SCI Terms & Definitions

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AFO; Ankle and Foot Orthoses. An AFO is a device worn on the foot, ankle and/or calf to support the motion, alignment and stability of the foot and ankle. 

Allodynia is a painful response to a nonpainful stimulus. For example; light touch or clothing causes a pain response. 

Anterior Cord Syndrome; This type of incomplete injury comes the closest to resembling a complete sci. There is a complete loss of motor and sensory below the injury level. The Proprioception (awareness of where the limbs are located and where they are in movement-also called kinaesthesia) and being able to feel vibration sensations remain intact. The causes may include disc herniation, surgery, aortic trauma to the spinal cord or column, a spinal stroke to plaque buildup in the arteries and various conditions that can cause compression to the spinal cord such as spinal curvatures and disorders. 

Arachnoiditis The membranes (arachnoid) that surround and protect the spinal cord nerves become inflamed and can cause chronic pain and neurological problems. 

Atrophy When muscles waste away. The most dominant reason for this a lack of physical use and immobility. 

Autonomic dysreflexia Is an over reaction of the autonomic nervous system.  Normally nerves send signals to the brain when a threatening stimulus occurs. When a person has an SCI, usually above T6, the signal gets interrupted. The autonomic nervous system reads this interruption and constricts the blood vessels and blood pressure rises. The brain then sends a message to the heart to slow down and for the blood vessels to dilate. Due to the signal interruption, the message can’t be read below the injury site.  Symptoms include; sweating, nausea, slow pulse below 60 BPM, high blood pressure, pounding headache, flushed face and nasal stuffiness. Common causes include; constipation, urinary tract infection, menstrual cramps, hemorrhoids, skin irritation or cuts.  

Baclofen pump a surgically inserted pump placed under the skin,  to deliver Baclofen (muscle relaxant used to treat spasticity) directly into the cerebral fluid section of the spinal cord via a catheter.  

Bladder augmentation/Cystoplasty A surgical procedure to enlarge the bladder. Conditions to have the procedure done may include; when the bladder isn’t large enough to hold the amount of urine produced by the kidneys, bladder spasticity, incontinence and bladder shrinkage.

Brown-Sequard Syndrome Another rare incomplete spinal cord injury. This sci results in the loss of sensation (temperature and pain) on one half of the body and the loss of motor (weakness or paralysis), proprioception and vibration on the other half below the region of the injury. The causes may include; trauma or compression of the spinal cord, blood vessel obstruction or disease. Brown Sequard Syndrome is also known as; BSS, Hemisection of the spinal cord, Partial Spinal Sensory Syndrome, hemiparaplegic, walking quad and Spastic Spinal Monoplegia Syndrome. 

Cauda Equina Lesion This sci is caused by a compression of the sac of nerve roots at the base of the spinal cord. These nerves send the signals for movement, sensation and bladder control. If they are compressed, it can lead to paralysis, loss of sensation and bowel/bladder control. The initial symptoms can include; leg weakness, incontinence, lower back pain, loss of sensation in the legs. The symptoms can also include “saddle anesthesia” which is the inability to feel parts of the body that would normally sit in a horse saddle. The causes CEL include; stenosis, trauma, herniation and disease.

Central Cord Syndrome CCS is considered the most common types of incomplete sci. The injury occurs in the cervical spine. It can be caused by hyperflexion of the neck, tumors or various types of trauma. It typically effects the sensory/motor portions of the hands and arms more than the legs. There can paralysis, loss of fine motor skills, neuropathy and loss of bladder control. 

Cervical Myelopathy Compression of the cervical spinal cord. The symptoms include; weakness, tingling, numbness in the hands or arms or a loss of balance. Cervical spondylotic myelopathy usually occurs over 50 years of age due to a gradual wear and tear. 

Clonus When a nerve is damaged, it can cause an involuntary rhythmic muscle spasm. The muscle will move in a rhythmic-like pattern. 

Contralateral Occurs or appears on the opposite side. 

CRPS Complex Regional Pain Syndrome. There are two types; CRPS I which there is no known prior nerve damage and CRPS II where there is a prior known nerve damage injury. The terms for both have changed. CRPS I was known as reflex sympathetic dystrophy syndrome. CRPS II was referred to as causalgia. It may affect the hands, arms, feet and legs. The pain felt, in these areas, are usually greater than the injury itself inflicted. CRPS is believed to be an autoimmune response to an injury. The pain is usually chronic. The symptoms include; change in skin temperature to the touch, sweating, blotchy skin, skin texture becomes shiny, changes in growth and texture of the fingernails or toenails, painful joints, hypersensitivity to stimulus that normally doesn’t cause pain and nerve pain such as burning or tingling. Treatment may include; physical/occupational therapy, a spinal cord stimulator, nerve stimulator or TENS and medication.  

Dorsiflexion Moving the foot, from the ankle or the hand, from the wrist, in an upward position. 

Hemiparesis Weakness on half of the body. 

Hemiplegia paralysis on half of the body.

