Understanding Spinal Cord Injury: Classification, Effects, and Management

The American Spinal Injury Association (ASIA) Classification system provides a framework for describing the extent of spinal cord injury (SCI). The ASIA grades range from A to E, where:

ASIA Grade D denotes preserved motor function below the neurological level with at least half of the muscles having a grade better than 3/5.
ASIA Grade E represents normal motor and sensory function. However, it is important to note that ASIA Grade E does not account for pain, spasticity, and dysesthesia that can result from SCI.

Spinal cord injuries can significantly affect bodily functions such as bladder control. The type of bladder issues experienced by an individual is dependent on the level and completeness of their injury. For instance, those with an incomplete injury may retain some sensation and control over urination.

There are two primary types of SCIs: complete and incomplete. A complete SCI leads to a total loss of sensation and motor function below the injury level, while an incomplete injury results in partial loss. The causes of these traumatic injuries can range from bruising of the spinal cord, loss of blood flow, to direct cuts in the cord. Additionally, tumors on the spinal cord, which may be benign or malignant, often originate in the spinal region rather than being metastatic.

The aftermath of an SCI includes a range of changes to bodily functions. The bladder, for example, cannot communicate with the brain as it did before, disrupting normal voiding patterns. Paraplegia, which refers to the loss of voluntary movement in the lower body, is another consequence of SCIs at certain levels, such as a complete T12 injury, resulting in paralysis from the waist down.

Guidelines for the preservation of upper limb function following an SCI stress the importance of early intervention, including maintaining blood pressure and oxygenation to prevent secondary injury and assessing changes in movement or sensation promptly.

For more detailed information on spinal cord injuries and their management, refer to the following resources:
UCSF Lecture on Spine and Spinal Cord Injuries,
Neurogenic Bladder Management,
University of Iowa Spinal Cord Injury Guide,
and
UAMS Guidelines for SCI Upper Extremity.