Spinal Cord Injury

We shall not, and those who come after us must not, accept the goals that were not reached yesterday as unsurmountable today or tomorrow. We will strive to render the world of the paralyzed-on-wheels but a transitory stop, and settle for nothing short of optimal recovery. N. Eric Naftchi In man, the process of "encephalization" culminates in almost complete control of the brain over the lower centers. Transection of the spinal cord severs the extensions of its nerve fiber tracts running to and from various brain centers. Although there is some confusion on the meaning of spinal shock, it is supposed to last from two to three weeks or longer in man, compared with less than a few minutes in the frog. This is a testimony to the complexity of the suprasegmental control in higher animals. Since the brain exerts its control over the internal environment through several monoamine, amino acids, and peptide neurotransmitters, it should not be surprising if the metabolism of these transmitters is found to be drastically altered along with other physical and metabolic dysfunctions which ensue following the spinal cord section. In spite of the major strides in rehabilitation of traumatic spinal cord injury, our knowledge of the etiology underlying the diverse neurophysiologic derangements remains limited. For instance, we are just becoming aware of some of the changes in the "milieu interieur.