Spinal shock is defined as a condition that occurs after a spinal cord injury with partial or complete severing of the nerve tracts in the body parts below the site of the injury, so that external and intrinsic reflexes are also completely eliminated. The skeletal muscles and also the visceromotor autonomic muscles succumb to the spinal shock and are completely paralyzed. Spinal shock lasts from a few hours to several months, with an average of four to six weeks.
What is spinal shock?
Spinal shock, which occurs after a spinal cord lesion, is characterized by a complete nervous blockage of certain parts of the body. These are the body regions whose nervous supply is directly affected by the spinal cord lesion. Spinal shock paralyzes not only the voluntary skeletal muscles but also the involuntary visceromotor muscles. For what does the abbreviation ds stand for, please visit usvsukenglish.com.
In addition, sensory perceptions and the vegetative control circuits of basic functions such as thermoregulation and the like are overridden. All affected muscles lose their basic tone, their basic tension. The spinal shock differs clearly from the paraplegia that may appear later.
In the event of a spinal shock, the entire voluntary and involuntary nerve network, including the sympathetic and parasympathetic nervous system, is completely blocked, regardless of whether the nerve connections are still there or whether the control circuits and sensors are still intact. One gets the impression that spinal shock corresponds to a protective mechanism.
This may prevent incorrect reactions or incorrectly reacting control circuits from forming. The temporary total shutdown allows the blockage to be gradually resolved later, which corresponds to a gradual and experimental reconnection of certain nerve groups.
Causes
Physiologically, spinal shock is triggered by a massive leakage of potassium ions from the cells into the intercellular space. The reasons why this mechanism is set in motion are mostly due to an accidental lesion of the spinal cord. Spinal shock can occur when all or part of the spinal cord is severed, cutting nerve pathways.
A sudden compression of the spinal cord can also trigger spinal shock, although all nerve connections are still mechanically intact – as it may turn out later. Accidents related to external forces are not the sole cause of spinal shock. Tissue proliferation within the spinal canal or at the entry and exit points of the nerves can lead to displacement and finally to a crushing of the nerves with loss of function and possibly trigger a spinal shock.
Similar symptoms can result from a sudden and massive herniated disc. Another triggering problem can arise with the otherwise gentle peridural or spinal anesthesia. In rare cases, there is a shock-like drop in blood pressure, which is probably due to the induction of spinal shock.
Symptoms, Ailments & Signs
Spinal shock is associated with serious symptoms and conditions that usually require treatment and care in a trauma room or intensive care unit. The symptoms and signs described below always relate to body regions below the level where the spinal cord lesion occurred.
First of all, a complete paralysis with a noticeably slack tone can be observed in all affected muscle parts. Due to the loss of sympathetic stimuli, the blood pressure drops sharply and the heart rate is usually slower. Symptomatic is an involuntary and uncontrollable loss of urine and stool.
The thermal and sweat regulation are disturbed. For a short time, the skin feels warm and has good blood circulation because the peripheral vessels dilate due to the lack of sympathetic stimuli, which can lead to rapid heat loss when outside temperatures are low.
Diagnosis & course of disease
In most cases, spinal shock occurs as a result of an accident, so the initial diagnosis is carried out at the scene of the accident with possibly insufficient tools. A reliable diagnosis as to whether spinal shock is present can only be made after initial care and admission to the shock room or intensive care unit.
The course of spinal shock depends very much on the severity and location of the spinal cord lesion, on the initial treatment and on the constitution of the injured person. In the case of minor injuries or a spinal cord sprain, the spinal shock can resolve itself after just a few hours, allowing normal bodily functions to return.
In the case of more serious injuries with subsequent paraplegia, spinal shock can last up to several months in extreme cases. On average, the shock resolves after a few weeks.
Complications
This condition is a very serious condition. In most cases, no treatment can be carried out if the nerve tracts have already been completely severed. Those affected primarily suffer from severe paralysis.
They usually occur directly below the affected level and can make everyday life of the patient considerably more difficult. This leads to restricted movement, so that most of those affected are dependent on a walking aid or a wheelchair. The shock also causes blood pressure to drop and the heart rate to drop, so that those affected can lose consciousness.
