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Nontraumatic Spinal Cord Injuries

  • Hyun-Yoon Ko
Chapter

Abstract

A variety of nontraumatic conditions can affect the spinal cord. Other vascular injuries, infections, developmental and genetic diseases, malnutrition, and inflammation are the causes of nontraumatic spinal cord injury. The number of nontraumatic spinal cord injuries is increasing as the elderly population increases. Neurological manifestations are similar to traumatic spinal cord injury, but tend to be older and more frequent in women. In addition, the degree of damage is usually incomplete, and it is likely to be accompanied by underlying disease. The incidence of complications such as skin, bowel, and bladder dysfunction is similar to that of traumatic spinal cord injury, but the incidence of deep vein thrombosis, autonomic dysreflexia, orthostatic hypotension, and pneumonia is significantly less common in nontraumatic spinal cord injury patients compared to traumatic spinal cord injury.

References

  1. Aebli N, Ruegg TB, Wicki AG, et al. Predicting the risk and severity of acute spinal cord injury after a minor trauma to the cervical spine. Spine J. 2013a;3:597–604.CrossRefGoogle Scholar
  2. Aebli N, Wicki AG, Rüegg TB, et al. The Torg-Pavlov ratio for the prediction of acute spinal cord injury after a minor trauma to the cervical spine. Spine J. 2013b;13:605–12.PubMedCrossRefGoogle Scholar
  3. Andersen PM, Abrahams S, Borasio GD, et al. EFNS guidelines on the clinical management of amyotrophic lateral sclerosis (MALS)-revised report of an EFNS task force. Eur J Neurol. 2012;19:360–75.PubMedCrossRefGoogle Scholar
  4. Asdorian PL, Weidenbaum M, Hammerberg KW, et al. The pattern of vertebral involvement in metastatic vertebral breast cancer. Clin Orthop Relat Res. 1990;250:164–70.Google Scholar
  5. Bakhsheshian J, Mehta VA, Liu JC. Current diagnosis and management of cervical spondylotic myelopathy. Global Spine J. 2017;7:572–86.PubMedPubMedCentralCrossRefGoogle Scholar
  6. Baptiste DC, Fehlings MG. Pathophysiology of cervical myelopathy. Spine J. 2006;6:190S–7S.PubMedCrossRefPubMedCentralGoogle Scholar
  7. Beh SC, Greenberg BM, Frohman T, et al. Transverse myelitis. Neurol Clin. 2013;31:79–138.PubMedCrossRefPubMedCentralGoogle Scholar
  8. Ben-Zacharia AB. Therapeutics for multiple sclerosis symptoms. Mt Sinai J Med. 2011;78:176–91.PubMedCrossRefPubMedCentralGoogle Scholar
  9. Bicknell CD, Riga CV, Wolfe JH. Prevention of paraplegia during thoracoabdominal aortic aneurysm repair. Eur J Vasc Endovasc Surg. 2009;37:654–60.PubMedCrossRefPubMedCentralGoogle Scholar
  10. Blackhall LJ. Amyotrophic lateral sclerosis and palliative care: where we are, and the road ahead. Muscle Nerve. 2012;45:311–8.PubMedCrossRefGoogle Scholar
  11. Bostroem A, Thron A, Hans FJ, et al. Spinal vascular malformations—typical and atypical findings. Zentralbl Neurochir. 2007;68:205–13.PubMedCrossRefGoogle Scholar
  12. Breig A, el-Nadi AF. Biomechanics of the cervical spinal cord. Relief of contact pressure on and overstretching of the spinal cord. Acta Radiol Diagn (Stockh). 1966;4:602–24.CrossRefGoogle Scholar
  13. Breig A, Turnbull I, Hassler O. Effects of mechanical stresses on the spinal cord in cervical spondylosis. A study on fresh cadaver material. J Neurosurg. 1966;25:45–56.PubMedPubMedCentralCrossRefGoogle Scholar
