Provid me the table were the level wise spinal cord injury for example from C1 to T12 which structure organ will be affected more pls provide the table along with also explain the types of Spinal cord injury

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I now have sufficient information to construct a detailed, well-sourced response. Let me compile everything.

Spinal Cord Injury: Level-Wise Effects & Types

Part 1 - Types of Spinal Cord Injury

A. Complete vs. Incomplete (ASIA Impairment Scale)

The American Spinal Injury Association (ASIA) Impairment Scale is the standard classification tool. The level of injury is defined as the lowest spinal cord segment with intact motor and sensory function.

ASIA Grade	Description
A - Complete	No sensory or motor function preserved below the level of injury (including sacral segments S4-S5)
B - Sensory Incomplete	Sensation present below the neurological level, but no motor function preserved below the level
C - Motor Incomplete	Motor function present below the level; more than half of key muscles grade <3/5
D - Motor Incomplete	Motor function present below the level; at least half of key muscles grade ≥3/5 (functional)
E - Normal	Sensory and motor function normal (may still have reflex changes)

Source: Bailey and Love's Short Practice of Surgery 28th Ed., p.413; Bradley and Daroff's Neurology in Clinical Practice

B. Incomplete Spinal Cord Syndromes

Approximately 90% of incomplete injuries fall into one of three classic syndromes:

1. Central Cord Syndrome (Most Common)

Mechanism: Hyperextension injury - the cord is squeezed between the anterior vertebral body and inward-buckling ligamentum flavum. Common in elderly with pre-existing cervical stenosis.
Deficits: Bilateral motor weakness - upper limbs > lower limbs, distal > proximal. Variable sensory loss and bladder dysfunction (urinary retention common).
Mnemonic: MUD - Motor > Sensory, Upper > Lower, Distal > Proximal
Prognosis: In patients <50 years: >80% regain bladder continence, ~90% return to walking. In patients >50 years: only ~30% regain bladder function and ~50% regain ambulation.

2. Brown-Séquard Syndrome (Best Prognosis)

Mechanism: Hemisection (half) of the spinal cord, usually from penetrating trauma, but also seen with tumors, epidural hematomas, vascular malformations, and radiation.
Deficits (classic pattern):
- Ipsilateral: Motor loss (corticospinal tract), proprioception, vibration loss (dorsal columns)
- Contralateral: Pain and temperature loss (lateral spinothalamic tract, 1-2 levels below lesion)
Prognosis: Best of all incomplete syndromes - 80-90% regain bowel/bladder function, 75% regain ambulation, 70% become ADL-independent.

3. Anterior Cord Syndrome (Worst Prognosis)

Mechanism: Damage to anterior 2/3 of cord - from hyperflexion, bone fragment/disc herniation, or anterior spinal artery occlusion (often after aortic surgery or hypotension).
Deficits: Loss of motor function, pain, and light touch below the lesion. Posterior column functions are preserved (proprioception, vibration, deep pressure).
Prognosis: Worst of the three - only partial motor recovery expected.

Syndrome	Mechanism	Motor	Pain/Temp	Proprioception/Vibration	Prognosis
Central Cord	Hyperextension	Bilateral - arms > legs	Variable loss	Often preserved	Moderate - age dependent
Brown-Séquard	Hemisection	Ipsilateral loss	Contralateral loss	Ipsilateral loss	Best (~90% recover)
Anterior Cord	Anterior artery / flexion	Bilateral loss	Bilateral loss	Preserved	Worst

Source: ROSEN's Emergency Medicine; Goldman-Cecil Medicine; Bradley and Daroff's Neurology in Clinical Practice

4. Posterior Cord Syndrome (Rare)

Selective damage to the dorsal columns.
Deficits: Loss of proprioception and vibration only; motor and pain/temperature sensation intact.
Very rare in isolation.

5. Conus Medullaris Syndrome

Injury at L1 vertebral level (where the spinal cord terminates).
Mixed UMN + LMN signs - flaccid lower limb weakness, saddle anesthesia, areflexia, bladder/bowel/sexual dysfunction.
Detrusor areflexia and flaccid anal sphincter on exam.

6. Cauda Equina Syndrome

Injury below the conus (below L1) - pure lower motor neuron lesion affecting the lumbar/sacral nerve roots.
Deficits: Lower limb weakness, areflexia, decreased tone, variable sensory loss, severe bladder/bowel/sexual dysfunction.
Carries significant central neuropathic pain in at least 1/3 of patients.

