from the hospital.

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