Cell biology considerations in Spinal Cord Injury - Review

Spinal cord injury (SCI) affects more than 2,5 million people worldwide, with more than 130 000 new injuries reported annually. SCI is the result of an aggression on the spinal cord, which totally or partially compromises its functions (motor, sensory, vegetative, reflex). SCI ends in 15% of cases with the victim's death before reaching the hospital. Also, a mortality of about. 5% is registered at the level of specialized assistance centers capable of providing qualified, multidisciplinary assistance, while in non-specialized centers the mortality can be between 25-40%. As soon as a severe bone marrow lesion occurs, the spinal cord enters a state of diminished excitability. This condition is called spinal shock or altered reflex activity. Transient inhibition of caudally located segments of the lesion is due to the sudden disappearance of the predominantly facilitating or excitatory influence of supraspinal centers. Thus there is a flaccid, flaccid paralysis. The duration of the spinal shock varies, a minimal refractive activity may occur within 3-4 days or only after 6-8 weeks, with an average duration of 3-4 weeks, after which occurring sequelae due to the medullary lesion, while medullary neurons under the lesion level becomes autonomous to the influences of the upper floors. The degree of neurological injury and neurological deficit is determined by the extent and severity of the action of these factors. Pain in patients with SCI dresses almost all possible variants from acute pain related to tissue trauma, colic pain caused by the presence of a lithiasis, various types of headache and especially medullary pain. The latter encounter an important proportion of people with a tetra or paraplegia. The pains encountered can be divided into five distinct categories: diffuse pain; segmental pain; root pain; visceral pain; and neurogenic pain. Fever is often present, especially in acute phases. Its value as a symptom of an infection should be carefully analyzed before administering anti-thermic drugs. Urinary, respiratory and esophageal infections are part of the clinical picture of many patients. Consequently, their correct diagnosis and diagnosis followed by the introduction of the treatment are the law. A mention should be made of the so-called fever of undetermined origin, often encountered in early stages, especially in patients with localized cervical medullary lesions. This fever, usually refractory to current treatments, would, in some cases, explain the disturbance of the afferent to the thermoregulation centers. Before declaring the existence of such a fever, it is necessary first to eliminate other causal factors. The balancing recovery step comprises the application for prophylactic and curative purposes of a variety of procedures based on water as a natural therapeutic factor at different temperatures and different states of aggregation as well as specific techniques.