Residual motor functions in spinal cord injury

Abstract

After acute spinal cord injury, only 10% of the patients experience significant functional recovery. The remaining 90% reveal numerous varieties of spinal cord dysfunctions with different degrees of incomplete and unsatisfactory recovery of functional usage. In such cases of partial recovery of spinal cord functions, a certain degree of restitution of functions can be achieved. By studying these patients and their neurocontrol, we can learn that there are minimal requirements for the restitution of brain influence on segmental mechanisms and that different degrees of control can exist and contribute to the control of steps. These cases exemplify that upper motor neuron paresis is not only a weaker control owing to the loss of a certain percentage of functional fibers: it is an alternative in neurocontrol resulting from suprasegmental and segmental mechanisms within residual structures and their functional performance. On the basis of our observations we conclude that in addition to the model of the "transected spinal cord injury" and the model of the partially injured spinal cord, there is a third model with "discomplete lesion," indicating that it is necessary to revise the conventional concept of "released segmental functions" in patients with transected spinal cord lesion.