Spinal Cord Injury Glossary

Simple definitions about a complex condition

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36Item Short-Form Health Survey (SF36): An assessment that measures quality of life after spinal cord injury (SCI).

Acute injury phase: The first damage phase after traumatic SCI, occurring in the first 48 hours after the traumatic event.
The word "meaning" under a magnifying glass.Definitions to help you understand the most common spinal cord injury (SCI) terms. Photo Source: 123RF.com.Ambulate (ambulation): Walking movement.

American Spinal Injury Association (ASIA) Impairment Scale: Determines whether the injury is complete or incomplete. The ASIA Impairment Scale assigns the SCI a grade based on its severity. Grades range from A to E, with A being the most severe injury and E being the least severe.

Anterior cord syndrome: Affects the anterior, or front section, of the spinal cord. This syndrome is most common in people with non-traumatic SCI as opposed to traumatic SCI. Anterior cord syndrome causes complete loss of movement, and pain and temperature loss, but it preserves light touch sensations.

ASIA motor score: Grades muscle strength and movement after traumatic SCI.

ASIA sensory score: Grades light touch and pinprick feeling after traumatic SCI.

Atrophy: Muscle wasting, loss of muscle size.

Autonomic dysreflexia (AD): A serious and potentially life-threatening emergency associated with SCI. AD causes over-activity of the autonomic nervous system that disrupts communication between the body and brain above the injury level. It occurs most often in people whose injuries are complete and occur at or above T6.

Autonomic nervous system: Governs involuntary actions, such as heart rate and blood pressure. Includes the sympathetic nervous system and parasympathetic nervous system.

Brown-Séquard syndrome: Affects either the left or right side of the spinal cord, but symptoms can affect both sides of the body. It is characterized by partial loss of function or impaired function, a vibrating sensation on the same side of the injury, and pain and temperature loss on the opposite side of the injury. It most often occurs in patients who suffered a penetrating traumatic SCI, such as knife wound.

Case manager: The person who coordinates care with insurance carriers and equipment providers.

Cellular transplantation: An SCI medical innovation that can help replace lost cells, regulate cell function at the injury site, and improve cell regeneration.

Central cord syndrome: The most common incomplete SCI syndrome, occurring in 15-25% of traumatic SCIs. The central spinal cord is the middle area of the spinal cord. These nerve fibers are large and exchange information between the spinal cord and cerebral cortex (gray matter of the brain). The cerebral cortex is important to personality, interpreting sensation (feeling), and movement (motor function). The central spinal cord is important for hand and arm function, such as fine motor control (eg, writing), although the lower body can be affected (eg, loss of bladder control), too.

Central nervous system (CNS): The nerve system that controls the activities of the body. It includes the brain and spinal cord.

Chronic injury phase: The fourth and final damage phase after traumatic SCI, occurring 6 months after the traumatic event.

Complete SCI: Loss of all function (motor) and feeling (sensory) below the injury level equally affecting both sides of the body.

Computed Tomography (CT) scan: A common SCI diagnostic imaging tool that may provide a clear, comprehensive picture of the spinal damage. However, CT scans are less useful at detecting soft-tissue damage affecting the spinal discs, ligaments, spinal cord, and nerve roots.

CT angiography: A test occasionally used during the SCI diagnostic process. It combines CT technology with a contrast medium (ie, radiopaque dye) to highlight details of the blood vessels.

Demyelination: Occurs when the myelin, a membrane (sheath) covering nerves, is destroyed. Myelin is needed to help nerves communicate.

Discomplete SCI: A third, less common category of SCI, referring to complete injuries that show some signs of brain-muscle connectivity.

Electrophysiology: An emerging SCI diagnostic imaging tool. Electrophysiology is the study of electric activity within the body, and it can help a doctor understand the extent of neurological damage.

Emergency medical technicians (EMTs): First responders who provide immediate urgent care that may be life-saving and help ensure safe arrival to the hospital.

Functional electrical stimulation (FES): A treatment that uses an electrical current to activate nerves affected by paralysis. It is used to stimulate functions, such as motor control, walking, arm and upper body movement, and urination.

