Tetraplegia, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Tetraplegia, Diagnosis and Treatment and Related Diseases

The most well known example of a tetraplegic patient was Christopher Reeves who was well known for his Superman movies.

He fell from his horse in 1995 and broke his first and second vertebrae injuring his spinal cord.

He became a tetraplegic, paralyzed from the neck downwards due to a spinal cord injury in the neck and had difficulty in breathing.

He started the Christopher and Dana Reeves Foundation to support the work on spinal paralysis and its treatment and was a great supporter of stem cell research for treatment of spinal injuries.

Tetraplegia (previously known as quadriplegia) is a medical disorder in which the lower extremities, upper extremities, and almost the complete trunk/body become paralyzed.

Tetraplegia is a form of paralysis that is produced by some injury or illness and causes partial or complete loss of usage of body and 4 limbs.

Generally both the sensory and motor nerves are involved, which indicates that one loses both sensation and motor control of that body part.

Most people with tetraplegia have significant paralysis below the neck, and many are totally unable to move.

This form of paralysis is inevitably the product of damage high in the spinal cord, normally in the cervical spine between C1-C7.

The higher the injury is, the more extensive the injury to the spine will be, and very high spinal cord injuries are often instantly fatal.

The injury to spinal cord is normally due to an injury suffered by the spinal vertebrae present in cervical section of spinal column.

The spinal cord injury may cause the loss of total or partial functioning of all the four limbs, i.e. the arms and legs.

If the vertebrae are dislocated or fractured without the spinal cord being injured, it is quite possible to have a broken neck even without becoming tetraplegic.

A person can also injure his or her spinal cord without actually fracturing the spine, like when a bony spur or a ruptured disc on the vertebra protrudes itself into spinal column.

All tetraplegics have finger dysfunction in some form or another.

It is not really infrequent to find a tetraplegic person having fully functional arms but having difficulty in moving fingers.

Tetraplegia Classification

Based on the American Spinal Injury Association (ASIA), spinal cord injuries can be classified into 2 types:

A. Complete tetraplegia

The spinal cord of a tetraplegic individual can be classified into 3 segments that can be utilized to classify the injury:

1. The injured functional medullary segment has un-paralyzed, functional muscles whose motions are voluntary and not permanent.

Assessment of their strength can be done by the BMRC (British Medical Research Council) scale.

2. An injured metamere or a lesional segment is made up of many denervated corresponding muscles that have an injured LMN (lower motor neuron).
   These muscles are atrophic, hypotonic and reveal no spontaneous contractions.

3. The injured sub-lesional segment sited below metamere segment has an uninjured lower motor neuron that reveals intact medullary reflexes but has no upper cortical control.
   These muscles show some increase in tone when elongated and the trophicity is good

B. Incomplete spinal cord lesions

Incomplete spinal cord wounds may cause different post injury manifestations

1. Central cord syndrome:

The main part of cord lesion remains in gray matter of spinal cord; the lesion might occasionally persist in white matter.

2. Anterior cord syndrome:

This is a lesion happening in the anterior horns as well as in the anterolateral tracts.

3. Brown-Sequard syndrome

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