Source: Bradley and Daroff's Neurology in Clinical Practice, p.485

Part 2 - Level-Wise Spinal Cord Injury: Structures and Functions Affected

The following table covers C1 through T12 (the most clinically relevant range for complete injury consequences):

Cervical Levels (C1-C8)

Level	Key Muscles Innervated	Functions Lost/Affected	Respiratory Impact	Bladder/Bowel	Other Key Effects
C1-C2	None (intrinsic neck muscles only)	Quadriplegia - ALL four limbs; ALL trunk; ALL below	Total respiratory paralysis - requires permanent mechanical ventilation (phrenic nerve not functional)	Complete loss - urinary retention, bowel areflexia	Complete loss of sensation from head down (may spare face via CN V); cannot speak without ventilator; life-threatening autonomic instability
C3	Neck muscles partially	Quadriplegia - all four limbs and trunk	Requires ventilatory support - phrenic nerve (C3-C4-C5) compromised; may retain some neck muscle breathing	Complete neurogenic bladder/bowel	Extremely high level; needs full-time attendant care; total dependence
C4	Diaphragm partially (phrenic nerve C3-C4-C5)	Quadriplegia - all four limbs	Borderline ventilatory function - diaphragm partially functional; may wean off ventilator with effort	Complete neurogenic bladder/bowel	Shoulder shrug possible (trapezius via CN XI); power wheelchair with chin control; total ADL dependence
C5	Deltoid, biceps (elbow flexion)	Quadriplegia - hands, forearms, lower limbs; no grip	Independent breathing - diaphragm fully functional (phrenic nerve intact)	Neurogenic bladder, bowel program needed	Can feed self with devices (balanced forearm orthosis); can operate power-assisted wheelchair with hand control; shoulder abduction and elbow flexion present
C6	Wrist extensors, radial wrist extension	Paralysis of hands and lower limbs; no finger flexion	Intact	Neurogenic bladder - can self-catheterize with training	Tenodesis function (passive finger closure via wrist extension); upper limb dressing, manual wheelchair propulsion, sliding board transfers feasible
C7	Triceps (elbow extension), wrist flexors	Paralysis below C7; weak hand function	Intact	Neurogenic bladder - self-catheterization	Most ADLs from wheelchair feasible; can use suppositories for bowel program; triceps give better push-up ability
C8	Long finger flexors, intrinsic hand muscles	Paralysis below C8; finger grip possible	Intact	Neurogenic bladder/bowel	Most ADLs independent from wheelchair; long finger flexion permits most daily tasks

Thoracic Levels (T1-T12)

Level	Key Muscles/Structures	Functions Lost/Affected	Respiratory Impact	Bladder/Bowel	Other Key Effects
T1	Intrinsic hand muscles (thenar, hypothenar, interossei)	Paraplegia - both lower limbs + trunk below T1; weak hand intrinsics	Intact (intercostals above T1 intact)	Neurogenic bladder/bowel	Full upper limb function; independent manual wheelchair; Horner syndrome possible if T1 sympathetics disrupted
T2-T6	Upper intercostal muscles, upper trunk	Paraplegia - lower limbs + lower trunk; reduced intercostal function	Reduced respiratory reserve (upper intercostals affected); coughing weakened	Neurogenic bladder, constipation	Sympathetic outflow to heart at T1-T4 - lesions at T3 or above = neurogenic shock (bradycardia + hypotension + peripheral vasodilation); autonomic dysreflexia risk
T4	Mid-chest intercostals	Paraplegia below nipple line (T4 dermatome landmark = nipple)	Reduced but functional	Neurogenic bladder/bowel	T4 is nipple line landmark; cardiac sympathetics compromised above T4
T6	Mid-thoracic intercostals, upper abdominals	Paraplegia below T6	Moderately reduced	Neurogenic bladder/bowel	Above T6 = risk of autonomic dysreflexia (life-threatening hypertensive crisis triggered by noxious stimuli below lesion); splanchnic sympathetic disruption affects BP control
T7-T9	Lower intercostals, partial abdominals	Paraplegia - lower limbs + lower trunk; upper abdominals intact	Near-normal	Neurogenic bladder/bowel	Partial truncal stability; ambulatory with KAFO (knee-ankle-foot orthosis) and crutches possible for some
T10	Abdominals (full), lower intercostals	Paraplegia - legs and lower trunk below T10; full abdominal control intact	Normal	Neurogenic bladder/bowel	T10 dermatome = umbilicus (clinical landmark); good trunk stability; better cough/expiratory strength; wheelchair independent
T11-T12	Lower abdominals, iliopsoas partially	Paraplegia - lower limb weakness; hip flexors partially preserved	Normal	Neurogenic bladder/bowel (but improving toward conus level)	Lumbar orthosis may allow some household ambulation; better functional outcomes than upper thoracic

Part 3 - Summary of Critical Functional Levels

Injury Level	Functional Category	Functional Prognosis
C1-C3	High tetraplegic (quadriplegic)	Ventilator dependent; full-time attendant care; power wheelchair (head/chin/breath control)
C4	Tetraplegic	Possibly ventilator-free; power wheelchair; total ADL dependence
C5	Tetraplegic	Ventilator-free; self-feeding with aids; power-assist wheelchair
C6	Tetraplegic	Tenodesis hand function; manual wheelchair; partial ADL independence
C7-C8	Tetraplegic	Near-full upper limb function; manual wheelchair; ADL independent
T1-T6	Paraplegic	Full upper limb function; manual wheelchair; risk of autonomic dysreflexia if ≥T6
T7-T12	Paraplegic	Manual wheelchair; some potential for assisted/functional ambulation with orthoses

Key Clinical Points

Spinal shock: Immediately after SCI, all motor, sensory, and reflex function is lost below the injury (including bulbocavernosus reflex). This is temporary and resolves over days to weeks.
Neurogenic shock: If lesion is at T3 or above, sympathetic cardiac tone is lost → bradycardia + hypotension + peripheral vasodilation (the classic triad).
Autonomic dysreflexia: Life-threatening hypertension in injuries at T6 and above, triggered by any noxious stimulus below the lesion (e.g., bladder distension, pressure sore).
Bladder: Complete injuries almost never recover normal bladder/bowel function; ~15% of incomplete injuries do recover.
Burning hands sign: A complaint of "burning hands" in trauma should raise strong suspicion for cervical spinal cord injury.