  14. Campbell WW. DeJong’s the neurologic examination. 7th edn. Wolters Kluwer Lippincott Williams & Wilkins, New York; 1992.Google Scholar
  15. Caragine LP Jr, Halbach VV, Ng PP, et al. Vascular myelopathies-vascular malformations of the spinal cord: presentation and endovascular surgical management. Semin Neurol. 2002;22:123–32.PubMedCrossRefGoogle Scholar
  16. Compston A, Coles A. Multiple sclerosis. Lancet. 2002;359:1221–31.PubMedCrossRefGoogle Scholar
  17. Costa J, Swash M, de Carvalho M. Awaji criteria for the diagnosis of amyotrophic lateral sclerosis: a systematic review. Arch Neurol. 2012;69:1410–6.PubMedCrossRefGoogle Scholar
  18. de Almeida JP, Silvestre R, Pinto AC, et al. Exercise and amyotrophic lateral sclerosis. Neurol Sci. 2012;33:9–15.PubMedCrossRefGoogle Scholar
  19. Dropcho EJ. Neurotoxicity of radiation therapy. Neurol Clin. 2010;28:217–34.PubMedCrossRefGoogle Scholar
  20. Eagler GL, Cole J, Merton (eds). Spinal cord diseases: diagnosis and treatment. Marcel Dekker, Inc., New York; 1998.Google Scholar
  21. Edwards CC 2nd, Riew KD, Anderson PA, et al. Cervical myelopathy: current diagnostic and treatment strategies. Spine J. 2003;3:68–81.PubMedCrossRefGoogle Scholar
  22. EFNS Task Force on Diagnosis and Management of Amyotrophic Lateral Sclerosis, Andersen PM, Abrahams S, et al. EFNS guidelines on the clinical management of amyotrophic lateral sclerosis (MALS)-revised report of an EFNS task force. Eur J Neurol. 2012;19:360–75.CrossRefGoogle Scholar
  23. Epstein NE. Ossification of the posterior longitudinal ligament: diagnosis and surgical management. Neurosurg Q. 1992;2:223–41.Google Scholar
  24. Epstein N. Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament. Spine J. 2002;2:436–49.PubMedCrossRefGoogle Scholar
  25. Fattal C, Fabbro M, Gelis A, et al. Metastatic paraplegia and vital prognosis: perspectives and limitations for rehabilitation care. Part 1. Arch Phys Med Rehabil. 2011a;92:125–33.PubMedCrossRefGoogle Scholar
  26. Fattal C, Fabbro M, Rouays-Mabit H, et al. Metastatic paraplegia and functional outcomes: perspectives and limitations for rehabilitation care. Part 2. Arch Phys Med Rehabil. 2011b;92:134–45.PubMedCrossRefGoogle Scholar
  27. Garg RK, Somvanshi DS. Spinal tuberculosis: a review. J Spinal Cord Med. 2011;34:440–54.PubMedPubMedCentralCrossRefGoogle Scholar
  28. Ghogawala Z, Whitmore RG. Asymptomatic cervical canal stenosis: is there a risk of spinal cord injury? Spine J. 2013;13:613–4.PubMedCrossRefGoogle Scholar
  29. Go JL, Rothman S, Prosper A, et al. Spine infections. Neuroimaging Clin N Am. 2012;22:755–72.PubMedCrossRefGoogle Scholar
  30. Gray F, Gherardi R, Trotot P, et al. Spinal cord lesions in the acquired immune deficiency syndrome (AIDS). Neurosurg Rev. 1990;13:189–94.PubMedCrossRefGoogle Scholar
  31. Gruis KL, Lechtzin N. Respiratory therapies for amyotrophic lateral sclerosis: a primer. Muscle Nerve. 2012;46:313–31.PubMedCrossRefPubMedCentralGoogle Scholar
  32. Hardiman O, van den Berg LH, Kiernan MC. Clinical diagnosis and management of amyotrophic lateral sclerosis. Nat Rev Neurol. 2011;7:639–49.PubMedCrossRefGoogle Scholar
  33. Harrop JS, Hanna A, Silva MT, et al. Neurological manifestations of cervical spondylosis: an overview of signs, symptoms, and pathophysiology. Neurosurgery. 2007;60:S14–20.PubMedCrossRefGoogle Scholar
  34. Hawes J, Massey EW. Neurologic injuries from scuba diving. Neurol Clin. 2008;26:297–308.PubMedCrossRefGoogle Scholar
