The term "spinal shock" applies to all phenomena surrounding physiologic or anatomic transection of the spinal cord that results in temporary loss or depression of all or most spinal reflex activity below the level of the injury. Hypotension due to loss of sympathetic tone is a possible complication, depending on the level of the lesion.
What are the signs of spinal shock?
You may experience some or all of the following spinal shock symptoms as a result:
- Loss of sensation in your arms or legs
- Loss of movement in affected limbs
- Exaggerated reflexes
- Muscle spasms
- Tingling in your hands, fingers, feet, or toes
- Loss of bladder or bowel control
- Back pain
- An uncomfortable stinging sensation in your spine
- Breathing difficulties
- Pressure in your back or head
What is the treatment for spinal shock?
Spinal Shock Treatment Early medical intervention is crucial in the treatment of spinal cord injuries. By stabilizing the spinal cord as quickly as possible, the individual’s medical team may m inimize the progression of swelling and other secondary processes that contribute to spinal shock.
How long does spinal shock last?
The average duration of spinal shock is 4-12 weeks. If a patient has no motor control or sensation following SCI, a physician usually checks for a bulbocavernosus reflex, and/or anal reflex. If the anal sphincter does not contract with stimulation, it indicates that spinal shock is present.
What are the signs of spinal cord compression?
- Weakness in your arms and/or legs
- A loss of awareness of your limbs (this is called position sense)
- A feeling of electric-like pain or tingling shooting down your spine and into your legs after bending your neck forward (this is called Lhermitte sign)
- Reduced sensations of heat and cold in your hands and/or feet
- Reduced pain sensation
What are the signs and symptoms of spinal shock?
Symptoms of Spinal ShockAltered body temperature.Skin color and moisture changes (such as dry and pale skin)Abnormal perspiration function (decreased or increased sweating, flushing)Increased blood pressure and slowed heart rate.Irregularities in the musculoskeletal system.Altered sensory response.More items...
Does spinal shock go away?
Spinal shock usually lasts for days or weeks after spinal cord injury and the average duration is 4 to 12 weeks.
What type of shock is spinal shock?
Neurogenic shock is a devastating consequence of spinal cord injury (SCI). It manifests as hypotension, bradyarrhythmia, and temperature dysregulation due to peripheral vasodilatation following an injury to the spinal cord.
What are the stages of spinal shock?
We present here a new paradigm for spinal shock consisting of four phases: (1) areflexia/hyporeflexia, (2) initial reflex return, (3) early hyper-reflexia, and (4) late hyper-reflexia. It is increasingly apparent that spinal shock reflects underlying neuroplasticity after SCI.
Why does spinal shock happen?
Spinal shock is a result of severe spinal cord injury. It usually requires high-impact, direct trauma that leads to severe spinal cord injury and spinal shock. The initial encounter with a patient with spinal shock is usually under a trauma scenario.
What is the first reflex to recover after spinal shock?
The DPR was the first reflex to recover most often, followed by the BC, CRM in the first few days and later followed by the deep tendon reflexes (AJ & KJ) by 1-2 weeks respectively.
What are the 4 types of shock?
Hypovolemic shock (caused by too little blood volume) Anaphylactic shock (caused by allergic reaction) Septic shock (due to infections) Neurogenic shock (caused by damage to the nervous system)
How do we treat neurogenic shock?
Treatment for neurogenic shock generally involves:IV Fluids. IV fluids are the primary treatment for low blood pressure. ... Vasopressors. If IV fluids prove ineffective, vasopressors can help tighten blood vessels and increase blood pressure. ... Atropine. If your heart rate is low, your doctor may prescribe atropine.
How can you treat shock?
Shock TreatmentCall 911.Lay the Person Down, if Possible.Begin CPR, if Necessary.Treat Obvious Injuries.Keep Person Warm and Comfortable.Follow Up.
How do you diagnose spinal shock?
Diagnostic tests for spinal cord injuries may include a CT scan, MRI or X-ray These tests will help the doctors get a better look at abnormalities within the spinal cord. Your doctor will be able to see exactly where the spinal cord injury has occurred.
