Spinal shock: development mechanisms, symptoms and treatment

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2018-03-18 23:55:11

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Spinal shock – is a phenomenon in neurology, which is caused by the traumatic impact on the spine with spinal cord injury. It is expressed in the sudden depression of reflex centers in the spinal cord below the injury site. Artificial induction of reflexes above the affected area shows that there innervation is preserved. As a consequence, a decrease in blood pressure, lack of dermographism, as well as disruption of the pelvic organs.

Mechanism of development

spinal shock

A heavy blow on the body of man, fall from height, traffic accidents – all this can cause spinal shock. And the mechanisms of its development are the same in every case. The most frequent cause is a fracture of the spine, as the spinal damage will not only be at the site of injury, but in areas where disturbed blood circulation and lymph flow. This area and can be restored over time.

Nature provides a mechanism that protects tissues from more damage. It lies in the fact that the activity of nerve cells is inhibited below the injury site, thus, the affected area is at rest and recovers quickly. The transmission of nerve impulses through the conducting paths is terminated at the time of regeneration.

Diagnostics

spinal shock physiology

Immediately after the injury it is impossible to determine the damage to the spinal cord anatomical or functional nature. Spinal shock is characterized by the reversibility of the process and full or partial restoration of function. The level of injury of the spine forms a specific complex of symptoms, which gives the opportunity to diagnose the precise location of the lesions. For this you need to identify the lower portion of the spinal cord that are responsible for normal innervation. It may take some time, but the overall neurological examination will indicate the approximate region of the lesion.

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You must then send the patient for a brain imaging (CT or MRI) to accurately know the status of physician interest segments.

The Definition of sensitivity and motor activity

spinal shock and the mechanisms of its development

To determine the extent and level of the lesion, the neurologist evaluates the sensitivity and motor function of extremities of the patient on a scale. Five points – this is a normal performance, and zero - the complete absence of responses.

Muscles are investigated symmetrically and in turn from the trunk to the extremities. All results are summarized and displays the average total score, a separate sensitivity and motor areas. The inspection should be carried out several times during the entire period of stay in hospital, to dynamics, to monitor the recovery of functions. For example, if a month after initiation of treatment, patient total score of motor function of the lower limbs will be above fifteen points, by the end of the year, he very likely will be able to walk.

Levels of destruction

the stage of spinal shock

Signs of spinal shock is directly dependent on the level of the lesion.

If the injury was at the level of the cervical vertebrae, it leads to immobilization of the upper and lower extremities. Inhibited respiratory function and heartbeat. Patients have to be on the ventilator and they must be permanent care.

Defeat at the level of the lower segments of the cervical spine maintains the normal work of the upper limbs. But if affected and thoracic vertebrae, the patient is still experiencing breathing problems and heart rhythm. Damage at the level of the navel causes spinal shock with immobilization of the muscles of the back and lower limbs, and also disrupts the pelvic organs by type of delay.

The Most favorable option is a spinal cord injury at the level of the lumbosacral segment. Spinal shock is only a violation of movements in the lower extremities while preserving the parts of sensitivity.

Periods of disease

signs of spinal shock

The Disease is partially or completely reversible, so a few months later after injury, the patients feel better, they return the lost functions. There are four stages of spinal shock.

1. The acute phase, which lasts for the first three days after injury. It is characterized by the absence of nerve impulses below the injury regardless of the severity of damage.

2. Subacute period lasts about a month. During the restoration of the damaged structures of the spinal cord, the appearance of scar tissue at the site of trauma, the normalization of blood circulation and limfoottoka.

3. The interim period can last up to six months. At this stage the Central inhibition of nerve impulses is terminated, the clinic prevail only irreversible neurological changes.

4. Late period, which may last several years after injury. This time, the slow recovery of lost functions. But along with the probability of positive dynamics, it is also possible scarring matter of the spinal cord at the site of injury and worsening of neurological symptoms.

For doctors and patients it is helpful to remember that a complete lack of improvement in the first week is a bad prognostic sign and may indicate that the lost function is restored. Conversely, if in the first week there have been some shifts, then the chances of full recovery.

