What finding raises suspicion of a complete spinal cord injury in a trauma patient?

Urinary incontinence is a significant finding that raises suspicion of a complete spinal cord injury. In the case of a complete spinal cord injury, there is a total disruption of neural pathways below the level of injury, which can lead to a loss of voluntary control over bladder function. This results in urinary incontinence, as the affected individual cannot control when urine is released. Additionally, the loss of sensation and motor control below the injury level is characteristic of a complete injury, further supporting this finding as a critical indicator of such a condition.

In contrast, weak motor function can be present in cases of incomplete spinal cord injuries, where some movement is preserved. Intact reflexes may also occur in patients with incomplete injuries, indicating that reflex arcs are still functioning even if voluntary motor control is lost. Upper extremity strength can be maintained due to the involvement of different nerve pathways that may not be compromised in the same manner as lower faculties, so it does not necessarily indicate a complete injury. Therefore, the presence of urinary incontinence is the most indicative finding for a complete spinal cord injury.