What happens immediately after spinal cord injury?
A spinal cord injury can cause one or more symptoms including: Numbness, tingling, or a loss of or changes in sensation in the hands and feet. Paralysis that may happen immediately or develop over time as swelling and bleeding affects the spinal cord. Pain or pressure in head, neck, or back.
How does a spinal cord injury affect the brain?
When the spinal cord is damaged, the message from the brain cannot get through. The spinal nerves below the level of injury get signals, but they are not able to go up the spinal tracts to the brain. Reflex movements can happen, but these are not movements that can be controlled.
Is neurogenic shock permanent?
Neurogenic shock generally lasts between 1-6 weeks after a spinal cord injury occurs. While it mostly affects the cardiovascular system, neurogenic shock can lead to permanent tissue damage if left untreated.
How do you recover from shock?
Lay the Person Down, if Possible. Elevate the person's feet about 12 inches unless head, neck, or back is injured or you suspect broken hip or leg bones. ... Begin CPR, if Necessary. If the person is not breathing or breathing seems dangerously weak: ... Treat Obvious Injuries.Keep Person Warm and Comfortable. ... Follow Up.
How can you tell the difference between spinal and neurogenic shock?
With spinal shock, your muscles are limp and you don't have your reflexes after a spinal cord injury. If you have neurogenic shock, you have a slow heart rhythm. If you have hypovolemic shock, you have a fast heart rhythm.
How do you diagnose spinal shock?
Diagnostic tests for spinal cord injuries may include a CT scan, MRI or X-ray These tests will help the doctors get a better look at abnormalities within the spinal cord. Your doctor will be able to see exactly where the spinal cord injury has occurred.
What Happens After A Spinal Shock?
Just as your body goes into a state of shock after a life-threatening injury, your spinal cord goes into a state of shock after an injury. Almost a...
Neurogenic Shock: A Related Condition
In people who suffer spinal cord injuries above thoracic nerves (specifically above T6), neurogenic shock can occur. Neurogenic shock is also due t...
Can Spinal Shock Be Treated?
Spinal shock is to spinal cord injuries as fevers are to infections. Spinal shock is merely a symptom of an underlying problem, not a disease itsel...
Long-Term Prognosis After Spinal Shock
Spinal shock follows a predictable, stereotypical patterns, and no specific treatment is necessary. The presence of spinal shock, however, suggests...
How to treat spinal shock injury?
Prophylaxis should be initiated as soon as possible within days of the injury. Long-term management of spinal shock injury patients always requires multidisciplinary team treatment between different services. Approximately 60% of these patients will require spine stabilization with surgical intervention, and neurosurgery or orthopedic professionals should be consulted early. Lastly, maintain high suspicion, but constant movement of the patient on a regular basis should help the patient not to develop a pressure ulcer. [3][4][5][6]
Why is spinal shock a challenge?
The overall treatment of patients with significant spinal shock and injury presents a big challenge due to poor outcome, especially in patients that are in the prime of their youth. Two common mechanisms lead to spinal shock.
What is the best imaging for spinal cord injury?
After the initial trauma, evaluation is completed, and if the patient is stable enough to undergo imaging, a complete spinal computed tomogram (CT) should be the initial imaging obtained. MRI spine imaging is very helpful but should not be the initial imaging modality. Myelogram would be helpful if the spinal shock is associated with canal compromise after fracture and would be the imaging of choice if the patient cannot obtain an MRI.
Why do men have secondary spinal cord injuries?
Secondary spinal cord injuries may be due to occlusion or disruption of arterial blood supply. The hypoperfusion leads to anoxic damage to the spinal cord. Epidemiology. Young men in their second decades of life are prone to spinal cord injury and clinical diagnosis of spinal shock.
What is the medical team for spinal shock?
Spinal shock carries very high morbidity if not immediately treated, thus, these patients must be managed by an interprofessional team that includes a trauma surgeon, neurologist intensivist, neurosurgeon, ICU nurses and the emergency department physician.
