Abstract
The anatomical pattern of damage following upon traumatic injury to the human spinal cord is dependent upon the manner in which the injury is sustained. Hyperflexion typically results in anterior spinal cord injury, hyperextension in central spinal cord injury, stab wounds in hemisection injury, and complete crush in total spinal cord injury. Secondary lesions may appear hours to years later and may result in serious additional disability. The presence of congenital spinal stenosis, cervical spondylosis, or ossification of the posterior longitudinal ligament may greatly enhance the likelihood of damage following blunt injuries to the spine.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Khan M, Griebel R (1983) Acute spinal cord injury in the rat: comparison of three experimental techniques. Can J Neurol Sci 10(2):161–165
Sekhon LHS, Fehlings MG (2001) Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine 26(Suppl 24):S2–S12
Norenberg MD, Smith J, Marcillo A (2004) The pathology of human spinal cord injury: defining the problems. J Neurotrauma 21(4):429–440
Tator CH (1996) Classification of spinal cord injury based on neurological presentation. In: Narayan R, Wilberger JE Jr, Povlishock JT (eds) Neurotrauma. McGraw-Hill, New York, pp 1059–1073
Lipschitz R (1976) Stab wounds of the spinal cord. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 25. North-Holland, Amsterdam, pp 197–207
Kakulas BA (1984) Pathology of spinal injuries. CNS Trauma 1(2):117–129
Tator CH, Koyanagi I (1997) Vascular mechanisms in the pathophysiology of human spinal cord injury. J Neurosurg 86(3):483–492
Bailey FW (1971) Trauma of the spinal cord. In: Minckler J (ed) Pathology of the nervous system, vol 2. McGraw-Hill, New York, pp 1765–1774
Jellinger K (1976) Neuropathology of cord injuries. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 25. North-Holland, Amsterdam, pp 43–121
Zwimpfer TJ, Bernstein M (1990) Spinal cord concussion. J Neurosurg 72(6):894–900
Davison C (1945) General pathology of injuries of the spinal cord. Res Publ Assoc Nerv Ment Dis 24:151–187
Jellinger K (1976) Traumatic vascular disease of the spinal cord. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 12. North-Holland, Amsterdam, pp 556–630
Balentine JD (1988) Impact injuries of the spine and spinal cord. In: Leestma J (ed) Forensic neuropathology. McGraw-Hill, New York, pp 254–275
McVeigh JF (1923) Experimental cord crushes with special reference to the mechanical factors involved and subsequent changes in the areas of the cord affected. Arch Surg 7(3):573–600
Hashizume Y, Iijima S, Kishimoto H, Hirano A (1983) Pencil-shaped softening of the spinal cord: pathologic study in 12 autopsy cases. Acta Neuropathol 61(3–4):219–224
Ito T, Oyanagi K, Wakabayashi K, Ikuta F (1997) Traumatic spinal cord injury: a neuropathological study on the longitudinal spreading of the lesions. Acta Neuropathol 93(1):13–18
Bunge RP, Puckett WR, Becerra JL, Marcillo A, Quencer RM (1993) Observations on the pathology of human spinal cord injury: a review and classification of 22 new cases with details from a case of chronic cord compression with extensive focal demyelination. Adv Neurol 59:75–89
Kakulas BA (1999) A review of the neuropathology of human spinal cord injury with emphasis on special features. J Spinal Cord Med 119(2):117–124
Cornish R, Blumbergs PC, Manavis J, Scott G, Jones NR, Reilly PL (2000) Topography and severity of axonal injury in human spinal cord trauma using amyloid precursor protein as a marker of axonal injury. Spine 25(2):1227–1233
