ABPMR SCI Medicine key terms

A five-grade classification (A through E) describing spinal cord injury severity from the ASIA examination, based on completeness and sacral sparing, where A is a complete injury and E is normal sensory and motor function.

The most caudal spinal cord segment with intact sensory and motor function on both sides, determined by the ASIA examination; it may differ from the skeletal level of fracture seen on imaging.

Preserved sensation at the anal mucocutaneous junction, deep anal pressure, or voluntary anal sphincter contraction, which marks an injury as incomplete and generally predicts better neurological recovery.

The spinal segments below the neurological level that retain some sensory or motor function in a complete injury; by definition it is recorded only when no sacral sparing is present.

The sum of manual muscle test grades from 0 to 5 for ten key muscles on each side, giving a total from 0 to 100 that is used to track motor recovery over time.

Transient flaccid paralysis with loss of all reflexes below the injury immediately after cord trauma, lasting days to weeks and considered ended when the bulbocavernosus reflex returns.

Hemodynamic instability after cervical or high thoracic injury from loss of sympathetic tone, producing hypotension with bradycardia or an absent compensatory tachycardia; treated with fluids, vasopressors, and atropine when needed.

An incomplete injury, often from hyperextension of a stenotic canal, causing greater weakness in the arms than the legs with variable sensory loss and a generally favorable but incomplete prognosis.

Hemisection of the cord producing ipsilateral motor and proprioceptive loss with contralateral loss of pain and temperature sensation beginning one or two levels below the lesion.

Damage to the anterior cord from flexion injury or vascular compromise, causing bilateral loss of motor function and pain-temperature sensation while posterior column proprioception and light touch remain intact.

Injury below the conus involving lumbosacral nerve roots, producing asymmetric lower motor neuron weakness, saddle anesthesia, and bowel or bladder dysfunction; acute cases require urgent surgical evaluation.

Injury at the terminal cord near L1 with symmetric findings, early and prominent bowel and bladder dysfunction, and a mixture of upper and lower motor neuron signs in the legs.

Spinal cord injury without radiographic abnormality, seen mainly in children whose elastic spinal ligaments stretch and recoil; magnetic resonance imaging may reveal cord edema or hemorrhage.

Guideline-recommended maintenance of mean arterial pressure at roughly 85 to 90 mmHg for about seven days after acute injury to support cord perfusion, although evidence for the best target remains limited.

A potentially life-threatening syndrome in injuries at T6 or above with sudden severe hypertension, headache, flushing, and bradycardia triggered by noxious stimuli below the lesion, most often bladder distention.

Involuntary contraction of the external urethral sphincter during bladder contraction, producing high storage pressures, incomplete emptying, and risk of upper urinary tract damage.

Scheduled bladder emptying with a single-use catheter, preferred for neurogenic retention because it lowers infection rates and pressure-related renal risk compared with an indwelling catheter.

A scheduled routine combining diet, fluids, oral or rectal medications, and timed evacuation techniques, tailored to reflexic upper motor neuron or areflexic lower motor neuron bowel patterns.

An international classification running from stage 1 nonblanchable erythema through stage 4 full-thickness loss with exposed fascia, muscle, or bone, plus unstageable and deep tissue injury categories.

Formation of lamellar bone in soft tissue, usually around the hips or knees weeks to months after injury, causing swelling, warmth, and restricted motion, often with elevated alkaline phosphatase.

A fall of at least 20 mmHg systolic or 10 mmHg diastolic on standing or head-up tilt, common after cervical injury from lost sympathetic vasoconstriction and managed with gradual mobilization, compression, and medication.

A fluid-filled cavity within the cord that may enlarge years after injury, producing ascending sensory loss, new weakness, or pain; magnetic resonance imaging confirms it and surgery may be required.

A velocity-dependent increase in muscle tone from hyperexcitable stretch reflexes after upper motor neuron injury, managed with stretching, positioning, oral medications, chemodenervation, or intrathecal baclofen.

Application of electrical current to paralyzed nerve or muscle to produce contraction, used for cycling, grasping, standing, and bladder or bowel assistance after spinal cord injury.

Passive finger flexion generated by active wrist extension in a person with C6 tetraplegia, allowing grasp without finger flexor control; training and splinting can optimize the pattern.

Locomotor practice with partial body-weight unloading and manual or robotic assistance, intended to activate spinal locomotor circuits and improve stepping in incomplete injuries.

A device that gradually raises a patient toward upright to improve orthostatic tolerance, provide weight bearing, and assess cardiovascular response before standing or gait training.

Structured practice of moving between surfaces such as bed, wheelchair, and toilet using preserved strength, balance, and technique; it strongly influences discharge destination and independence.

Return to participation in work, school, recreation, relationships, and civic life after injury, measured with instruments such as the CHART and supported by accessible housing and transportation.

The physical, emotional, and financial strain experienced by family or paid helpers of a person with spinal cord injury, which predicts depression and institutionalization and warrants separate assessment and support.

Routine use of validated instruments such as the PHQ-9 to detect treatable mood disorder, which occurs two to three times more often after spinal cord injury than in the general population.

Coordinated services including work assessment, retraining, workplace accommodation, and job placement that help a person with spinal cord injury return to or enter competitive employment.

Assistance from mentors who have lived with spinal cord injury, offering practical advice, role modeling, and hope; it is associated with better adjustment and self-management.

The earlier and accelerated onset of conditions such as shoulder overuse, osteoporosis, cardiovascular disease, and pressure injury in long-term survivors, requiring proactive screening across the lifespan.

Rapid bone loss below the injury level during the first one to two years, especially at the distal femur and proximal tibia, raising low-trauma fracture risk; bisphosphonates and weight bearing may help.