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Motor control after spinal cord injury

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    Motor control after spinal cord injury

    Posted by Celtic
    I wonder if you could help with a few queries Dr Young? Post-injury I was left with a degree of bowel and bladder control and feeling all over my body varying in intensity.I can make my legs jump using spasm (either left/right or both) when I want but with no control over how far they move.If I try and move say, my toes, I get a small flicker and no more.Could this be down to the injury site being compressed and would decompression have any effect after so long?
    Motor control has two components. One component initiates the movement and the second modulates the movement. The first is primarily excitatory while the latter is primarily inhibitory. A majority of descending tracts of the spinal cord are devoted to the latter. Your description suggests that you are able to initiate some movements. Motor control can be amplified and trained through biofeedback therapy which helps you focus the motor control on specific muscles at a time. In addition, groups of neurons in the spinal cord that coordinate complex patterns of movement. These include the central pattern generator which corrodinates locomotion, reflexes that activate the other side of the body, reflexes that involve multisegmental movements. Spasms are a form of motor initiation. It sounds as if you have some motor initiation but insufficient motor control.

    Regarding the possibility of the injury site being compressed or tethered by scars, the way to rule this in or out is to do serial magnetic resonance imaging. This should be done regularly. Most neurosurgeon, however, are luctant to operate basdon romorroric

    Thanks for your reply Dr Young but what does "basdon romorric" mean? (excuse my ignorance).One thing I did learn was the importance of stretching exercises as away of keeping limbs flexible.Since my injury I spend afew minutes each morning stretching and when I went on the physio course (6 years post injury at the time) the physiotherapist commented that my limbs were looser and had a greater range of movement than patients 2 years post injury.
    On the subject of compression I had always assumed that decompression would be carried out as a matter of course and was amazed to find out that this was not always the case.



      Whoops. I am sorry but the turkey was calling and I hurriedly copied what I was writing to the post. What I meant to say was:

      Doctors are reluctant to operate on chronic spinal cord injury unless there is progressive loss of function. This is because most clinicians believe that surgery itself has undesirable risks that do not balance the benefits of decompression.



        Thanks again Dr Young.It looks like I should forget about decompression as there seems tobe little benefit in it.