Traumatic/contusive spinal injury produces all or most of the following disruptions of spinal cord integrity: tearing of the meninges with leakage of cerebral spinal fluid (CSF); disruption of the blood–spinal cord barrier; vertebral scarring with eventual tethering/compression of the cord; inflammation; vascular disruption with hemorrhage, edema and ischemia; free-radical injury with neuronal excitotoxicity, at-level neuronal hyperactivity, apoptosis and eventual cellular loss; mitochondrial dysfunction; electrolytic changes; accumulation or loss of transmitters; up- and down-regulation of transmitter receptors; damage to and/or constriction of dorsal and ventral roots; demyelination of propriospinal and long-track axons; interruption of long ascending and descending pathways to an indeterminant extent, with anterograde and retrograde degeneration; gliosis and scarring with impaired regeneration of axons; and spontaneous activity rostral and caudal to the injury in proportion to the extent and duration of neuronal deafferentation.
from The Journal of Pain https://ift.tt/2ZOeEx9
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