Nontraumatic Spinal Cord Injury: Epidemiology, Etiology and Management

Abstract

The spinal cord is a conduit within the central nervous system (CNS) that provides ongoing communication between the brain and the rest of the body, conveying complex sensory and motor information necessary for safety, movement, reflexes, and optimization of autonomic function. After a traumatic spinal cord injury (SCI), supraspinal influences on the peripheral nervous system and autonomic nervous system (ANS) are disrupted, leading to spastic paralysis, sympathetic blunting, and parasympathetic dominance, resulting in cardiac dysrhythmias, systemic hypotension, bronchoconstriction, copious respiratory secretions, and uncontrolled bowel, bladder, and sexual dysfunction. This article outlines the pathophysiology of the less reported nontraumatic SCI (NTSCI), its classification, its influence on sensory/motor function, and introduces the probable comorbidities associated with SCI that will be discussed in more detail in the accompanying manuscripts of this special issue. Finally, management strategies for NTSCI will be provided.

Keywords: autonomic dysfunction; neurogenic bladder; neurogenic bowel; nontraumatic spinal cord injury; paraplegia; tetraplegia.

Figure 1

MRI appearance of different intramedullary spinal tumors. Adapted with permission from reference [48] Mechtler, L.L.; Nandigam, K. Spinal cord tumors: new views and future directions. Neurol. Clin. 2013, 31, 241–268.