Disease Duration

Not only do people get spinal shock. Physiology, in the broadest sense of the word, proves that in animals a similar condition is also possible. For example, in frogs it lasts up to five minutes, the dogs – about a week, monkeys are forced to endure the inconvenience a month. The people in this list are the most recent position. They have the greatest duration of spinal shock – two months.

If after the injury the spinal cord remains anatomically intact, then after a while the reflexes are restored. It all depends on how the patient is to the treatment and have faith in yourself.

Treatment

spinal shock is characterized by

The sooner the victim gets to a hospital, where he will be able to provide expert help, the greater the chance that he will recover. In addition, great importance is first aid and transportation. To shift the patient to gently, move only on a rigid Board or panel so as not to exacerbate the damage.

To Treat spinal shock up correctly with immobilization of the spine. Then conduct a series of surgical interventions for decompression of spinal cord, removal of bone fragments vertebrae of necrotic tissue and foreign bodies. After this, the surgeon makes a plastic lost bone formation.

Conservative therapy is the use of corticosteroids, such as"Dexamethasone" or "Prednisolone", and muscle relaxants Central actions – "Mydocalm", "Sirdalud", "Baclofen". First relieve pain symptoms, swelling, reduce inflammation. And the second help to relieve stress on the spine.

As a long time patient is immobilized, it is necessary for the prevention of bedsores, massages, gymnastics and breathing exercises to prevent pneumonia.

Hope for recovery

the greatest duration of spinal shock

Complete immobility adversely affects the patient's mind. People mentally prepare themselves for a lifetime be confined to bed or a wheelchair and will be dependent on family and friends. At this point it is important to have someone around who, no matter what, would believe in the success of the ongoing procedures.

Often after the skilled assistance of the victims quickly be on his feet. The most severe cases occur in patients with injuries of the cervical and thoracic spine. In this case, a high risk of death from stopping breathing or heartbeat. If medical assistance was rendered incorrectly or late, the state of spinal shock can last for years.

Spinal shock – reversible lesion of the spinal cord, which may enter into the human mind in the motionless body. It all depends on the conditions of injury, level of injury, and literacy assistance.

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Article in other languages:

AR: https://www.tostpost.com/ar/health/13753-spinal-shock-development-mechanisms-symptoms-and-treatment.html

BE: https://www.tostpost.com/be/zdaro-e/24589-sp-nal-nyh-shok-mehan-zmy-razv-ccya-s-mptomy-asabl-vasc-lyachennya.html

DE: https://www.tostpost.com/de/gesundheit/24606-spinale-schock-mechanismen-der-entwicklung-symptome-und-behandlung-fea.html

ES: https://www.tostpost.com/es/la-salud/24631-spinal-nyy-shock-mecanismos-de-desarrollo-los-s-ntomas-y-las-caracter-.html

HI: https://www.tostpost.com/hi/health/13776-spinal-shock-development-mechanisms-symptoms-and-treatment.html

JA: https://www.tostpost.com/ja/health/13778-spinal-shock-development-mechanisms-symptoms-and-treatment.html

KK: https://www.tostpost.com/kk/densauly/24578-spinal-nyy-shok-damu-mehanizm-belg-ler-zh-ne-emdeu-erekshel-kter.html

PL: https://www.tostpost.com/pl/zdrowie/24503-spinal-szok-mechanizmy-rozwoju-objawy-i-mo-liwo-ci-leczenia.html

PT: https://www.tostpost.com/pt/sa-de/24516-spinal-nyy-choque-mecanismos-de-desenvolvimento-os-sintomas-e-caracter.html

TR: https://www.tostpost.com/tr/sa-l-k/24582-spinal-ok-geli-me-mekanizmalar-belirtileri-ve-tedavi-zellikleri.html

UK: https://www.tostpost.com/uk/zdorov-ya/24556-sp-nal-niy-shok-mehan-zmi-rozvitku-simptomi-ta-osoblivost-l-kuvannya.html






Alin Trodden - author of the article, editor
"Hi, I'm Alin Trodden. I write texts, read books, and look for impressions. And I'm not bad at telling you about it. I am always happy to participate in interesting projects."

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