Sources: Goldman-Cecil Medicine, International Edition; Bradley and Daroff's Neurology in Clinical Practice; ROSEN's Emergency Medicine; Gray's Anatomy for Students; Bailey and Love's Short Practice of Surgery 28th Ed.

Create a summary PDF with this level-wise table for quick clinical reference

Reading File

Running Command

ls -la /home/daytona/workspace/ 2>/dev/null || mkdir -p /home/daytona/workspace && ls -la /home/daytona/workspace/

Running Command

mkdir -p /home/daytona/workspace/sci-reference

Writing File

~/sci-reference/build_sci_pdf.py

from reportlab.lib.pagesizes import A4, landscape
from reportlab.lib import colors
from reportlab.lib.units import cm, mm
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    PageBreak, HRFlowable
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_RIGHT
from reportlab.platypus import KeepTogether

OUTPUT = "/home/daytona/workspace/sci-reference/SCI_Clinical_Reference.pdf"

# ── Colour palette ──────────────────────────────────────────────────────────
C_DARK_BLUE   = colors.HexColor("#0D2B55")
C_MED_BLUE    = colors.HexColor("#1A5276")
C_LIGHT_BLUE  = colors.HexColor("#D6EAF8")
C_RED         = colors.HexColor("#C0392B")
C_ORANGE      = colors.HexColor("#E67E22")
C_AMBER       = colors.HexColor("#F9E79F")
C_GREEN       = colors.HexColor("#1E8449")
C_LIGHT_GREEN = colors.HexColor("#D5F5E3")
C_YELLOW_HDR  = colors.HexColor("#FFF3CD")
C_GREY_ROW    = colors.HexColor("#F2F3F4")
C_WHITE       = colors.white
C_BLACK       = colors.black

# ── Document ─────────────────────────────────────────────────────────────────
doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=landscape(A4),
    leftMargin=1.2*cm, rightMargin=1.2*cm,
    topMargin=1.5*cm, bottomMargin=1.5*cm,
    title="Spinal Cord Injury – Level-wise Clinical Reference",
    author="Orris Medical Reference"
)

styles = getSampleStyleSheet()

# Custom styles
def S(name, **kw):
    return ParagraphStyle(name, **kw)

title_style = S("Title2", fontSize=18, textColor=C_WHITE,
                fontName="Helvetica-Bold", alignment=TA_CENTER, leading=22)
sub_style   = S("Sub",    fontSize=10, textColor=C_LIGHT_BLUE,
                fontName="Helvetica", alignment=TA_CENTER, leading=13)
h1_style    = S("H1",     fontSize=13, textColor=C_DARK_BLUE,
                fontName="Helvetica-Bold", spaceBefore=10, spaceAfter=4)
h2_style    = S("H2",     fontSize=10, textColor=C_MED_BLUE,
                fontName="Helvetica-Bold", spaceBefore=6, spaceAfter=3)
body_style  = S("Body2",  fontSize=8.5, textColor=C_BLACK,
                fontName="Helvetica", leading=11)
note_style  = S("Note",   fontSize=7.5, textColor=colors.HexColor("#555555"),
                fontName="Helvetica-Oblique", leading=10)
small_bold  = S("SmBold", fontSize=8, textColor=C_BLACK,
                fontName="Helvetica-Bold", leading=10)
cell_style  = S("Cell",   fontSize=7.5, textColor=C_BLACK,
                fontName="Helvetica", leading=10)
cell_bold   = S("CellB",  fontSize=7.5, textColor=C_BLACK,
                fontName="Helvetica-Bold", leading=10)
cell_red    = S("CellR",  fontSize=7.5, textColor=C_RED,
                fontName="Helvetica-Bold", leading=10)
cell_green  = S("CellG",  fontSize=7.5, textColor=C_GREEN,
                fontName="Helvetica-Bold", leading=10)
hdr_style   = S("TblHdr", fontSize=8, textColor=C_WHITE,
                fontName="Helvetica-Bold", alignment=TA_CENTER, leading=10)

def P(text, style=cell_style): return Paragraph(text, style)
def PB(text): return Paragraph(text, cell_bold)
def PR(text): return Paragraph(text, cell_red)
def PG(text): return Paragraph(text, cell_green)
def PH(text): return Paragraph(text, hdr_style)
def PBody(text): return Paragraph(text, body_style)

story = []

# ═══════════════════════════════════════════════════════════════════════════
# PAGE 1 – COVER BANNER + ASIA TABLE + SYNDROMES TABLE
# ═══════════════════════════════════════════════════════════════════════════

