Compressive and Contusive Spinal Cord Injury Secondary to Intervertebral Disc Displacement: A Clinical Perspective
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2015 ACVS Foundation. For the purposes of simplification, we can consider compressive spinal cord injury (SCI) to represent spinal cord deformation and shifting from its normal position within the vertebral canal. Contusive SCI, on the other hand, is the actual disruption of parenchyma (neuronal cell bodies, axons, glial cells, myelin, and microvasculature) within the substance of the spinal cord. The main deleterious effect of spinal cord compression is demyelination, without transection of neurons or blood vessels. After demyelination, conduction block might occur leading to paresis or even paralysis. Recovery occurs rapidly by restoration of continuous conduction prior to the return of saltatory conduction. Clinicians must always bear in mind that surgery for intervertebral disc (IVD) herniation is, regardless of the nuances of particular technique, generally limited in therapeutic value to spinal cord decompression.