• Ditunno JF, Little JW, Tessler A and Burns AS (2004). Spinal shock revisited: a four-phase model. Spinal Cord. 1Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA, USA. Spinal shock has been of interest to clinicians for over two centuries. Advances in our understanding of both the neurophysiology of the spinal cord and neuroplasticity following spinal cord injury have provided us with additional insight into the phenomena of spinal shock. In this review, we provide a historical background followed by a description of a novel four-phase model for understanding and describing spinal shock. Clinical implications of the model are discussed as well.Spinal Cord advance onine publication, 23 March 2004; doi:10.1038/sj.sc.3101603.