Nagamoto-Combs K, McNeal DW, Morecraft RJ, Combs CK (2007) Prolonged microgliosis in the rhesus monkey central nervous system after traumatic brain injury. J Neurotrauma 24(11):1719–1742
Ramlackhansingh AF, Brooks DJ, Greenwood RJ, Bose SK, Turkheimer FE, Kinnunen KM et al (2011) Inflammation after trauma: microglial activation and traumatic brain injury. Ann Neurol 670(3):374–383
Wallace MC, Tator CH, Frazee P (1986) Relationship between posttraumatic ischemia and hemorrhage in the injured rat spinal cord as shown by colloidal carbon angiography. Neurosurgery 18(4):433–439
Tator CH, Fehlings MG (1991) Review of the secondary injury theory of acute spinal cord trauma with emphasis on vascular mechanisms. J Neurosurg 75(1):15–26
Guha A, Tator CH (1988) Acute cardiovascular effects of experimental spinal cord injury. J Trauma 28(3):481–490
Choi DW (1988) Glutamate neurotoxicity and disease of the nervous system. Neuron 1(8):623–634
Panter SS, Yum SW, Faden AI (1990) Alteration in extracellular amino acids after traumatic spinal cord injury. Ann Neurol 27(1):96–99
Liu D, Thangnipan W, McAdoo DJ (1991) Excitatory amino acids rise to toxic levels upon impact injury to the rat spinal cord. Brain Res 547:344–348
Balentine JD, Spector M (1977) Calcification of axons in experimental spinal cord trauma. Ann Neurol 2(6):520–523
Young W (1992) Role of calcium in central nervous system injuries. J Neurotrauma 9(Suppl 1):S9–S25
Braughler JM, Hall ED (1989) Central nervous system trauma and stroke: biochemical considerations for oxygen radical formation and lipid peroxidation. J Free Rad Biol Med 6(4):289–301
Braughler JM, Hall ED (1992) Involvement of lipid peroxidation in CNS injury. J Neurotrauma 9(Suppl 1):S1–S7
Blight AR (1985) Delayed demyelination and macrophage invasion: a candidate for secondary cell damage in spinal cord injury. CNS Trauma 2(4):299–315
Totoiu MO, Keirstead HS (2005) Spinal cord injury is accompanied by chronic progressive demyelination. J Comp Neurol 486(4):373–383
Siegenthaler MM, Tu MK, Keirstead HS (2007) The extent of myelin pathology differs following contusion and transection spinal cord injury. J Neurotrauma 24(10):1631–1646
Emery E, Aldana P, Bunge MB, Puckett W, Srinivasan A, Keane RW et al (1998) Apoptosis after traumatic human spinal cord injury. J Neurosurg 89(6):911–920
Bruce JH, Norenberg MD, Kraydieh S, Puckett W, Marcillo A, Dietrich D (2000) Schwannosis: role of gliosis and proteoglycan in human spinal cord injury. J Neurotrauma 17(9):781–788
Kim RC (2003) Pathology of non-neoplastic, regional disorders of the spinal cord. In: Nelson JS, Mena H, Parisi JE, Schochet SS Jr (eds) Principles and practice of neuropathology, 2nd edn. Oxford University Press, New York, pp 459–496
Göritz C, Dias DO, Tomilin N, Barbacid M, Shupliakov O, Frisén J (2011) A pericyte origin of spinal cord scar tissue. Science 333(6039):238–242
Wolman L (1967) Posttraumatic regeneration of nerve fibers in the human spinal cord and its relation to intramedullary neuroma. J Pathol Bacteriol 94(1):123–129
Sung JH, Mastri AR, Chen KTK (1981) Aberrant peripheral nerves and neuromas in normal and injured spinal cords. J Neuropathol Exp Neurol 40(5):551–565
Kamiya M, Hashizume Y (1989) Pathological studies of aberrant peripheral nerve bundles of spinal cords. Acta Neuropathol 79(1):18–22
Schmitt AB, Buss A, Breuer S, Brook GA, Pech K, Martin D et al (2000) Major histocompatibility complex class II expression by activated microglia caudal to lesions of descending tracts in the human spinal cord is not associated with a T cell response. Acta Neuropathol 100(5):528–536