  35. Hawes J, Massey EW. Neurologic injuries from scuba diving. Phys Med Rehabil Clin N Am. 2009;20:263–72.PubMedCrossRefGoogle Scholar
  36. Hirabayashi K, Miyakawa J, Satomi K. Operative results and postoperative progression of ossification among the patients with ossification of cervical posterior longitudinal ligament. Spine. 1981;6:354–63.PubMedCrossRefPubMedCentralGoogle Scholar
  37. Hirabayashi K, Watanabe K, Suzuki N, et al. Expansive open door laminoplasty for cervical spinal stenotic myelopathy. Spine. 1983;8:693–9.PubMedCrossRefGoogle Scholar
  38. Hirabayashi K, Satomu K, Sasaki T. Ossification of the posterior longitudinal ligament in the cervical spine. In: The cervical spine, 2nd ed. Philadelphia: J.B. Lippincott; 1989.Google Scholar
  39. Ho EL. Infectious etiologies of myelopathy. Semin Neurol. 2012;32:154–60.PubMedCrossRefPubMedCentralGoogle Scholar
  40. Holmes A, Han ZH, Dang GT, et al. Changes in cervical canal spinal volume during in vitro flexion-extension. Spine (Phila Pa 1976). 1996;21:1313–9.CrossRefGoogle Scholar
  41. Huang ME, Sliwa JA. Inpatient rehabilitation of patients with cancer: efficacy and treatment considerations. PM R. 2011;3:746–57.PubMedCrossRefGoogle Scholar
  42. Jaiser SR, Winston GP. Copper deficiency myelopathy. J Neurol. 2010;257:869–81.PubMedPubMedCentralCrossRefGoogle Scholar
  43. Kalsi-Ryan S, Karadimas SK, Fehling MG. Cervical spondylotic myelopathy: the clinical phenomenon and the current pathobiology of an increasingly prevent and devastating disorder. Neuroscientist. 2013;19:409–21.PubMedCrossRefGoogle Scholar
  44. Kamin S, Garstang S. Vascular disease of the spinal cord. Top Spinal Cord Inj Rehabil. 2008;14:42–52.CrossRefGoogle Scholar
  45. Karadimas SK, Erwin WM, Ely CG, et al. The pathophysiology and natural history of cervical spondylotic myelopathy. Spine (Phila Pa 1976). 2013;38(Suppl 1):S21–36.CrossRefGoogle Scholar
  46. Kettler A, Werner K, Wilke HJ. Morphological changes of cervical facet joints in elderly individuals. Eur Spine J. 2007;16:987–92.PubMedPubMedCentralCrossRefGoogle Scholar
  47. Klineberg E. Cervical spondylotic myelopathy: a review of the evidence. Orthop Clin North Am. 2010;41:193–202.PubMedCrossRefPubMedCentralGoogle Scholar
  48. Koyanagi I, Iwasaki Y, Hida K, et al. Clinical features and pathomechanisms of syringomyelia associated with spinal arachnoiditis. Surg Neurol. 2005;63:350–5.PubMedCrossRefPubMedCentralGoogle Scholar
  49. Kumar N. Neurologic presentations of nutritional deficiencies. Neurol Clin. 2010;28:107–70.PubMedCrossRefPubMedCentralGoogle Scholar
  50. Kumar N. Metabolic and toxic myelopathies. Semin Neurol. 2012;32:123–36.PubMedCrossRefGoogle Scholar
  51. Lammertse DP. Neurorehabilitation of spinal cord injuries following lightning and electrical trauma. NeuroRehabilitation. 2005;20:9–14.PubMedGoogle Scholar
  52. Lawrence BD, Wang J, Arnold PM, et al. Predicting the risk of adjacent segment pathology after lumbar fusion: a systematic review. Spine. 2012;37(22 Suppl):S123–32.PubMedCrossRefGoogle Scholar
  53. Loblaw DA, Mitera G, Ford M, et al. A 2011 updated systematic review and clinical practice guideline for the management of malignant extradural spinal cord compression. Int J Radiat Oncol Biol Phys. 2012;84:312–7.PubMedCrossRefGoogle Scholar
