1. Complete section of spinal cord Prof. Ashraf Husain

2. Spinal shock Stages 1.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 1.At the level of section of spinal cord: Lower motor neuron type of paralysis 2.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.