Horner’s syndrome A rare syndrome that can occur after a spinal cord injury. The symptoms include; the drooping of one eyelid which is called ptosis, a constricted pupil which is called miosis, a lack of facial sweating called anhidrosis and the sinking of the eyeball into the socket which is called enophthalmos.  

Hyperextension An extension of the neck moving backwards past the point of where it would normally extend. 

Hyperflexion is excessive movement of the neck in a forward motion.

Incomplete vs Complete Injury  An incomplete injury can still send signals to areas. These areas might have moment and/or sensation. A complete injury is where no signals are going through and there is no sensation or movement. 

Ipsilateral Occurs or appears on the same side. 

Laminectomy A surgery to remove a part of the lamina (the vertebrae that covers the spinal canal), in order to remove compression.

Lichtheim's Disease A degeneration of the spinal cord due to deficiencies in b12, vitamin E and copper.

Myopathy Disorders of the skeletal muscles

Neurogenic bowl/bladder Is when the nerve signals from the bladder to the brain are interrupted. Symptoms include; an overactive bladder, underactive bladder, a change in frequency, bladder urgency, incontinence, a dribbling of urine and being unable to feel a full bladder. Treatments may include; medications, changing fluid intake, surgery, stimulators, catheter, pelvic exercises, Botox and lifestyle changes. 

Neuropathy Dermatitis A rash or dermatitis that occurs after a surgical incision due to a possible autoimmune reaction, after the skin’s nerves being cut. 

Parasthesia a skin sensation (tingling, prickly, numbness, burning) for which there is no known cause. 

Peripheral Neuropathy Numbness, weakness or pain sensations (tingling, burning, prickly sensations) caused by the peripheral nerves. 

Positive Romberg Sign While standing straight, a person closes their eyes and then loses their balance. 

Posterior Cord Syndrome Is one of the rarest types of incomplete spinal cord injuries. Possible causes may include trauma, tumors, hyperflexion (forward movement) of the neck or injury to the back of the spinal cord. Sensory (pain and temperature) and motor remain intact. This injury may include the loss of proprioception, vibration sensation, light touch, positive Romberg sign and muscle coordination. 

Proprioception is also known as kinaesthesia. It is the awareness of where the body is positioned. The nerves in the skin travel to the brain to send messages of where the limbs are located. When the message is interrupted, as with certain spinal cord injuries, then the brain doesn’t receive this information. A person, without an injury, can close their eyes and know what position their limbs are in. When the connection disrupted, as with an sci, they might not be aware of the positioning of their arms or legs. 

Radiculopathy Term for a pinched nerve, which can lead to pain, muscle weakness and numbness.

Spasms An involuntary contraction of a muscle. It can cause twitching, jerking or involuntary movement in a muscle. 

Spasticity When there is a tightening or contraction of the muscles. Different stimulus can create spasticity. The brain misinterprets stimulus, due to the nerve pathways being disrupted, and sends back a signal to react, which results in the muscle suddenly moving or becoming stiff. An increase in spasticity may signal another issue such as a urinary tract infection, some irritant on your skin that you may not feel due to sensation loss. 

Spinal Cord Stroke/Infarction The main blood vessels, in the spinal cord, are the interior (front) and the posterior (back). During a spinal cord stroke, the blood supple carrying oxygen and nutrients can be cut off. When this happens, a portion of the spinal cord signals will cease to be able to communicate past the injury. The stroke can be caused by bleeds (ischaemic spinal strokes) or by blood clots (haemorrhagic spinal strokes). Symptoms include; not feeling hot or cold temperatures, weakness in the leg muscles, tightness in the trunk of the body, incontinence of the bowels or bladder, spasms, paralysis, nerve pain, back pain, neck pain and numbness.  

Spondylolisthesis When a vertebra slips out and rests on the bone below it either forward (anterolisthesis) or backward (retrolisthesis). This can cause compression of the nerves leaving the spinal canal leading to weakness, numbness, pain and lack of mobility.

Syrinx/syringomyelia a fluid filled cyst that occurs in the spinal cord. A syrinx may occur due to a congenital abnormality, trauma, hemorrhage, tumor, meningitis or arachnoiditis. Typically, the onset of symptoms is slow. Symptoms may include; a loss of feeling temperature, weakness in the extremities, incontinence, numbness, tingling and pain. They symptoms may worsen as the syrinx slowly grows and lengthens. 

Tactile Hyperesthesia Is a hypersensitivity to touch caused by peripheral neuropathy. 

Tethered Cord Syndrome A neurologic disorder. It occurs when tissues or scar tissues attach to the spinal cord and cause it to pull, stretch and limits the movement of the spinal cord. The condition can occur congenitally or near the site of injury after an sci. Symptoms may include; weakness, incontinence, sensation loss, sweating, spasticity, pain and Horner’s Syndrome.

Types of incomplete injuries Anterior Cord Syndrome, Central Cord Syndrome, Posterior Cord Syndrome, Brown Sequard Syndrome, Cauda Equina Lesion.

Walking Quad Quadriplegia is the partial or total loss (sensory and motor) of all four limbs. A walking quad is someone who’s had an sci that effects the sensory and motor of all four limbs but can still walk.