# -- Cover banner -----------------------------------------------------------
banner_data = [[Paragraph("SPINAL CORD INJURY", title_style)],
               [Paragraph("Level-wise Clinical Reference Card  •  ASIA Classification  •  Incomplete Syndromes", sub_style)]]
banner_tbl = Table(banner_data, colWidths=[26.6*cm])
banner_tbl.setStyle(TableStyle([
    ("BACKGROUND",  (0,0), (-1,-1), C_DARK_BLUE),
    ("TOPPADDING",  (0,0), (-1,-1), 10),
    ("BOTTOMPADDING",(0,0),(-1,-1), 10),
    ("ROUNDEDCORNERS",[6]),
]))
story.append(banner_tbl)
story.append(Spacer(1, 8))

# ── Two side-by-side boxes: ASIA + Key Definitions ─────────────────────────

# ASIA Impairment Scale
asia_header = [PH("Grade"), PH("Description"), PH("Clinical Meaning")]
asia_rows = [
    [PR("A – Complete"),       P("No motor or sensory function below injury level"),          PR("Total paralysis & anaesthesia below lesion")],
    [PB("B – Sens. Incompl."), P("Sensation present below level; NO motor function"),          P("Feels, cannot move below")],
    [PB("C – Motor Incompl."), P("Motor present below level; >half key muscles grade <3/5"),   P("Weak, non-functional movement")],
    [PG("D – Motor Incompl."), P("Motor present below level; ≥half key muscles grade ≥3/5"),   PG("Functional motor preserved")],
    [PG("E – Normal"),         P("Normal sensory and motor function"),                          PG("May still have reflex changes")],
]
asia_tbl = Table([asia_header]+asia_rows, colWidths=[3.0*cm, 7.5*cm, 5.5*cm])
asia_tbl.setStyle(TableStyle([
    ("BACKGROUND",   (0,0), (-1,0),  C_MED_BLUE),
    ("BACKGROUND",   (0,1), (-1,1),  C_GREY_ROW),
    ("BACKGROUND",   (0,2), (-1,2),  C_WHITE),
    ("BACKGROUND",   (0,3), (-1,3),  C_GREY_ROW),
    ("BACKGROUND",   (0,4), (-1,4),  C_LIGHT_GREEN),
    ("BACKGROUND",   (0,5), (-1,5),  C_LIGHT_GREEN),
    ("BOX",          (0,0), (-1,-1), 0.5, C_MED_BLUE),
    ("INNERGRID",    (0,0), (-1,-1), 0.3, colors.HexColor("#AAAAAA")),
    ("VALIGN",       (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",   (0,0), (-1,-1), 4),
    ("BOTTOMPADDING",(0,0), (-1,-1), 4),
    ("LEFTPADDING",  (0,0), (-1,-1), 5),
]))

# Incomplete syndromes summary
syn_header = [PH("Syndrome"), PH("Mechanism"), PH("Motor Loss"), PH("Sensory Loss"), PH("Prognosis")]
syn_rows = [
    [PB("Central Cord"),   P("Hyperextension;\ncervical stenosis"),     P("Arms > Legs\nDistal > Proximal"),   P("Variable pain/temp;\nproprio. spared"),  PG("Moderate\n<50 yrs: 90% walk")],
    [PB("Brown-Séquard"),  P("Hemisection;\npenetrating trauma"),        P("Ipsilateral\nbelow lesion"),       P("Contralateral pain/temp\nIpsilateral proprio."), PG("BEST\n80-90% recover")],
    [PB("Anterior Cord"),  P("Ant. spinal art.\nHyperflexion / disc"),   P("Bilateral\nbelow lesion"),         P("Pain/touch lost\nProprio. INTACT"),      PR("WORST\nPartial recovery")],
    [PB("Posterior Cord"), P("Rare; dorsal column\ndamage"),             P("Intact"),                         PR("Proprio. & vibration\nlost only"),       P("Good motor\noutcome")],
    [PB("Conus Medullaris"),P("L1 level injury"),                        P("Flaccid lower\nlimb weakness"),   P("Saddle anaesthesia"),                    P("Mixed UMN+LMN\nsigns")],
    [PB("Cauda Equina"),   P("Below L1\n(nerve roots)"),                 P("Flaccid, areflexic\nlower limbs"), P("Variable lower\nlimb + perineum"),       P("Pure LMN;\nbladder/bowel affected")],
]
syn_tbl = Table([syn_header]+syn_rows, colWidths=[2.8*cm, 3.2*cm, 3.5*cm, 3.8*cm, 3.3*cm])
syn_tbl.setStyle(TableStyle([
    ("BACKGROUND",   (0,0), (-1,0),  C_DARK_BLUE),
    ("ROWBACKGROUNDS",(0,1),(-1,-1), [C_GREY_ROW, C_WHITE]),
    ("BOX",          (0,0), (-1,-1), 0.5, C_DARK_BLUE),
    ("INNERGRID",    (0,0), (-1,-1), 0.3, colors.HexColor("#AAAAAA")),
    ("VALIGN",       (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",   (0,0), (-1,-1), 4),
    ("BOTTOMPADDING",(0,0), (-1,-1), 4),
    ("LEFTPADDING",  (0,0), (-1,-1), 4),
]))

