The Interplay of Secondary Degeneration and Self-Repair After Spinal Cord Injury

Trauma to the spinal cord involves the initial damage to the cells at the impact site, followed by expansion of the injury as a result of secondary injury mechanisms. Early after injury, there is substantial cell death, both necrotic and apoptotic. This is followed by the initiation of reparative mechanisms by the spinal cord, including proliferation of precursor cells and ependymal cells, and the infiltration of the lesion by Schwann cells and axons. Although the mammalian spinal cord is not capable of fully repairing itself after injury, it does undergo substantial remodeling. This article discusses the progression of contusive spinal cord injury and the remodeling that occurs. By understanding the endogenous repair responses that occur after injury, it may be possible to enhance them and thus produce more effective therapies.