Types of Spinal Cord Injuries

 
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Spinal cord injuries are divided into complete injuries and incomplete injuries. It is possible that the classification of the injury may change during recovery (26).

Complete Spinal Cord Injury: Usually the loss of sensation and motor ability associated with a complete spinal cord injury caused by bruising, loss of blood to the spinal cord, or pressure on the spinal cord; cut and severed spinal cords are rare. Generally, complete spinal cord injuries result in total loss of sensation and movement below the site of the injury.

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This MRI scan shows the damaged, but not cut spinal cord of a person with a complete spinal cord injury

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This is an MRI of the unimjured patient in the previous picture. The spinal cord is not compressed.

Incomplete Spinal Cord Injury: An incomplete spinal cord injury does not result in complete loss of movement and sensation below the injury site. A variety of patterns exist to classify such injuries:

1. Anterior cord syndrome- results from damage to the motor and sensory pathways in the anterior areas of the spinal cord. Effects include loss of movement and overall sensation, although some sensations that travel by way of the still intact pathways can be felt (1).

2. Central Cord Syndrome- results from injury to the center of the cervical area of the spinal cord (1). The damage affects the corticospinal tract, which is responsible for carrying signals between the brain and spinal cord to control movement (21). Patients of central cord syndrome experience weakness or paralysis in the arms and some loss of sensory reception. The loss of strength and sensation is much less in the legs than in the arms (1). Many patients with central cord syndrome spontaneously recover motor function, and others experience considerable recovery in the first six weeks following the injury.

3. Brown-Sequard syndrome- results from injury to the right or left side of the spinal cord. On the side of the body where the injury occurred, movement and sensation are lost below the level of the injury. On the side opposite the injury, temperature and pain sensation are lost due to the crossing of these pathways in the spinal cord (1)

4. Injuries to individual nerve cells- result in loss of sensory and motor function in the area of the body to which the injured nerve root corresponds. Thus, symptoms from these injuries vary depending on the location and function of the particular nerve root.

5. Spinal contusions- the most common type of spinal cord injury. The spinal cord is bruised, not severed, but the consequence is inflammation and bleeding from blood vessels near the injury (2). A spinal contusion results in temporary (usually one to two days) incomplete or complete debilitation of the spinal cord (1).

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The arrows and hash marks in this MRI of a patient with an incomplete spinal cord injury show the area of injury to the soft tissues in the back of the spine.

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The arrows in this MRI of another patient with an incomlete spinal cord injury indicate the fracture compressing the spinal cord. The view is from the side.

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The arrow in this MRI indicates the area of injury to the cervical spine.