# Place the two tables side by side
outer = Table(
    [[Paragraph("ASIA Impairment Scale", h2_style), Spacer(0.3*cm, 1), Paragraph("Incomplete Spinal Cord Syndromes", h2_style)],
     [asia_tbl, Spacer(0.4*cm, 1), syn_tbl]],
    colWidths=[16.2*cm, 0.4*cm, 16.2*cm] if False else None
)
# Use a simpler two-column approach
side_by_side = Table([[asia_tbl, syn_tbl]], colWidths=[16.2*cm, 16.4*cm])
side_by_side.setStyle(TableStyle([
    ("VALIGN",      (0,0),(-1,-1),"TOP"),
    ("LEFTPADDING", (0,0),(-1,-1),0),
    ("RIGHTPADDING",(0,0),(-1,-1),4),
]))

story.append(Paragraph("ASIA Impairment Scale &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Incomplete Spinal Cord Syndromes", h2_style))
story.append(side_by_side)
story.append(Spacer(1, 6))
story.append(Paragraph("Sources: Bailey & Love's Surgery 28e • ROSEN's Emergency Medicine • Goldman-Cecil Medicine • Bradley & Daroff's Neurology in Clinical Practice • Gray's Anatomy for Students", note_style))

story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# PAGE 2 – CERVICAL LEVEL TABLE (C1–C8)
# ═══════════════════════════════════════════════════════════════════════════

story.append(Table([[Paragraph("CERVICAL SPINAL CORD INJURY  (C1 – C8)", title_style)]],
    colWidths=[26.6*cm]))
story[-1].setStyle(TableStyle([
    ("BACKGROUND",(0,0),(-1,-1),C_MED_BLUE),
    ("TOPPADDING",(0,0),(-1,-1),7),("BOTTOMPADDING",(0,0),(-1,-1),7),
]))
story.append(Spacer(1, 6))

cerv_hdr = [PH("Level"), PH("Key Muscles\nInnervated"), PH("Respiratory\nStatus"),
            PH("Bladder /\nBowel"), PH("Motor Function\nLost"), PH("Autonomic /\nOther Effects"), PH("Functional\nOutcome")]

cerv_data = [
    [PR("C1–C2"), P("Intrinsic neck\nmuscles only"),
     PR("APNOEIC\nVentilator forever"),
     PR("Complete\nneurogenic\nbladder & bowel"),
     PR("Quadriplegia\nALL four limbs;\nALL trunk"),
     PR("Life-threatening\nautonomic instability;\ncomplete sensory loss"),
     PR("Full-time care;\npower chair\n(head/chin/breath)")],

    [PR("C3"), P("Neck muscles\n(partial)"),
     PR("Requires\nventilatory\nsupport"),
     PR("Complete\nneurogenic"),
     PR("Quadriplegia;\nno shoulder\nmovement"),
     P("Phrenic nerve\ncompromised\n(C3-4-5)"),
     PR("Full-time care;\npower wheelchair")],

    [P("C4"), P("Diaphragm\n(partial) via\nphrenic nerve"),
     P("Borderline;\nmay wean\noff vent."),
     PR("Neurogenic\nbladder/bowel"),
     P("Quadriplegia;\nshoulder shrug\n(trapezius via XI)"),
     P("Shoulder shrug\npossible (CN XI);\nno elbow/wrist"),
     P("Power wheelchair\nwith chin control;\ntotal ADL depend.")],

    [P("C5"), P("Deltoid, biceps\n(elbow flexion)"),
     PG("Independent\nbreathing"),
     P("Neurogenic\nbladder/bowel"),
     P("Hands, forearms,\nlower limbs;\nno grip"),
     P("Can self-feed\nwith forearm\northosis & splints"),
     P("Power-assist\nwheelchair;\npartial self-care")],

    [PG("C6"), P("Wrist extensors;\nradial wrist\nextension"),
     PG("Normal"),
     P("Neurogenic;\nself-catheter-\nisation feasible"),
     P("Paralysis of hands\n& lower limbs;\nno finger flex."),
     PG("Tenodesis grip\n(passive finger\nclosure)"),
     PG("Manual wheelchair;\nupper limb dressing;\nsliding transfers")],

    [PG("C7"), P("Triceps (elbow\nextension);\nwrist flexors"),
     PG("Normal"),
     P("Neurogenic;\ncan use\nsuppositories"),
     P("Weak hand\nintrinsics;\nlower limb paresis"),
     PG("Better push-up\nability;\ntriceps intact"),
     PG("Most ADLs from\nwheelchair;\nbowel program")],

