11
Neurological Neurological Assessment for patient Assessment for patient
with Spinal Injurywith Spinal Injury
KO KwokKO KwokSpine teamSpine team
Department of O&TDepartment of O&TPrince of Wales HospitalPrince of Wales Hospital
22nd April, 200722nd April, 200722
33
OjectiveOjective of neurological of neurological assessmentassessment
Normal / with deficitNormal / with deficitComplete or incomplete Complete or incomplete -- prognosisprognosisUpper motor neuron lesion/ lower motor Upper motor neuron lesion/ lower motor neuron lesionneuron lesionDetail documentation for progress Detail documentation for progress monitoringmonitoring
44
Function appears normalFunction appears normal
Palpate each segment Palpate each segment Inspect the skin for focal Inspect the skin for focal kyphosiskyphosisEvaluate focal pain, spasmEvaluate focal pain, spasmNote any apprehensionNote any apprehension
Indicate instabilityIndicate instability
55
Deficit is foundDeficit is found
Complete / incomplete Complete / incomplete 1. Check spinal shock 1. Check spinal shock
by by bulbocavernosusbulbocavernosus reflexreflex2. Check sacral sparing 2. Check sacral sparing
66
77
Detail documentationDetail documentation
ToneToneMotorMotorCoordinationCoordinationReflexReflexSensationSensation
88
ToneTone
FlaccidFlaccidLower motor neuron lesionLower motor neuron lesionAcute lesionAcute lesion
RigidRigidUpper motor neuron lesionUpper motor neuron lesionChronicChronic
99
MotorMotor
0 = total paralysis0 = total paralysis1 = palpable or visible contraction1 = palpable or visible contraction2 = active movement, gravity eliminated2 = active movement, gravity eliminated3 = active movement, against gravity3 = active movement, against gravity4 = active movement, against some resistance4 = active movement, against some resistance5 = active movement, against full resistance5 = active movement, against full resistance
1010
1111 1212
1313 1414
1515 1616
1717 1818
Conclusion Conclusion
Continuous monitoringContinuous monitoringSpecial patternSpecial pattern
Central cord syndromeCentral cord syndromeASIA score for ASIA score for tetra/paraplegic patienttetra/paraplegic patient
1919
ENDEND