Furthermore, stimuli or reflexes are also lost. In many cases, those affected also suffer from psychological problems or depression due to the loss of movement. Since direct treatment of the paralysis is usually not possible, only the remaining symptoms are treated. There are no particular complications.
However, those affected also need psychological treatment. Furthermore, no general statement can be made about life expectancy. As a rule, the further course of the disease also depends heavily on the cause of this shock.
When should you go to the doctor?
In the event of such a shock, a doctor must always be consulted immediately. Only by treating this complaint quickly and directly can further complications be prevented. In the worst case, the nerve tracts are completely severed, leaving the patient completely paraplegic.
The doctor should be contacted if there is severe paralysis of the muscles in different parts of the body. This paralysis usually affects the body regions below the hips, so that the person concerned can no longer move his legs. The muscles become slack and can no longer be moved. In many cases, a strong or even uncontrolled urge to urinate can also indicate this shock. Furthermore, some of those affected also show uncontrolled sweat production. If these symptoms occur, the doctor to be treated in the hospital must be contacted immediately.
Treatment & Therapy
The treatment of spinal shock is initially limited to emergency care, taking into account the other injuries, especially spinal cord injuries. First aid or emergency care is aimed at maintaining or regaining vital functions such as breathing and circulation. In addition, heat regulation plays a major role.
It must be ensured that the heat loss is minimized by a special blanket or even heat is supplied in order to keep the body temperature in an acceptable range above 35 degrees Celsius. Further treatment is usually based on the diagnosed injuries. A direct medicinal or other therapy for the rapid resolution of the spinal shock is not known.
Prevention
Direct preventive measures to avoid spinal shock do not exist. Indirect preventive protection consists in avoiding high-risk sports and other situations with a risk of spinal injuries. Regular light sport with back gymnastics largely prevents intervertebral disc problems. Nevertheless, residual risks remain that cannot be completely avoided and can be assigned to the general risk of life.
Aftercare
Spinal shock is caused by trauma to the spine. The characteristic symptoms include signs of paralysis, immobility, shortness of breath and restricted activity of the internal organs. In any case, this situation must be taken seriously. It requires immediate medical attention. Follow-up care is necessary to avoid permanent damage.
Most often, the spinal cord is damaged by an accident. Spinal shock occurs about an hour after injury. It lasts from a few days to six weeks. Only after this period can the severity of the paraplegia be determined. During this time, the patient is under medical care in the hospital. Follow-up care begins during the patient’s stay in the hospital.
Consequential damage can be combated in a more targeted manner with early therapy. The muscle reflexes gradually return. If the course is favorable, the spinal shock heals without consequences. A slight contusion of the spinal cord does not have any long-term consequences. The patient is discharged from the clinic. He should still attend regular check-ups by a neurologist.
In severe cases, permanent damage to the spine remains. Follow-up care for paraplegia lasts a lifetime. The person concerned learns how to deal with the paralysis appropriately. There is no universal treatment. It is different for each patient. The orthopedist adjusts them individually.
You can do that yourself
In the case of spinal shock, the possibilities for self-help for the person concerned are very small. It is primarily about strengthening the psyche and optimizing the inner attitude for dealing with the disease. Self-help approaches are very limited, since there are no treatment methods outside of medical care that would allow for an improvement in the state of health. Mental support is therefore particularly important.
Regular exercises to support the skeletal system and the muscular system can be carried out as a preventive measure. Therapeutic exercises for stabilization and a timely reaction to severe physical stress are particularly helpful. States of overexertion should therefore be avoided.
However, once the condition has been diagnosed, the sufferer has little ability to control his own body. The paralysis and loss of movement prevent him from performing adequate activities. If the muscles can be moved in some areas of the body, they should be trained regularly. Learned training units can also be carried out independently outside of therapy.
What is important is a positive attitude towards life and the belief that improvements are possible despite all adversities. The state of shock represents an emergency situation. Trust in the treating physician is particularly important at this time. You should work with them as closely as possible.
