Question

G. H. is a 26-year-old male who was involved in a serious motorcycle accident that fractured his vertebrae and compressed his spinal cord at the level of T8. Answer the following questions:

1. What is spinal shock? How long can it last? Why is it difficult to determine the degree of injury and impairment during this time frame?
2. Immediately after this injury, what should you expect to occur for each of the following:
   1. Range of movement for his arms? For his legs? Why?
   2. Spastic or flaccid paralysis? Why?
   3. Bowel and/or bladder dysfunction? Why or why not?
   4. Breathing difficulties? Why or why not?
3. After the period of spinal shock, what changes should you expect to see (if any) in the manifestations listed in #2 above?
4. What type of rehabilitative treatments might G. H. need to promote his recovery and return to function?
5. If G. H. has mild-to-moderate chronic back pain one year after his accident, explain the pain management medications you would suggest to improve his quality of life and why you selected those particular medications.

Answer 1

#. The term “spinal shock” applies to all phenomena surrounding physiologic or anatomic transection of the spinal cord that results in temporary loss or depression of all or most spinal reflex activity below the level of the injury.

Spinal shock usually lasts for days or weeks after spinal cord injury and the average duration is 4 to 12 weeks.

#. It is difficult to determine degree of injury because often accompanied by a brain injury, preventing them from being able to verbalize what happened or what the damage is

#.Immediately after this injury, I would expect to occur the following:

Decreased range of movement for his arms, for his legs because  complete spinal cord injury affects everything from the injury down.

Flaccid paralysis:-

This abnormal condition may be caused by disease or by trauma affecting the nerves associated with the involved muscles

Bowel and/or bladder dysfunction :-

Due to interrupted communication between the brain and nerves supplying the bowel and bladder movement results in incontinence .

Breathing difficulties because complete spinal cord injury affects everything from the injury down. This means that if the diaphragm is affected, so are the intercostal and abdominal muscles. Without the use of these muscles, a person cannot breathe as easily or cough or sneeze well .

#. After the period of spinal shock, the changes that are expected to see are :-

- spastic paralysis

- hyperreflexia

- normal bowel and bladder function

- improvement in leg movement

- decreased breathing difficulty