Complete section of spinal cord

1
Complete section of spinal cord

• Prof. Ashraf Husain

2
Spinal shock

• Stages
• Spinal shock
• Paralysis of movement flaccidity, tendon
  reflexes absent
• Loss of all sensation
• Paralysis of bladder and rectum

3
Stage of reflex activity

• Two weeks after spinal shock there is return
• Of reflex activity
• Knee jerks come back first
• At the level of section of spinal cord
• Lower motor neuron type of paralysis
• Below the level of lesion
• upper motor neuron type of paralysis

4
Stage of failure reflex activity

• Causes
• If the gap between two cut ends of spinal cord
  are far apart.
• Abscess formation at the level of cut end.
• Cut ends becomes neuroma.

5
Complications of failure of reflex activity

• Loss of autonomic reflex.
• Reflex contraction of bladder occurs but rarely
  are urine is emptied, The bladder becomes atonic
  become automatic emptying every 3-4 hrs. through
  a reflex.
• Loss of sexual reflexes

6
Mass reflex

• In chronic spinal animals afferent stimuli
  irradiates from one reflex center to another even
  in minor stimuli this produce evacuation of
  bladder rectum, sweating, pallor, fluctuation
  in blood pressure associated with withdrawal
  reflex.

7
Effect of level of injury

• Upper cervical transverse section of spinal cord
  when includes C 3,4 5 will result in
  quadriplegia diaphragmatic paralysis. Such
  condition is usually fatal but now since
  diaphragmatic pacemakers are available life can
  be compatible.
• If the lesion is below C5 upto T1 there will be
  quadriplegia only.
• In the mid thoracic region down to lumbar will
  results in paraplegia. Paraplegia can be either
  in extension or in flexion depending on increased
  tone in extensor or flexor group of muscle.

8
Prognosis of transection of spinal cord

• Usually very poor death occurs due to
  septicemia, uremia, infection, bed soar (skin
  ulcer)
• Lot of future research is going on which might
  lead to meaningful life.