    [PG("C8"), P("Long finger\nflexors;\nhand intrinsics"),
     PG("Normal"),
     P("Neurogenic;\ncan perform self-\ncatheterisation"),
     P("Lower limb\nparaplegia;\nsome hand weakness"),
     PG("Grip present;\nalmost full\nUL function"),
     PG("Nearly full ADL\nindependence\nfrom wheelchair")],
]

cerv_tbl = Table([cerv_hdr]+cerv_data,
    colWidths=[1.6*cm, 3.5*cm, 3.2*cm, 3.2*cm, 3.8*cm, 4.3*cm, 4.0*cm],
    repeatRows=1)
cerv_tbl.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),  C_MED_BLUE),
    ("ROWBACKGROUNDS",(0,1),(-1,-1),  [C_GREY_ROW, C_WHITE]),
    ("BACKGROUND",    (0,1), (-1,3),  colors.HexColor("#FDECEA")),  # C1-C4 danger tint
    ("BACKGROUND",    (0,4), (-1,7),  C_WHITE),
    ("BACKGROUND",    (0,4), (-1,4),  C_GREY_ROW),
    ("BOX",           (0,0), (-1,-1), 0.6, C_MED_BLUE),
    ("INNERGRID",     (0,0), (-1,-1), 0.3, colors.HexColor("#BBBBBB")),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 4),
    ("FONTNAME",      (0,0), (-1,0),  "Helvetica-Bold"),
]))
story.append(cerv_tbl)

story.append(Spacer(1, 5))
story.append(Paragraph(
    "<b>Key:</b>  Red text = critical/life-threatening deficit  •  Green text = favourable function  •  "
    "Phrenic nerve origin = C3-C4-C5 (supplies diaphragm)  •  Brachial plexus starts at C5",
    note_style))

story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# PAGE 3 – THORACIC LEVEL TABLE (T1–T12)
# ═══════════════════════════════════════════════════════════════════════════

story.append(Table([[Paragraph("THORACIC SPINAL CORD INJURY  (T1 – T12)", title_style)]],
    colWidths=[26.6*cm]))
story[-1].setStyle(TableStyle([
    ("BACKGROUND",(0,0),(-1,-1),C_DARK_BLUE),
    ("TOPPADDING",(0,0),(-1,-1),7),("BOTTOMPADDING",(0,0),(-1,-1),7),
]))
story.append(Spacer(1, 6))

thor_hdr = [PH("Level"), PH("Key Muscles /\nStructures"), PH("Respiratory\nStatus"),
            PH("Bladder /\nBowel"), PH("Motor Loss"), PH("Autonomic /\nSpecial Effects"), PH("Functional\nOutcome")]

thor_data = [
    [PB("T1"), P("Intrinsic hand\nmuscles (thenar,\nhypoth., interossei)"),
     PG("Normal\n(intercostals\nabove intact)"),
     P("Neurogenic\nbladder/bowel"),
     P("Paraplegia (both\nlower limbs);\nweak hand intrinsics"),
     P("Horner syndrome\npossible if T1\nsympathetics cut"),
     PG("Full UL function;\nindependent manual\nwheelchair")],

    [PR("T2–T5"), P("Upper intercostal\nmuscles; upper\ntrunk"),
     P("Reduced reserve;\nweak cough;\nURI risk"),
     P("Neurogenic\nbladder;\nconstipation"),
     P("Paraplegia below\nT2; lower limbs &\nlower trunk"),
     PR("Cardiac sympathetics\n(T1-T4): neurogenic\nshock risk if >=T3"),
     P("Manual wheelchair;\nfull upper limb\nfunction")],

    [PR("T4"), P("Mid-chest\nintercostals"),
     P("Moderately\nreduced"),
     P("Neurogenic\nbladder/bowel"),
     P("Paraplegia below\nnipple line"),
     PR("NIPPLE LINE landmark\n(T4 dermatome);\nautonomic dysreflexia\nif stimulated"),
     P("Manual wheelchair;\nindependent\nupper body")],

    [PR("T6"), P("Mid-thoracic\nintercostals;\nupper abdominals"),
     P("Near-normal\nupper chest\nmovements"),
     P("Neurogenic\nbladder/bowel"),
     P("Paraplegia;\nupper abdominals\nnot yet intact"),
     PR("ABOVE T6 = RISK OF\nAUTONOMIC\nDYSREFLEXIA\n(splanchnic sympath.)"),
     P("Wheelchair\nindependent;\nimproved truncal\ncontrol")],

    [PG("T7–T9"), P("Lower intercostals;\npartial abdominals"),
     PG("Near-normal"),
     P("Neurogenic\nbladder/bowel"),
     P("Paraplegia; lower\nthoracic & lower\nlimbs affected"),
     P("Improving truncal\nstability; risk of\nautonomic dysreflexia\ndecreasing"),
     PG("Household ambulation\nwith KAFO+crutches\npossible for some")],

    [PG("T10"), P("Full abdominals;\nlower intercostals"),
     PG("Normal\n(full respiratory\nmuscle function)"),
     P("Neurogenic\nbladder/bowel\n(modifying)"),
     P("Paraplegia below\numbilicus; legs\nand lower trunk"),
     PG("UMBILICUS landmark\n(T10 dermatome);\ngood trunk stability;\nstrong cough"),
     PG("Good wheelchair\nindependence;\nsome walk with\northoses")],

