Spinal Shock

Spinal shock is a term used for condition that follows transection of the spinal cord lasting about 2-3 weeks. It threatens the patient particularly by a severe temporary disturbance of sphincter functions.

Causes

The spinal shock is usually caused by a complete interruption of the spinal cord continuity. The reason is most often an injury during various accidents, spinal cord injuries are typically related to jumping into unknown shallow waters.

Symptoms

It is well-known that during spinal cord transection, the affected person immediately loses sensitivity and locomotion of the body parts innervated by nerves that comes from the spinal cord below the point of transection. This usually means loss of sensitivity and muscle paralysis of the trunk and lower limbs. In phase of the spinal shock, the affected muscles are flabby and we are not able to trigger muscle reflexes. The sphincters (anal and bladder sphincter) are also affected and they are unable to loosen. This causes disruption of urine flow and stool passage. Defecation disorder is especially dangerous as the stools accumulate in the intestine with increased risk of bacterial peritonitis.

 

If the patient is stabilized for about two or three weeks, the spinal shock will slowly disappear. The sensitivity and muscle ability to move do not return but at least muscle reflexes and involuntary sphincter functions reappear. The sphincters can not be relaxed by will but their spontaneously react to filled bladder or rectum allowing the urine or feces to leave the body. Involuntary leakage of urine and stool is of course also a problem but still better than their accumulation.

Diagnosis

The diagnosis of a spinal shock is relatively easy. It is stated by a neurologist in patients shortly after spinal cord injuries. The extent of injury may be further specified by computed tomography or magnetic resonance imaging of the spine.

Treatment

During the period of the spinal shock, it is advisable to catheterise the patient to allow the drainage of the urine; the feces must be removed manually. Often, the doctors temporary administer liquid diet or parenteral nutrition (i.e. nutritional solutions administered into the veins) together with prokinetic agents to prevent the formation of hard stool. Rehabilitation, careful nursing care, sanitation, adequate hygiene and prevention of dehydration and bedsores are important in supportive therapy.