How long does spinal shock last?
The symptoms of spinal shock may last a few hours to several days/weeks. Primary spinal cord injury may be due to transection, mechanical injury, gunshots, abscess, metastatic disease or distraction of the nerves. These injuries are usually associated with dislocation and/or fracture of the vertebral bodies.
How common is spinal shock?
Spinal shock after a traumatic event affects mostly young; the average age is 29. It is more common in men (80%) than in women. Cord injury is often associated with fracture-dislocation, tearing of ligaments, rotational distraction, as well as tearing of the disc space.
What Causes Spinal Shock?
While the underlying mechanisms of spinal shock have yet to be fully understood, it’s suggested that spinal shock is caused by swelling following damage to the spinal cord. Generally, swelling peaks at about 3-6 days post-injury.
How long does spinal shock last?
Individuals may also initially experience hypotension (low blood pressure) and bradycardia (slow heart rate). Depending on the severity of the injury, spinal shock can last for days to weeks. The average duration is 4-12 weeks. While an official consensus has yet to be reached, many define the end of spinal shock as “the return ...
What does it mean when your reflexes are back?
The return of any sensation, motor control, or reflexes below the level of injury is an excellent sign of recovery. It indicates the SCI is incomplete, meaning that neural connections between the brain and areas innervated below the level of injury exist. Those spared neural connections are capable of using neuroplasticity (the central nervous system’s ability to adapt and reorganize itself) to potentially recover affected functions.
How to promote neuroplasticity after spinal cord injury?
The most effective way to promote neuroplasticity after spinal cord injury is through highly repetitive and task-specific practice of affected movements. Continuously practicing weakened functions will help reinforce demand for them and encourage the spinal cord to make adaptive changes.
How do you know if you have spinal shock?
Generally, individuals with spinal shock go from one extreme to the other. Initially, they experience flaccid, limp muscles and an absence of reflexes below their level of injury.
What does it mean when your anal sphincter is not contracting with stimulation?
If the anal sphincter does not contract with stimulation, it indicates that spinal shock is present. ...
Can you mistake a spinal cord injury for a complete one?
Due to the complete loss of functions, it is possible to mistake an incomplete spinal cord injury for a complete one. It isn’t until the swelling subsides that functions below the level of injury may begin to return. Make sure to speak with your medical team about whether they believe you are in spinal shock or not.
What is spinal shock?
Spinal Shock. Spinal shock is a result of severe spinal cord injury. It usually requires high-impact, direct trauma that leads to spinal cord injury and spinal shock. The initial encounter with a patient that has spinal shock is usually under a trauma scenario.
What is the best treatment for spinal shock?
Two common mechanisms lead to spinal shock. Regarding the treatment of spinal cord injury, the best treatment for the primary spinal cord injury is prevention. The injury associated with the primary event is irreversible. However, secondary injuries such as hypotension and hypoxia are preventable. Aggressive medical management can reduce its effect ...
What is cord injury?
Cord injury is often associated with fracture-dislocation, tearing of ligaments, rotational distraction, as well as tearing of the disc space. If the spinal shock is not associated with significant injury of the spinal column itself, then the prognosis for these patients is more favorable than when the fracture is present.
How old is the average person who gets spinal shock?
Spinal shock after a traumatic event affects mostly young; the average age is 29. It is more common in men (80%) than in women.
Can spinal cord injury cause spina?
Ischemia of the spinal cord can also produce a spina …. Spinal shock is a result of severe spinal cord injury. It usually requires high-impact, direct trauma that leads to spinal cord injury and spinal shock. The initial encounter with a patient that has spinal shock is usually under a trauma scenario. Ischemia of the spinal cord can also produce ...
Can spinal shock be a trauma?
The initial encounter with a patient that has spinal shock is usually under a trauma scenario. Ischemia of the spinal cord can also produce a spinal shock, for example, a hypotensive patient in the medical intensive care unit (ICU) or a post-angiography patient with thrombotic occlusion of arteries that supply the cervical spine.
