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Spinal Shock: Definition and Reflex Evolution Pattern

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Management and Rehabilitation of Spinal Cord Injuries

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Abstract

Initially, it was defined by Bastian as a complete severance of the spinal cord, which leads to a complete loss of motor and sensory function below the level of the lesion, as well as permanent extinction of tendon reflexes and muscle tone although the reflex arc remains intact. Flaccid motor paralysis is observed immediately after the acute onset of complete spinal cord injury below the level of injury with no motor responses to external stimuli. Sherrington replaced Bastian’s use of the term “permanent” with a “temporary” extinction of the reflex below the level of the lesion. Spinal shock is pronounced only in primates, especially in humans, due to such a dominance of an inhibitory mechanism in the spinal cord. In general, the more severe the physiologic or anatomic transection of the spinal cord, the more profound the spinal shock. Spinal shock does not occur with slowly developing spinal cord diseases or injuries.

The pattern of natural course following a spinal cord injury distinguishes between sudden onset and slow changes in the spinal cord. In the next days and weeks, motor reactions to external stimuli gradually reappear systematically. The definition of spinal shock and the pattern of reflex recovery or evolution and muscle tone recovery remain issues of debate and controversy. This chapter describes the definition, pathophysiology, and clinical significance of spinal shock, which is not well established and has a lot of controversies.

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Authors and Affiliations

  1. Parkside Rehabilitation Hospital, Busan, Korea (Republic of)

    Hyun-Yoon Ko

  2. Department of Rehabilitation Medicine, Rehabilitation Hospital, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Yangsan, Korea (Republic of)

    Hyun-Yoon Ko

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Ko, HY. (2022). Spinal Shock: Definition and Reflex Evolution Pattern. In: Management and Rehabilitation of Spinal Cord Injuries. Springer, Singapore. https://doi.org/10.1007/978-981-19-0228-4_14

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  • DOI: https://doi.org/10.1007/978-981-19-0228-4_14

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