Basic Physical and Neurological Examinations for Spinal Cord Injury

  • Hyun-Yoon Ko


Given the simplified representation of the physiology and function of the spinal cord, the signs and symptoms of dysfunction of the spinal cord are not difficult to determine. Varieties of motor weakness, sensory disturbance, autonomic problems, and pain include almost all clinical problems associated with spinal cord injury/disease. So the only problem is to determine the injury or lesion site and to combine the symptoms and the results in various combinations.


  1. Bican O, Minagar A, Pruitt AA. The spinal cord: a review of functional neuroanatomy. Neurol Clin. 2013;31:1–18.CrossRefGoogle Scholar
  2. Brown PJ, Marino RJ, Herbison GJ, Ditunno JF. The 72-hour examination as a predictor of recovery in motor complete quadriplegia. Arch Phys Med Rehabil. 1991;72:546–8.PubMedGoogle Scholar
  3. Calancie B, Molano MR, Broton JG. Tendon reflexes for predicting movement recovery after acute spinal cord injury in humans. Clin Neurophysiol. 2004;115:2350–63.CrossRefGoogle Scholar
  4. Kingwell SP, Curt A, Dvorak MF. Factors affecting neurological outcome in traumatic conus medullaris and cauda equina injuries. Neurosurg Focus. 2008;25(5):E7.CrossRefGoogle Scholar
  5. Ko HY, Ditunno JF, Graziani V, et al. The pattern of reflex recovery during spinal shock. Spinal Cord. 1999;37:402–9.CrossRefGoogle Scholar
  6. Pearce JM. Beevor’s sign. Eur Neurol. 2005;53:208–9.CrossRefGoogle Scholar
  7. Saboe LA, Reid DL, Davis LA, et al. Spinal trauma and associated injuries. J Trauma. 1991;31:43–8.CrossRefGoogle Scholar
  8. Soler JM, Previnaire JG, Amarenco G. Dartos reflex as autonomic assessment in persons with spinal cord injury. Spinal Cord Ser Cases. 2017;13(3):17097.CrossRefGoogle Scholar
  9. van Munster CE, Weinstein HC, Uitdehaag BM, et al. The plantar reflex: additional value of stroking the lateral border of the foot to provoke an upgoing toe sign and the influence of experience. J Neurol. 2012;259:2424–8.CrossRefGoogle Scholar
  10. van Gijn JV. Babinski response: stimulus and effector. J Neurol Neurosurg Psychiatry. 1975;38:180–6.CrossRefGoogle Scholar
  11. van Gijn J. The Babinski sign and the pyramidal syndrome. J Neurol Neurosurg Psychiatry. 1978;41:865–73.CrossRefGoogle Scholar
  12. van Gijn J. The Babinski sign: the first hundred years. J Neurol. 1996a;243:675–83.CrossRefGoogle Scholar
  13. van Gijn J. Should the Babinski sign be part of the routine neurologic examination? Neurology. 1996b;66:1607–9.CrossRefGoogle Scholar
  14. Vodusek DB. Bulbocavernous reflex revisited. Neurourol Urodyn. 2003;22(7):681–2.CrossRefGoogle Scholar
  15. Yilmaz U, Yang CC, Berger RE. Dartos reflex: a sympathetically mediated scrotal reflex. Muscle Nerve. 2006;33(3):363–8.CrossRefGoogle Scholar

Suggested Reading

  1. Afifi AK, Bergman RA. Functional neuroanatomy: text and atlas. 2nd ed. New York: Lange Medical Books/McGraw-Hill; 2005.Google Scholar
  2. American Spinal Injury Association. International standards for neurological classification of spinal cord injury. Revised 2011. Updated 2015 ed. Atlanta: American Spinal Injury Association; 2015.Google Scholar
  3. Bromley I. Tetraplegia and paraplegia. a guide for physiotherapists. New York: Churchill Livingstone; 1976.Google Scholar
  4. Campbell WW. DeJong’s the neurologic examination. 7th ed. New York: Wolters Kluwer Lippincott Williams & Wilkins; 1992.Google Scholar
  5. Crossman A, Neary D. Neuroanatomy: an illustrated colour test. 5th ed. Philadelphia: Elsevier; 2015.Google Scholar
  6. Durrant DH, True JM. Myelopathy, Radiculopathy, and peripheral entrapment syndromes. Boca Raton: CRC Press; 2002.Google Scholar
  7. Felten DL, O’Banion MK, Maida MS. Netter’s atlas of neuroscience. 3rd ed. London: Elsevier; 2016.Google Scholar
  8. Fulton JF, Keller AD. The sign of Babinski: a study of the evolution of cortical dominance in primates. Springfield: Charles C Thomas; 1932.Google Scholar
  9. Guttmann L. Spinal cord injuries. comprehensive management and research. Oxford: Blackwell Scientific Publications; 1976.Google Scholar
  10. Illis LS, editor. Spinal cord dysfunction: assessment. Oxford: Oxford University Press; 1988.Google Scholar
  11. Ko HY. Manual of spinal cord medicine for physiatrists (in Korean). Seoul: Koonja; 2016.Google Scholar
  12. Mai JK, Paxinos G. The human nervous system. 3rd ed. London: Elsevier; 2011.Google Scholar
  13. Mancall E. Gray’s clinical neuroanatomy: the anatomic basis for clinical neuroscience. Philadelphia: Elsevier; 2011.Google Scholar
  14. Mtuid E, Gruener G, Dockery P. Fitzgerald’s clinical neuroanatomy and neuroscience. 7th ed. Philadelphia: Elsevier; 2016.Google Scholar
  15. Passias PG, editor. Cervical myelopathy. Philadelphia: Jaypee Brothers Medical Publishers (P) Ltd; 2016.Google Scholar
  16. Patestas MA, Gartner LP. A text book of neuroanatomy. Oxford: Blackwell Publishing; 2006.Google Scholar
  17. Patten J. Neurological differential diagnosis. 2nd ed. London: Springer; 1996.CrossRefGoogle Scholar
  18. Vanderah T, Gould DJ. Nolte’s the human brain. Philadelphia: Elsevier; 2016.Google Scholar
  19. Vinken PJ, Bruyn GW, editors. Injuries of the spine and spinal cord. Part I, Handbook of clinical neurology, vol. 25. Oxford: North-Holland Publishing Company; 1976a.Google Scholar
  20. Vinken PJ, Bruyn GW, editors. Injuries of the spine and spinal cord. Part II, Handbook of clinical neurology, vol. 25. Oxford: North-Holland Publishing Company; 1976b.Google Scholar
  21. Weidner N, Rupp R, Taney KE, editors. Neurological aspects of spinal cord injury. Cham: Springer; 2017.Google Scholar
  22. Windle WF. The spinal cord and its reaction to traumatic injury. In: Bousquet WF, Palmer RF, editors. Modern pharmacology-toxicology: a series of monographs and textbooks. New York: Marcel Dekker, Inc.; 1980.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Hyun-Yoon Ko
    • 1
  1. 1.Department of Rehabilitation MedicineRehabilitation Hospital, Pusan National University Yangsan Hospital, Pusan National University School of MedicineYangsanSouth Korea

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