Glial cell: Provides nutrients and other support to the nerve cells in your CNS. During the secondary injury cascade, glial cells in your spinal cord begin to die.

Hemodynamics: A medical focus on providing adequate blood flow to your spinal cord to prevent further damage after SCI.

Hematoma: Localized semisolid mass of blood.

“High” tetraplegia: SCI occurring at the top of your neck (C1-C4), resulting in paralysis of all 4 limbs.

Incomplete SCI: Some function and feeling remains below the injury level.

Intermediate injury phase: The third damage phase after traumatic SCI, from 14 days to 6 months after the traumatic event.

International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI): A universal SCI classifying method based on 3 scores: the ASIA motor score, ASIA sensory score, and ASIA Impairment Scale grade.

Ischemia: Inadequate blood supply. During the secondary injury cascade, the blood vessels in your spinal cord lose function, which reduces blood supply to the spinal cord.

Lesions: A wound or injury creating a change in tissues.

Local complications: SCI complications that affect a specific site in the body.

Locomotor central pattern generator: A region of neurons that can trigger movement without any sensory input or input from the brain.

“Low” tetraplegia: SCI occurring at the lower part of your neck (C5-C7), resulting in paralysis of all 4 limbs.

Magnetic resonance imaging (MRI): A common SCI diagnostic imaging tool. MRI can reveal specifics about a spinal injury, such as hemorrhage, disc herniation, or other types of soft tissue disruptions.

Methylprednisolone sodium succinate (MPSS): A glucocorticoid that may be administered via intravenous infusion shortly after SCI is diagnosed. This drug may improve a prognosis by helping nerves recover, but the use in the acute phase of SCI is controversial.

Motor: Response to a stimulus, such as a nerve signal, to a muscle to contract.

Neurogenic shock: Slowed heart activity after SCI. Neurogenic shock may occur after SCI occurring in the neck or upper back.

Neuropathic joint arthropathy: The slow destruction of a joint. This SCI complication is often diagnosed as many as 15 years after the initial injury.

Neuroprotective treatments: A category of innovative drug therapies for SCI.

Neuroregenerative treatments: A category of innovative drug therapies for SCI.

Non-traumatic spinal cord injury: SCI caused by non-traumatic diseases in the spine. Spinal tumors are the leading cause of non-traumatic SCI, but infections and degenerative disc disease can also cause it.

Occupational therapist: A professional who addresses the social, emotional, and functional aspects of an SCI patient's life. His or her goal is to help the patient be independent.

Paralysis: The partial or complete loss of sensation and function.

Paraplegia: Paralysis of both legs.

Parastep®: An ambulation assistance system that is combined with FES (functional electrical stimulation) approved by the U.S. Food and Drug Administration. Parastep helps patients stand and walk without bracing and helps them become more independent. It is a functional neuromuscular stimulation system controlled by a microcomputer. Stimulation is routed through skin electrodes.

Physiatrist: A medical doctor who specializes in physical medicine and rehabilitation.

Physical therapist: A specialist who helps patients to restore function, improve mobility, and limit permanent physical disability. Physical therapy promotes fitness and health.

Posterior cord syndrome: Affects the posterior, or back section, of the spinal cord. This syndrome is most common in people with non-traumatic SCI as opposed to traumatic SCI. Posterior cord syndrome causes loss of light touch sensation, but it preserves movement, and pain and temperature sensation.

Primary injury: Injury caused by the initial traumatic event.

Proprioception: The sense of body position.

Psychologist: A doctor who offers patient and family support to help everyone adjust to change. People with SCI and their partners may receive sexual and/or family planning counseling.

Rehabilitation nurse: A nurse specialist who helps prevent complications and assists patients with functional activities. They are a resource for patient advocacy, case management, counseling, and education.

Robotics: An innovation helping people with SCI regain function and independence after injury.

SCI-QOL: An assessment that measures quality of life after SCI.

Secondary injury cascade: A series of biological changes weeks and months after the initial traumatic SCI. The secondary injury cascade may interfere with the spinal cord’s ability to recover itself after the injury.

