Spinal shock


Spinal shock was first defined by Whytt in 1750 as a loss of sensation accompanied by motor paralysis with initial loss but gradual recovery of reflexes, following a spinal cord injury (SCI) -- most often a complete transection. Reflexes in the spinal cord caudal to the SCI are depressed (hyporeflexia) or absent (areflexia), while those rostral to the SCI remain unaffected. Note that the 'shock' in spinal shock does not refer to circulatory collapse


Absence of reflexes Tetraplegia Paraplegia Bladder overflow incontinence Paralysis of the bowel wall


Most serious spinal injuries result from motor vehicle accidents, falls, dives into shallow water, and gunshot wounds. Less serious injuries result from heavy object lifting and minor falls. Spinal dysfunction may also result from hyperparathyroidism and neoplastic lesions. Spinal cord injuries occur in 12,000 to 15,000 people per year in the United States. About 10,000 of these injuries cause permanent paralysis; many other patients die as a result of these injuries. Most spinal cord injuries occur in males between the ages of 15 to 35 years; about 5% occur in children. Mortality is higher in pediatric spinal cord injuries.


Treatment begins with the emergency medical personnel who make an initial evaluation and immobilise the patient for transport. Immediate medical care within the first 8 hours following injury is critical to the patient's recovery. Nowadays there is much greater knowledge about the moving and handling of spinal injury patients. Incorrect techniques used at this stage could worsen the injuries considerably.