The spinal cord is an elongated bundle of nervous tissue comprising of the cell bodies of locally acting neurons encased in white matter tracts, making it a highway for information to pass between the body and the brain. Together with the brain, it makes up the mammalian central nervous system (CNS). Spinal cord injury (SCI) results from an insult to the spinal cord that compromises, either temporarily or permanently, its major sensory, motor, autonomic, and reflex functions. This usually results in loss of function (paralysis) of the limbs, reduced organ and cardiovascular performance, autonomic dysreflexia, spasticity, and/or chronic pain. Secondary damage after the initial traumatic event includes programmed cell death (PCD), inflammatory immune response, and glial scarring, amongst others.

Spinal cord injury has a considerable impact on quality of life and life expectancy, especially as most cases occur in young adults between the ages of 16 and 30 (80% male). 52% of all patients develop paraplegia, and another 47% tetraplegia. There are currently about 250,000 cases in the United States alone, with 11,000 new cases every year. Damage from SCI is almost always irreversible, and thus has significant financial consequences. The lifetime cost for a tetraplegic comes to about $1.35 million. Treatment of SCI currently focuses on cellular (replacing neurons and myelin to improve endogenous repair) or molecular therapies (preventing secondary cell death and enhancing neurite growth), followed by rehabilitation. While many treatments have been found effective for clinical trials, many others are being researched on animal models.



  1. Mechanisms of secondary tissue degeneration following SCI (Jiayin Sun)
    1. Causes of Secondary Cell Death
    2. Glial Death
    3. Neuronal Death
    4. Wallerian Degeneration
  2. The pathophysiology underlying the inflammatory processes following SCI (Orest Kayder)
    1. Neutrophils
    2. Microglia infiltration
    3. Lymphocytes
    4. Macrophages
    5. Blood-spinal cord barrier alterations
  3. SCI therapeutics (Sanaz Shaghaghi)
    1. Manipulation of the glial scar as a therapy for SCI
    2. Genetically modified cell transplantation
    3. Stem cell transplantation
    4. Pharmacologic management
    5. Other strategies

References:

Amador MJ, and Guest JD. (2011). An Appraisal of Ongoing Experimental Procedures in Human Spinal Cord Injury. Journal of Neurological Physical Therapy. 29(2):70-
86.

Gaudet A.D., Popovich P.G., Ramer M.S. (2011). Wallerian degeneration: gaining perspective on inflammatory events after peripheral nerve injury, Journal of Neuroinflammation, 8(110): 1-13.

Saijo K., Glass C.K. (2011). Microglial cell origin and phenotypes in health and disease, Nature Review: Immunology, 11(11):775-87.

Thuret S, Moon LDF, and Gage FH. (2006). Therapeutic interventions after spinal cord injury. Nat Rev Neurosci. 7(8): 628-43.