Buss A, Brook GA, Kakulas B, Martin D, Franzen R, Schoenen J et al (2004) Gradual loss of myelin and formation of an astrocytic scar during Wallerian degeneration in the human spinal cord. Brain 127(1):34–44
Puckett WR, Hiester ED, Norenberg MD, Marcillo AE, Bunge RP (1997) The astroglial response to Wallerian degeneration after spinal cord injury in humans. Exp Neurol 148(2):424–432
Barnett HJM, Jousse AT (1976) Posttraumatic syringomyelia (cystic myelopathy). In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 26. North-Holland, Amsterdam, pp 113–157
Nielsen OA, Biering-Sørensen F, Bötel H, Gardner BP, Little J, Ohta H et al (1999) Posttraumatic syringomyelia. Spinal Cord 37(10):680–684
Püschel J (1930) Der Wassergehalt normaler und degenerierter Zwischenwirbelscheiber. Beitr Pathol Anat 84:123–130
Saunders JBdeCM, Inman VT (1939) Intervertebral disc: critical and collective review. Int Abstr Surg 69:14–29
Bowden REM (1971) The applied anatomy of the cervical spine. In: Wilkinson M (ed) Cervical spondylosis: its early diagnosis and treatment. Saunders, Philadelphia, pp 10–34
Wilkinson M (1960) The morbid anatomy of cervical spondylosis and myelopathy. Brain 83(4):589–617
Wilkinson M (1971) Pathology. In: Wilkinson M (ed) Cervical spondylosis: its early diagnosis and treatment. Saunders, Philadelphia, pp 35–58
Yu YL, du Boulay GH, Stevens JM, Kendall BE (1986) Computer-assisted myelography in cervical spondylotic myelopathy and radiculopathy: clinical correlations and pathogenetic mechanisms. Brain 109(2):259–278
Bedford PD, Bosanquet FD, Russell WR (1952) Degeneration of the spinal cord associated with cervical spondylosis. Lancet 260(6724):55–59
Brain WR, Northfield D, Wilkinson M (1952) The neurological manifestations of cervical spondylosis. Brain 75(2):187–225
Mair WGP, Druckman R (1953) The pathology of spinal cord lesions and their relation to the clinical features in protrusion of cervical intervertebral discs (a report of four cases). Brain 76(1):70–91
Ogino H, Tada K, Okada K, Yonenobu K, Yamamoto T, Ono K et al (1983) Canal diameter, anteroposterior compression ratio, and spondylotic myeloopathy of the cervical spine. Spine 8(1):1–15
Taylor AR (1964) Vascular factors in the myelopathy associated with cervical spondylosis. Neurology 14(1):62–68
Turnbull IM (1971) Microvasculature of the human spinal cord. J Neurosurg 35(2):141–147
Gooding MR (1974) Pathogenesis of myelopathy in cervical spondylosis. Lancet 304(7890):1180–1181
Quencer RM, Bunge RP, Egnor M, Green BA, Puckett W, Naidich TP, Post MJD, Norenberg M (1992) Acute traumatic central cord syndrome: MRI-pathological correlations. Neuroradiology 34(2):85–94
Chikuda H, Seichi A, Takeshita K, Matsunaga S, Watanabe M, Nakagawa Y et al (2011) Acute cervical spinal cord injury complicated by preexisting ossification of the posterior longitudinal ligament. Spine 36(18):1453–1458
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media, LLC
About this protocol
Cite this protocol
Kim, R.C. (2013). The Pathological Findings in Traumatic Injury to the Human Spinal Cord. In: Aldskogius, H. (eds) Animal Models of Spinal Cord Repair. Neuromethods, vol 76. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-197-4_2
Download citation
DOI: https://doi.org/10.1007/978-1-62703-197-4_2
Published:
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-62703-196-7
Online ISBN: 978-1-62703-197-4
eBook Packages: Springer Protocols