What Is Spinal Shock and How Is It Treated?
Spinal shock is a condition that results in the temporary reduction or the loss of reflexes following a spinal cord injury. Similar to how your body can go into a state of shock after a traumatic experience, your spine can go into shock after a severe injury. Today, we take a closer look at what happens when your spine goes into shock, and how the condition is treated.
Why is spinal shock not easy to treat?
Treating spinal shock isn’t all that easy because it is a symptom of a larger issue, so trying to fix the symptoms won’t address the whole problem. It’s like trying to cure a fever that is caused by an infection.
What is stage IV in spinal cord injury?
Stage IV – Less frequent occurrences of hyperreflexia and muscle spasticity, return of normal reflexes as is consistent with the degree of your spinal cord injury.
What is it called when your spinal cord is swollen?
After a traumatic injury, your spinal cord may enter what’s known as hyporeflexia or areflexia.
Can your spine go into shock?
Similar to how your body can go into a state of shock after a traumatic experience, your spine can go into shock after a severe injury. Today, we take a closer look at what happens when your spine goes into shock, and how the condition is treated.
Can you heal from spinal shock?
Testing for spinal shock can help doctors gauge the severity of the spinal cord injury, and surgery to fix a problem can aid in reflex recovery, but most doctors allow spinal shock healing to occur on its own. Depending on your condition, you may be told to attend physical therapy sessions that will work to strengthen the spine and maintain function in the area.
Where does spinal shock occur?
Spinal shock can occur anywhere on the spine where there is spinal cord damage. Neurogenic shock, however, is a related but slightly different condition. It occurs when the damage is higher up, above the thoracic nerves, which can have an impact on autonomic responses such as your heartbeat and respiration.
What are the symptoms of spinal shock?
A person with spinal shock may also exhibit other symptoms such as changes in heart rate and blood pressure and bladder overflow and incontinence. These vary from individual to individual, however, and each case is unique.
What are the symptoms of spinal cord injury?
Because of their nature, spinal cord injuries give rise to a wide range of symptoms. One of the most common of these symptoms is spinal shock, where patients suffer a temporary or permanent loss of their natural reflex response.
How long does spinal shock last?
The first stage usually lasts about 24 hours and is accompanied by feelings of numbness and lack of response to reflex producing stimuli. The second stage is where the reflexes gradually begin to return and this normally takes place over couple of days after injury. The third and fourth stages of spinal shock can be a little disturbing ...
How to treat spinal cord injury?
Long term treatments may include physical therapy, medication and exercise therapy.
Why is spinal shock dangerous?
Spinal shock is a condition that inhibits our ability to do this and can put individuals at risk because they are unable to avoid dangerous situations. It normally accompanies any spinal injury and affects areas below the damage.
How many stages of spinal shock are there?
There are thought to be four stages to spinal shock.
What is spinal shock?
First defined in the 1700s, spinal shock is a loss of reflexes that occurs within minutes of a SCI. How severe it is will depend on the extent of the SCI. There are four common stages of spinal shock that typically occur following an injury to the spinal cord.
How long does it take for a spinal shock to set in?
Patients may notice a full or partial loss of spinal cord reflexes in the affected area. These initial symptoms start to develop soon after the SCI happens, although it may take several hours for the full effects of spinal shock to set in.
What reflexes do you have to have to recover from spinal shock?
As recovery from spinal shock continues, delayed plantar reflexes that usually respond to foot stimulation and bulbocavernosus reflexes may return next. The bulbocavernosus reflex is also what doctor’s may test to determine the extent of spinal shock.
What is it called when a patient's nervous system is twitching?
Patients at this stage may twitch involuntarily or become spastic. This reaction is referred to as hyperreflexia. While it may seem odd or disturbing when it occurs, it’s a positive sign of nervous system healing.
Can reflexes return to normal after SCI?
