The human spine is a remarkable creation, but it’s still susceptible to damage from some type of trauma, as may be the case with a spinal cord injury (SCI). When a SCI does occur, the body reacts with what’s known as spinal shock. First defined in the 1700s, spinal shock is a loss of reflexes that occurs within minutes of a SCI. How severe it is will depend on the extent of the SCI. There are four common stages of spinal shock that typically occur following an injury to the spinal cord.
Stage I: Less Responsive Spinal Nerve Cells
When spinal shock occurs, the nervous system can’t transmit signals. Immediately after the SCI, nerve cells in the spine become less responsive. Patients may notice a full or partial loss of spinal cord reflexes in the affected area. These initial symptoms start to develop soon after the SCI happens, although it may take several hours for the full effects of spinal shock to set in.
Stage II: Some Reflexes Return
Spinal shock typically lasts for about 4-6 weeks after the initial injury. After a few months, some reflexes may start to return. Polysynaptic reflexes that require signals to go from sensory neurons to motor neurons are usually the first type of reflexes to return.
A practical example of this is the knee taps doctors sometimes do to determine if sensation and reflexes are coming back. When polysynaptic reflexes return, a tap on a knee results in a nerve signal being sent to the spinal cord. The spine will then relay this signal to the appropriate motor nerve to make the tapped knee jerk.
As recovery from spinal shock continues, delayed plantar reflexes that usually respond to foot stimulation and bulbocavernosus reflexes may return next. The bulbocavernosus reflex is also what doctor’s may test to determine the extent of spinal shock. The test involves monitoring anus contractions by pressing the glans penis or vulva or pulling an attached catheter.
Stage III: Overactive or Overresponsive Reflexes
The growth of new nerve connections (synapses) sometimes results in what may seem like an odd nervous system response in patients with SCIs. Patients at this stage may twitch involuntarily or become spastic. This reaction is referred to as hyperreflexia. While it may seem odd or disturbing when it occurs, it’s a positive sign of nervous system healing.
Stage IV: Signs of Normal Reflex Reactions
During this stage, patients have less spastic reflex reactions. Reflexes begin to return to normal at this point. How well reflexes are able to get back to normal depends on the extent of the SCI. It’s possible to have a loss of sensation in some parts of the body from the SCI and the return of some reflex reactions.
Spinal shock is often left to heal on its own since doctors are more focused on treating the injured spinal cord and not related reflex problems. Treatment for spinal shock may include decompression or spinal fusion surgery. Beverly Hills patients with SCIs must remember that a damaged spinal cord can’t heal itself. However, there’s promising research involving stem cells and the creation of special neurons that may help the 17,000+ people who sustain SCIs each year.
If you have sustained a spinal injury, make sure to speak with a trusted minimally invasive spine surgeon. Beverly Hills residents can rely on Dr. Hyun Bae at The Spine Institute to diagnose the source of their pain and determine an effective method for finding relief. Call 310-828-7757 today to schedule an in-person evaluation.