Abstract
The neuropathology of spinal cord injury (SCI) is reviewed in the light of clinical problems and as a guide to future research. The pathology of SCI in the acute stage suggests that the spinal cord may be partly preserved even in the most severe injuries. This finding emphasises the need for great care in roadside management. In the acute phase there are irreversible changes and possibly reversible changes which have not been adequately identified. Even a small percentage of nerve fibres escaping the initial injury would be of great benefit to the patient.
In the subacute stage when transynaptic degeneration is proceeding there may also be associated functional changes leading to abnormal reflex activity. It is possible through an improved understanding of the neuropathology and neurophysiology of the isolated or partly isolated segments of the cord that new reflex connections may be stimulated to develop by artificial means. In the chronic stage there are well recognised complications such as osteoarthrosis with spinal stenosis, post-traumatic syringomyelia and traumatic nerve root neuroma formation, which may lead to clinical deterioration and which may be amenable to treatment.
In a more theoretical sense it is possible that improved understanding of CNS plasticity and transplant neurobiology using recombinant DNA technology, grafting and ‘re-education’ of the regenerated tissues may be rewarding in the longterm future. Although this outcome is entirely hypothetical at this stage basic research deserves great emphasis.
Similar content being viewed by others
Article PDF
References
Kakulas B A, Bedbrook G M 1976 Injuries of the spine and spinal cord. In: Vinken PJ, Bruyn GW (eds) Handbook of Clinical Neurology, Chapter 3. North Holland Publishing Company, Amsterdam, pp. 27-42
Kakulas B A 1984 Pathology of spinal injuries. Central Nervous System Trauma 1: 117–129
Kao C C, Bunge R P, Reier P J (eds) 1983 Spinal Cord Reconstruction, Raven Press
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kakulas, B. The clinical neuropathology of spinal cord injury a guide to the future. Spinal Cord 25, 212–216 (1987). https://doi.org/10.1038/sc.1987.37
Issue Date:
DOI: https://doi.org/10.1038/sc.1987.37
Keywords
This article is cited by
-
Chemokines as Possible Targets in Modulation of the Secondary Damage After Acute Spinal Cord Injury: A Review
Cellular and Molecular Neurobiology (2009)
-
Neurom der Nervenwurzel L5 bei Zustand nach bestrahltem Neuroblastom
Klinische Neuroradiologie (1999)