Reflexes begin to return to normal at this point. How well reflexes are able to get back to normal depends on the extent of the SCI. It’s possible to have a loss of sensation in some parts of the body from the SCI and the return of some reflex reactions. Spinal shock is often left to heal on its own since doctors are more focused on treating ...
Is the human spine susceptible to trauma?
The human spine is a remarkable creation, but it’s still susceptible to damage from some type of trauma, as may be the case with a spinal cord injury (SCI). When a SCI does occur, the body reacts with what’s known as spinal shock.
Can spinal shock heal itself?
Treatment for spinal shock may include decompression or spinal fusion surgery. Beverly Hills patients with SCIs must remember that a damaged spinal cord can’t heal itself.
What is spinal cord injury?
A spinal cord injury — damage to any part of the spinal cord or nerves at the end of the spinal canal (cauda equina) — often causes permanent changes in strength, sensation and other body functions below the site of the injury.
What is the term for a spinal cord injury that is completely lost?
Complete. If all feeling (sensory) and all ability to control movement (motor function) are lost below the spinal cord injury, your injury is called complete .
What are the two types of transmissions that the spinal cord and the brain carry?
Tracts in your spinal cord carry messages between your brain and the rest of your body. Motor tracts carry signals from your brain to control muscle movement. Sensory tracts carry signals from body parts to your brain relating to heat, cold, pressure, pain and the position of your limbs.
What causes nontraumatic spinal cord injury?
A nontraumatic spinal cord injury can be caused by arthritis, cancer, inflammation, infections or disk degeneration of the spine.
What percentage of spinal cord injuries are caused by violent encounters?
Acts of violence. About 12% of spinal cord injuries result from violent encounters, usually from gunshot wounds. Knife wounds also are common.
What is the lowest part of the spinal cord?
The lowest normal part of your spinal cord is referred to as the neurological level of your injury.
What causes a stinging sensation in the spinal cord?
Loss of bowel or bladder control. Exaggerated reflex activities or spasms. Changes in sexual function, sexual sensitivity and fertility. Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord.
What Is Spinal Shock?
This condition is simply a temporary reduction or loss of reflexes after an injury. It’s usually a combination of hyporeflexia and autonomic dysfunction.
What is the treatment for spinal shock?
There are various treatments for spinal chord injuries including surgery, traction, and medication (Medrol). A decompression laminectomy is a surgical procedure to remove tissue or fluid that is pressing on the spinal cord.
How long does it take for a spinal cord injury to return?
The second stage is the initial return of some of the reflexes. This occurs two to three days following the injury. The reflexes tend to return in phases with polysynaptic reflexes coming first.
What happens when you have a spinal cord injury?
When you experience a spinal cord injury, you’re likely to have a spinal shock. Most patients are curious about the recovery process because of the complex nature of the spine.
Why is the spinal cord important?
This is why it helps the rest of the body to communicate with the brain. Due to the intricacy of the central nervous system, any impact to the spinal cord is likely to affect several body functions.
How does the spinal cord work?
The nerves in the body are like a network of connected lines. All of them connect to the brain, and the spinal cord is the main line that connects nearly all body parts to the brain. The cord begins from the brain stem and goes all the way to the bottom ...
What is the Comprehensive Spine Institute?
At Comprehensive Spine Institute, we help you find the right treatment for your case. We offer different services, including surgery , physical therapy, and neurostimulation, to help manage your injury .
Overview
Your spinal cord is a cylindrical structure that runs through the center of your spine, from your brainstem to your low back. It's a delicate structure that contains nerve bundles and cells that carry messages from your brain to the rest of your body. Your spinal cord is one of the main parts of your nervous system.
Function
Your spinal cord’s main purpose is to carry nerve signals throughout your body. These nerve messages have three crucial functions. They:
Conditions and Disorders
Many disorders or injuries can affect your spinal cord. Spinal cord injuries and disorders are serious. Any injury to your spinal cord can cause severe symptoms in the parts of your body below the injury.
Care
You can keep your spinal cord, vertebral column and entire back healthier by practicing healthy habits. You may:
