Articles from prior issues of The Advocate

July/August, 1999

Spinal Cord Injuries Said to Peak Over The 4th of July
by Marion L Stuenkel, Wisconsin DDS

DR. KEITH SPERLING SCHEDULES HIS vacations in February and is on call the 4th of July weekend. WHY? The reason is spinal cord injuries occur least frequently in February and peak over the 4th of July. The Dr. quipped that the greatest preventative measure which could be take to decrease the occurrence of spinal cord injuries would be to eliminate the Independence holiday! Risk factors for spinal cord injuries are youth (16-30), high velocity activity and alcohol consumption. Motor vehicle accidents, shallow water dives and falls (including trampoline ejections) are the most dangerous activities. There have been many improvements in the treatment of spinal cord injuries, but Emergency Medical Technicians are the greatest single factor in reducing severity. Men make up 82% and females 18% of spinal cord injured. Despite a four-fold increase of women in the work place, men are the risk takes and more frequently injured. When the spinal cord is injured, it does not repair (though the future may hold hope). The spinal cord is rarely severed because the spinal cord anatomy is so well designed, but it is vulnerable through a cutoff of the vascular supply. The average life expectancy after injured is 30.2 years. It is interesting to note that 25% are employed five years following injury. The first three months is a critical period. There are very good statistics regarding status and outcome for spinal cord injuries. The leading cause of death for those with spinal cord injuries is respiratory system diseases followed by cardiac diseases. Dr. Sperling showed slides and gave an overview with sufficient detail to describe spinal cord anatomy and illustrate points regarding injury and outcome. Slides also illustrated the long term persistent severe medical management problem of pressure sores for folks with spinal cord injuries. Dr. Sperling emphasized memorizing the ASIA (American Spinal Injury Association) classification of spinal cord injury which follows:

ASIA A no motor or sensory function (below level of injury)

ASIA B sensory function only (below level of injury)

ASIA C sensory and minimal motor function (below level of injury) ASIA D sensory and major motor function (below level of injury)

ASIA E normal sensory and normal motor function

Dr. Sperling also emphasized memorizing the Manual Muscle Testing Grading System which follows:

Score Description

0 No movement

1 Palpable or visible contraction

2 Active movement, full range of motion with gravity eliminated

3 Active movement, full range of motion against gravity

4 Active movement, full range of motion against moderate re sistance

5 Normal strength (based on age, sex and body habitus)

These grading systems are most important to know when reading cases of people with spinal cord injuries.