    [PG("T11–T12"), P("Lower abdominals;\niliopsoas (partial);\nhip flexors begin"),
     PG("Normal"),
     P("Neurogenic bladder\nimproving toward\nconus level"),
     P("Paraplegia; hip\nflexors partially\npreserved"),
     PG("Closest to lumbar\nlevel; improving\nlower limb control"),
     PG("Better functional\noutcomes; lumbar\northosis + ambul.\nfeasible")],
]

thor_tbl = Table([thor_hdr]+thor_data,
    colWidths=[1.8*cm, 3.8*cm, 3.0*cm, 3.0*cm, 3.8*cm, 4.5*cm, 3.7*cm],
    repeatRows=1)
thor_tbl.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),  C_DARK_BLUE),
    ("ROWBACKGROUNDS",(0,1),(-1,-1),  [C_GREY_ROW, C_WHITE]),
    ("BACKGROUND",    (0,1), (-1,3),  colors.HexColor("#FDECEA")),  # T1-T6 danger
    ("BACKGROUND",    (0,4), (-1,7),  C_LIGHT_GREEN),
    ("BOX",           (0,0), (-1,-1), 0.6, C_DARK_BLUE),
    ("INNERGRID",     (0,0), (-1,-1), 0.3, colors.HexColor("#BBBBBB")),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 4),
    ("FONTNAME",      (0,0), (-1,0),  "Helvetica-Bold"),
]))
story.append(thor_tbl)

story.append(Spacer(1, 5))
story.append(Paragraph(
    "<b>Autonomic Dysreflexia:</b> Life-threatening hypertension triggered by noxious stimulus below lesion in injuries >=T6. "
    "<b>Neurogenic Shock:</b> Bradycardia + Hypotension + Vasodilation in injuries >=T3 (cardiac sympathetics T1-T4 disrupted). "
    "<b>Spinal Shock:</b> Temporary loss of ALL reflexes below injury immediately after SCI.",
    note_style))

story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# PAGE 4 – FUNCTIONAL SUMMARY + CLINICAL PEARLS
# ═══════════════════════════════════════════════════════════════════════════

story.append(Table([[Paragraph("FUNCTIONAL OUTCOMES SUMMARY  &  CLINICAL PEARLS", title_style)]],
    colWidths=[26.6*cm]))
story[-1].setStyle(TableStyle([
    ("BACKGROUND",(0,0),(-1,-1),C_MED_BLUE),
    ("TOPPADDING",(0,0),(-1,-1),7),("BOTTOMPADDING",(0,0),(-1,-1),7),
]))
story.append(Spacer(1, 8))

# ── Functional summary table ─────────────────────────────────────────────
func_hdr = [PH("Level"), PH("Category"), PH("Ventilation"), PH("Wheelchair"), PH("Upper Limb\nFunction"), PH("ADL\nIndependence"), PH("Ambulation\nPotential")]
func_data = [
    [PR("C1–C3"), PR("HIGH TETRAPLEGIA"), PR("Vent. dependent"), P("Power chair\nhead/chin ctrl"), PR("None"), PR("Total dependence"), PR("None")],
    [PR("C4"),    PR("TETRAPLEGIA"),     P("Possibly vent-free"), P("Power chair\nchin control"),  P("Shoulder shrug"),    PR("Total depend."),          PR("None")],
    [P("C5"),    PB("TETRAPLEGIA"),     PG("Independent"), P("Power-assist\nchair"),         P("Elbow flex;\nno grip"),         P("Partial; needs\ndevices"),          P("None")],
    [PG("C6"),   PB("TETRAPLEGIA"),     PG("Independent"), PG("Manual chair"),               PG("Tenodesis grip;\nwrist ext."),  PG("Partial ADL\nindependence"),       P("None")],
    [PG("C7"),   PB("TETRAPLEGIA"),     PG("Independent"), PG("Manual chair"),               PG("Triceps; most\nUL function"),   PG("Most ADLs"),                       P("None")],
    [PG("C8"),   PB("TETRAPLEGIA"),     PG("Independent"), PG("Manual chair"),               PG("Near-full\nhand function"),    PG("ADL independent"),                 P("None")],
    [PG("T1–T6"),PG("PARAPLEGIA"),      PG("Normal"),      PG("Manual chair"),               PG("Full"),                        PG("Independent"),                     P("Therapeutic only;\nKAFO needed")],
    [PG("T7–T12"),PG("PARAPLEGIA"),     PG("Normal"),      PG("Manual chair"),               PG("Full"),                        PG("Independent"),                     PG("Household / community\nambulation possible")],
]

func_tbl = Table([func_hdr]+func_data,
    colWidths=[1.8*cm, 3.5*cm, 3.0*cm, 3.5*cm, 4.0*cm, 4.0*cm, 4.0*cm],
    repeatRows=1)
func_tbl.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),  C_MED_BLUE),
    ("ROWBACKGROUNDS",(0,1),(-1,-1),  [C_GREY_ROW, C_WHITE]),
    ("BOX",           (0,0), (-1,-1), 0.6, C_MED_BLUE),
    ("INNERGRID",     (0,0), (-1,-1), 0.3, colors.HexColor("#BBBBBB")),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 5),
]))
story.append(func_tbl)
story.append(Spacer(1, 10))

