Medical Complications in Spinal Cord Injury

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Original Editor - George Prudden

Top Contributors - Naomi O'Reilly, Kim Jackson, Admin, George Prudden, Tarina van der Stockt, Rucha Gadgil and Vidya Acharya  

Introduction

Spinal cord injury results not only in motor and sensory deficits but also in autonomic dysfunctions as a result of the disruption between higher brain centers and the spinal cord. Autonomic dysfunction can include compromised cardiovascular, respiratory, urinary, gastrointestinal, thermoregulatory, and sexual activities. Maintaining optimal health and well-being after sustaining a spinal cord injury can be a challenge.  Common secondary health conditions like pressure sores, spasms, chronic pain, and urinary tract infections often negatively affect quality of life and social participation.

Autonomic Dysfunction

Autonomic Dysreflexia

Autonomic dysreflexia is a potentially but often unrecognised life-threatening condition and should be considered a medical emergency that requires immediate intervention. It is an acute syndrome characterised by paroxysmal hypertensive episodes associated with sever, pounding headache, decreased heart rate, and upper body flushing which occurs in individuals with spinal cord lesions above the T6 Spinal Cord Level.

AD is the result of overstimulation of the autonomic (involuntary) nervous system. It is characterized the sudden onset of severe high blood pressure known as paroxysmal hypertension. This manifests itself as throbbing headaches, profuse sweating, nasal stuffiness, flushing of the skin above the level of the lesion, slow heart rate, anxiety, and sometimes cognitive impairment.

Respiratory Dysfunction

Impaired respiratory function is common following SCI. Typical respiratory complications following SCI include hypoventilation, atelectasis, secretion retention and pneumonia. Respiratory function of people with SCI is primarily determined by neurological level. Paralysis or partial paralysis of key muscles has a marked impact on respiratory function.

Gastrointestinal Dysfunction

Neurogenic Bowel

Upper Motor Neuron Bowel Syndrome

Lower Motor Neuron Bowel Syndrome

Urological Dysfunction

Neurogenic Bladder

Hypereflexia of Detrusor and Sphincter 

Areflexia of Detrusor and Sphincter

Areflexia of Detrusor with Hyperreflexia of Sphincter

Hyperreflexia of Detrusor with Areflexia of Sphincter