Sensory: Relating to sensation: feeling, pressure, temperature.

Spasticity: Long-term muscle contractions caused by SCI. The contractions make muscles stiff and rigid, which makes movement—including walking and talking—difficult.

Speech and language pathologist: A therapist who assesses, diagnoses, and treats disorders related to speech, language, and cognition. This may include voice, swallowing, and fluency.

Spinal cord: The spinal cord carries the nerves affecting body function. It is the pathway for impulses passing to and from the brain. The spinal cord is protected by cerebral spinal fluid and is surrounded by membranes, termed meninges, the dura mater, arachnoid, and pia mater. The gray matter, resembling a butterfly, is in the center section of the cord. The gray matter is surrounded by myelinated (protective sheath) white matter composing the outer portion of the spinal cord.

Spinal cord stimulation: Uses a surgically implanted electrical current in the epidural space to improve functional and walking-related outcomes in patients with chronic SCI.

Spinal decompression surgery: A key part of the treatment plan after traumatic SCI. The goal of decompression surgery is to relieve the pressure on the spinal cord and/or spinal nerves by removing damaged structures or soft tissues pressing on the cord and nerves.

Spinal shock: A short-term state of paralysis after SCI.

Spinal stabilization surgery: May be part of the traumatic SCI treatment plan. If the spine is unstable, spinal stabilization surgery, often with spinal fusion is performed following decompression. The spine may be unstable from the traumatic event, or the decompression procedure may create spinal instability.

Stem cell: A cell with the potential to develop into different types of cells, such as a muscle, nerve, blood, or brain cell. For stem cells to be useful, they must be able to reproduce in sufficient numbers, develop into the desired cell type, survive transplantation, and function without harm throughout a lifetime.

Subacute injury phase: The second damage phase after traumatic SCI, from 48 hours to 14 days after the traumatic event.

Sympathetic nervous system (SNS): One of the 2 main components of the autonomic nervous system. The SNS is key to several active functions throughout the body, including breathing and digestion.

Syringomyelia: The formation of a fluid-filled cyst, or syrinx, within the spinal cord. About 3% of people with SCI develop syringomyelia.

Systemic complications: SCI complications that may become chronic disorders with widespread impact throughout the body.

Tetraplegia (quadriplegia): Paralysis affecting all 4 limbs. Tetraplegia occurs in the cervical spine, or neck.

Therapeutic hypothermia: Medically lowering body temperature to slow circulation, reduce inflammation, and control damage from injury (eg, bleeding).

Therapeutic recreational specialist: A specialist who helps patients with physical, mental, and emotional well-being. Using activities like arts and crafts, games, music, and outings, these therapists help patients manage depression and stress. Activities help build confidence and socialization skills.

“Time Is Spine:” A phrase referring to the critical first 48 hours after the SCI, known as the acute injury phase. Nerve tissue quickly dies during this phase, so promptly diagnosing patients and starting treatment is essential to preserving long-term health.

Traumatic spinal cord injury: SCI caused by an external physical impact that damages the spinal cord. Common causes of traumatic SCI include car accidents, sports injuries, violent acts, and falls.

Vocational rehabilitation therapist: A professional who works with the patient's doctor on therapy directed toward work-related skills. After evaluating interests, skill sets, and current abilities, the therapist assists the patient to develop a return to work plan.

Weight-supported locomotor training (WSLT): Uses both assisted devices and therapists to support a patient’s weight while walking on a treadmill or on the ground. The goal of WSLT is to promote the remaining nerve connectivity between regions above the traumatic injury and the locomotor central pattern generator with the spinal cord.

X-ray: A common SCI diagnostic imaging tool. X‑rays can detect obvious spinal fractures that often occur after SCI, but they are less helpful at identifying smaller fractures in the neck.

Learn more spinal terms by visiting the General Spinal Glossary.

Updated on: 01/27/19
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Upper Neck Disorders and the Cervical Spine
Michael G. Fehlings, MD, PhD, FRCSC, FACS
Professor of Neurosurgery
Department of Surgery
University of Toronto