# ── Clinical Pearls ────────────────────────────────────────────────────────
story.append(Paragraph("Clinical Pearls", h1_style))
story.append(HRFlowable(width="100%", thickness=1.5, color=C_MED_BLUE))
story.append(Spacer(1, 4))

pearls = [
    ("<b>Phrenic Nerve (C3-C4-C5):</b>", "Injury above C5 = loss of diaphragm = respiratory failure. Injury at C5 = borderline; may deteriorate as cord swells superiorly."),
    ("<b>Burning Hands Sign:</b>", "Complaint of 'burning hands' after trauma strongly suggests cervical SCI. Urgent imaging required."),
    ("<b>Neurogenic vs. Spinal Shock:</b>", "Spinal shock = temporary loss of ALL reflexes below lesion (resolves in days-weeks). Neurogenic shock (>=T3) = triad of bradycardia + hypotension + peripheral vasodilation (cardiac sympathetics T1-T4 lost)."),
    ("<b>Autonomic Dysreflexia:</b>", "Occurs in injuries >=T6. Massive sympathetic discharge from noxious stimulus below lesion (e.g., bladder distension, pressure sore). Presents as severe hypertension. EMERGENCY - remove stimulus immediately."),
    ("<b>T4 and T10 Landmarks:</b>", "T4 dermatome = nipple line. T10 dermatome = umbilicus. Use these to quickly estimate injury level on exam."),
    ("<b>Bladder in SCI:</b>", "Complete injuries almost never recover normal bladder function. ~15% of incomplete injuries do. Aggressive bladder management is essential to prevent upper tract damage and renal failure."),
    ("<b>Prognosis Rule:</b>", "ASIA A injuries: No motor recovery 2 levels below cervical SCI at 8 weeks = poor prognosis. ASIA C injuries: Highly likely to continue gaining motor function. 80% of central cord patients <50 yrs regain ambulation."),
    ("<b>Brown-Sequard Rule:</b>", "Hemisection = ipsilateral motor + proprio. loss; contralateral pain/temperature loss (spinothalamic tract crosses 1-2 segments before ascending). Best prognosis of all syndromes."),
]

pearl_rows = [[P(bold), PBody(desc)] for bold, desc in pearls]
pearl_tbl = Table(pearl_rows, colWidths=[5.2*cm, 21.4*cm])
pearl_tbl.setStyle(TableStyle([
    ("ROWBACKGROUNDS",(0,0),(-1,-1), [C_LIGHT_BLUE, C_WHITE]),
    ("VALIGN",       (0,0),(-1,-1),  "MIDDLE"),
    ("TOPPADDING",   (0,0),(-1,-1),  5),
    ("BOTTOMPADDING",(0,0),(-1,-1),  5),
    ("LEFTPADDING",  (0,0),(-1,-1),  6),
    ("BOX",          (0,0),(-1,-1),  0.5, C_MED_BLUE),
    ("INNERGRID",    (0,0),(-1,-1),  0.3, colors.HexColor("#AAAAAA")),
]))
story.append(pearl_tbl)

story.append(Spacer(1, 8))
story.append(Paragraph(
    "References: Goldman-Cecil Medicine Int. Ed. • Bradley & Daroff's Neurology in Clinical Practice • "
    "ROSEN's Emergency Medicine • Bailey & Love's Short Practice of Surgery 28e • Gray's Anatomy for Students • "
    "Ganong's Review of Medical Physiology 26e",
    note_style))

# ═══════════════════════════════════════════════════════════════════════════
# BUILD
# ═══════════════════════════════════════════════════════════════════════════
doc.build(story)
print("PDF generated:", OUTPUT)

Running Command

cd /home/daytona/workspace/sci-reference && python build_sci_pdf.py 2>&1

Running Command

ls -lh /home/daytona/workspace/sci-reference/SCI_Clinical_Reference.pdf

Your PDF is ready. Here's a summary of what's inside:

SCI Clinical Reference
PDF Document · PDF

A 4-page A4 landscape clinical reference card containing:

Page	Content
Page 1	ASIA Impairment Scale (Grade A-E) + Incomplete Syndromes comparison table (Central Cord, Brown-Sequard, Anterior Cord, Posterior Cord, Conus, Cauda Equina)
Page 2	Cervical Level Table (C1-C8) - Key muscles, respiratory status, bladder/bowel, motor loss, autonomic effects, functional outcome - color-coded red for critical levels (C1-C4)
Page 3	Thoracic Level Table (T1-T12) - Full level-wise breakdown with autonomic dysreflexia warnings at T6, neurogenic shock warning at T3, dermatome landmarks (T4=nipple, T10=umbilicus)
Page 4	Functional Outcomes Summary table (all levels C1-T12 in one grid) + 8 Clinical Pearls (burning hands sign, phrenic nerve rule, autonomic dysreflexia, prognosis rules, etc.)

Design features: Color coding (red = dangerous/critical, green = favourable function, light blue for pearls), clear column headers, alternating row shading for quick scanning, and source references at the bottom of each page.

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