Spinal Cord Injury Complete Or Incomplete - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the conditions of complete and incomplete Spinal Cord Injury.
With a complete spinal cord injury, the patient will develop complete motor and sensory loss below the level of the injury. No sacral sparing. No motor or sensory below the level of the lesion after the disappearance of the spinal shock and the return of the bulbocavernosus reflex. The physician will be unable to differentiate between a complete and incomplete injury during spinal shock. The spinal shock usually lasts 24-72 hours (hypotension & bradycardia).
With complete injury, one cervical root could recover in 80%. Two nerve roots may recover in some patients.
Incomplete injury: check for sacral sparing. Preservation of any sensory or motor function indicates an incomplete lesion. The most important prognostic factor for recovery is the severity of the neurological deficit.
Central cord syndrome
Caused by a hyperextension injuy. It has a favorable prognosis but poor recovery of the hand function. The lesion occurs in the central part of the spinal cord and the grey matter. The injury can be caused by minimal trauma in the elderly, usually caused by osteophytes. The spinal cord will become compressed between the ligamentum flavum and the intervertebral disc or a bony spur. The injury causes an upper motor neuron lesion in the lower extremity and a lower motor neuron lesion in the upper extremity. Motor weakness is more severe in the upper extremities compared to the lower extremities.
Anterior cord syndrome
There will be complete motor paralysis and impairment of the sensory function. The damage occurs in the anterior part of the spinal cord due to vascular insufficiency or mechanical compressions such as form a bony spur or a fracture. Anterior cord syndrome has the worst prognosis. With anterior cord syndrome, the corticospinal tract is affected and there is a very low chance of motor recovery (only 15% will show functional recovery). Anterior cord syndrome is usually a result of a flexion/compression injury and damage to the spinal cord is usually in the anterior 2/3 of the cord. The lower extremities are affected more than the upper extremities. The posterior column is spared with position, proprioception and sense of vibration not being affected.
The anterior syndrome is different from central cord syndrome- central cord syndrome is caused by a hyperextension injury.
Brown sequard syndrome
Brwon sequard syndrome has the best prognosis with 90% recovery. It is caused by hemisection of the spinal cord usually due to penetrating trauma. There will be ipsilateral deficit of the motor function, proprioception, vibration and deep touch. There will be contralateral loss of pain and temperature and the spinothalamic tract crosses at the spinal cord.
Posterior cord syndrome
This syndrome is very rare and is associated with loss of proprioception, deep touch and vibration. The motor, pain, temperature, and light touch are preserved.

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