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Spinal Shock in Spinal Cord Injuries ‐ Is Duration of Shock Related to Neurological Level?: Paper #63

Srivastava, Rajeshwar N. MS

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Spine Journal Meeting Abstracts: September 2009 - Volume 10 - Issue - p 98
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Introduction: A study was done to determine the duration of spinal shock in spinal cord injury (SCI), the first reflex to return while recovering from spinal shock & the factors influencing duration of spinal shock.

Methods: 116 patients in spinal shock following SCI were included. A detailed neurological examination of sensory, motor and reflex activity was done everyday till the patients were out of spinal shock. The duration of spinal shock by appearance of any reflex, the first reflex to return & the influence of variable factors on duration of spinal shock were studied

Results: In 76 patients (85.4%) anal wink (AW) was the first reflex to return either alone or simultaneous with BC / DPR.In 7 patients cremastric reflex, in 3 pathological reflexes & in 2 deep tendon reflexes (ankle) were the first to return. Mean duration of spinal shock (MD of SS) was shorter in children, shorter in malnourished, shorter in untrained/laborers, shorter in patients admitted early and shorter in patients without any complications. ‘MD of SS’ was not influenced by sex of patient, associated injuries and by different modalities of treatment.

Conclusion: On statistical analysis of duration of spinal shock with neurological level as a variable ‘MD of SS 'was 1.7 days in cervical cord lesions, 8.2 days in upper thoracic, 15 days in lower thoracic and 17 days in lumbar cord lesions. Such an arithmetical progression was also found at each segmental level i.e. the duration of spinal shock progressively increased at every segmental level. ‘MD of SS’ was 1.36days at C4, 1.60 at C5, 1.72 at C6, 8.1 at T6, 12.4 at T8, 13.1 at T10, 15.3 at T12 & 21.6 at L2.

Significance: An arithmetical relationship exist between the duration of spinal shock and the segmental level of spinal cord injury ‐ the duration of spinal shock was directly proportional to level of injury We do not have the answer of this important observation of arithmetical progression of spinal shock duration in relation to level of injury. Higher or proximal the lesion, shorter is the duration. Does the duration of spinal shock dependant on the cord length/ neuronal mass involved?

© 2009 Lippincott Williams & Wilkins, Inc.