Spinal Trauma

Acute spinal cord injury can result from compression, contusion, laceration, ischaemia or inflammation, with there often being a combination of these problems. The consequence of trauma is a series of harmful biochemical, vascular and metabolic events, typically referred to as secondary spinal cord injury. This process ultimately results in the death of neurons and supporting cells in an expanding zone of spinal cord tissue necrosis. The majority of this secondary damage occurs within the first 24 hours, depending on the nature of the initial insult. Neurons within the CNS cannot effectively regenerate axons, and so recovery following axonal transection or neuronal death is dependent on developing alternative routes of conduction through the surviving tissue. As a result, prognosis is greatly influenced by the severity of the damage at the time of evaluation. Treatment focuses on surgical decompression of compressive lesions, stabilization of unstable vertebral fractures, supportive care and physical rehabilitation to facilitate and maximize recovery.