New Clinical-Pathological Classification of Intraspinal Injury Following Traumatic Acute Complete Thoracic Spinal Cord Injury: Postdurotomy/Myelotomy Observations From the INSPIRE Trial

摘要

Copyright © 2017 by the Congress of Neurological SurgeonsTraumatic spinal cord injury (SCI) can produce a sudden and devastating impact on quality of life due to severe motor, sensory, and autonomic dysfunction, including bowel, bladder, and sexual impairment. The adverse consequences of traumatic SCI result from a well-described pathological process involving primary and secondary mechanisms.1,2 The primary injury follows mechanical disruption of spinal cord tissue due to blunt or penetrating trauma. The initial local deformation and energy transfer results in cellular damage and death. A secondary phase of injury, involving inflammation, proapoptotic signaling, edema, reduced blood flow, and local tissue ischemia, results in further cellular necrosis, often culminating in the formation of large, fluid-filled cystic cavities.3-5...While a common pathological process underlies most traumatic SCIs, each individual SCI is unique. The anatomic location of the injury determines which segmental myotomes and sensory...