ĭue to mobility limitations, paraplegia or tetraplegia patients do not load their spine or limbs, disturbing bone homeostasis as a result of mechanical unloading. However, these must be weighed against the negative effects that include contractures, gait disturbances, decreased mobility, and pain. Spasticity may potentially have beneficial effects by promoting venous return, decreasing the incidence of orthostatic hypertension and deep venous thrombosis, increasing stability, and facilitating activities such as transfers. Spasticity is a velocity-dependent increase in muscle tone due to a hyperexcitable stretch reflex. Any complete level thoracic SCI results in paraplegia, however, SCI distal to L2 level may spare varying lower extremity function.ĭamage to descending spinal cord tracks results in hyperexcitability and spasticity. These patients require less assistance and fewer adaptive aids for activities of daily living. SCI below C6 results in relatively greater independence, with patients able to achieve transfers either with the assistance of a transfer board (C6) or independently (C7/C8). The C6 nerve root controls wrist extension and biceps flexion, the C7 nerve root controls elbow extension and wrist flexion, and the C8 nerve roots controls finger flexion. Accordingly, C5 complete SCI (ASIA A) results in complete dependence for transfers and assistance for activities of daily living. The C5 nerve root primarily innervates the deltoid muscle to perform shoulder abduction, but is also responsible elbow flexion. ![]() While C1–C4 SCI typically results in tetraplegia, lower cervical (C5–C8) SCI can spare varying degrees of upper extremity function. ![]() The SCI level determines which systems are affected and has a significant impact on the potential rehabilitation and final functional status of the patient. Neurologic injury of the spinal cord affects nearly every physiologic system, and patients can present with a multitude of symptoms that drastically influence their function and quality of life.
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