Complete spinal cord injuries
- No Anal contraction or Deep anal pressure sensation in the absence of spinal shock
- Prognosis
- Within 24hrs: 3% of patients with complete injuries on initial exam will develop some recovery
- Beyond 72hrs: Recovery is essentially zero if the spinal cord injury remains complete
- In addition to loss of voluntary movement, sphincter control and sensation below the level of the injury, there may be priapism.
- Hypotension and bradycardia (Neurogenic shock) may also present
Bulbar-cervical dissociation
- Occurs as a result of spinal cord injury at or above ≈ C3
- Includes SCI from atlantooccipital and atlantoaxial dislocation
- Causes
- Immediate pulmonary and, often, cardiac arrest.
- Death results if CPR is not instituted within minutes.
- Patients are usually quadriplegic and ventilator dependent (phrenic nerve stimulation may eventually allow independence from ventilator).