PAPER 191: DURATION OF SPINAL SHOCK IN SPINAL CORD INJURIES

Abstract

Purpose: 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.

Method: 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 The mean duration of spinal shock was studied on factors as age, sex, nutritional status (haemoglobin, triceps skin fold thickness, & mid arm circumference), occupation (educated/uneducated, trained/untrained), mode of trauma, duration of injury, skeletal level of injury, neurological level, associated injuries, treatment modality and development of complications during spinal shock

Results: 59 patients (51%) had spinal shock duration of < 1 week; 10 (8.6%) recovered between 1st and 2nd week, 15 (13%) between 2nd and 3rd week & 4 (5%) had recovered after 3 weeks. 28 patients (25%) remained in spinal shock till discharge (6 weeks). In 76 patients (85.4%) anal wink (AW) was the first reflex to return either alone or simultaneous with BC/DPR. In none of the patients BC or DPR appeared before AW. In 7 patients (9%) cremastric reflex was first reflex to return, in 3 pathological reflexes & in 2 deep tendon reflexes (ankle) were the first to return.

Conclusion: On statistical analysis mean duration of spinal shock was shorter in children as compared to adults, shorter in malnourished as compared to normal, shorter in untrained as compared to trained, shorter in patients admitted early and shorter in patients who developed complications as compared to those who did not. Mean duration of spinal shock increased progressively down the spine and spinal cord as we move from cervical to thoracic to lumbar region. Mean duration of spinal cord was not influenced by sex of patient, associated injuries to other parts of body and by different modes of treatment