  54. Lublin FD, Reinggold SC, Cohen JA, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83:278–86.PubMedPubMedCentralCrossRefGoogle Scholar
  55. Ludolph AC, Brettschneider J, Weishaupt JH. Amyotrophic lateral sclerosis. Curr Opin Neurol. 2012;25:530–5.PubMedCrossRefGoogle Scholar
  56. Matz PG, Anderson PA, Holly LT, et al. Joint section on disorders of the spine and peripheral nerves of the American Association of Neurological Surgeons and Congress of Neurological Surgeons. The natural history of cervical spondylotic myelopathy. J Neurosurg Spine. 2009;11:104–11.PubMedCrossRefGoogle Scholar
  57. McGarvey ML, Mullen MT, Woo EY, et al. The treatment of spinal cord ischemia following thoracic endovascular aortic repair. Neurocrit Care. 2007;6:35–9.PubMedCrossRefGoogle Scholar
  58. McKinley W. Nontraumatic spinal cord injury/disease: etiologies and outcomes. Top Spinal Cord Inj Rehabil. 2008;14:1–9.CrossRefGoogle Scholar
  59. McKinley WO, Seel RT, Hardman JT. Nontraumatic spinal cord injury: incidence, epidemiology, and functional outcome. Arch Phys Med Rehabil. 1999;80:619–23.PubMedCrossRefGoogle Scholar
  60. Mechtler LL, Nandigam K. Spinal cord tumors: new views and future directions. Neurol Clin. 2012;31:241–68.CrossRefGoogle Scholar
  61. Melissano G, Civilini E, Bertoglio L, et al. Angio-CT imaging of the spinal cord vascularisation: a pictorial essay. Eur J Vasc Endovasc Surg. 2010;39:436–40.PubMedPubMedCentralCrossRefGoogle Scholar
  62. Mizuno J, Nakagawa H, Iwata K, et al. Pathology of spinal cord lesion caused by ossification of the posterior longitudinal ligament, with special reference to reversibility of the spinal cord. Neurol Res. 1992;14:312–4.PubMedCrossRefGoogle Scholar
  63. Nikolaidis I, Fouyas IP, Sandercock PA, et al. Surgery for cervical radiculopathy or myelopathy. Cochrane Database Syst Rev. 2010;(1):CD001466.Google Scholar
  64. Nouri A, Tetreault L, Singh A, et al. Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine. 2015;40:E675–93.PubMedCrossRefGoogle Scholar
  65. Novy J, Carruzzo A, Maeder P, et al. Spinal cord ischemia: clinical and imaging patterns, pathogenesis, and outcomes in 27 patients. Arch Neurol. 2006;63:1113–20.CrossRefGoogle Scholar
  66. Perera AH, Gibbs RGJ. Paraplegia as a complication of thoracic and thoracoabdominal aortic interventions. In: Dionyssiotis Y, editor. Topics in paraplegia. InTech; 2014. p. 25–51. https://www.intechopen.com/books/topics-in-paraplegia/paraplegia-as-a-complication-of-thoracic-and-thoracoabdominal-aortic-interventionsGoogle Scholar
  67. Phukan J, Hardiman O. The management of amyotrophic lateral sclerosis. J Neurol. 2009;256:176–86.PubMedCrossRefGoogle Scholar
  68. Rezania K, Roos RP. Spinal cord: motor neuron diseases. Neurol Clin. 2013;31:219–39.PubMedCrossRefGoogle Scholar
  69. Richie MB, Pruitt AA. Spinal cord infections. Neurol Clin. 2013;31:19–53.PubMedCrossRefGoogle Scholar
  70. Robberecht W, Philips T. The changing scene of amyotrophic lateral sclerosis. Nat Rev Neurosci. 2013;14:248–64.PubMedCrossRefGoogle Scholar
  71. Rodesch G, Lasjaunias P. Spinal cord arteriovenous shunts: from imaging to management. Eur J Radiol. 2003;46:221–132.PubMedCrossRefGoogle Scholar
  72. Roos E, Dingemans KD. Mechanisms of metastasis. Biochem Biophys Acta. 1979;560:135–66.PubMedPubMedCentralGoogle Scholar
  73. Rubin MN, Rabinstein AA. Vascular diseases of the spinal cord. Neurol Clin. 2013;31:153–81.PubMedPubMedCentralCrossRefGoogle Scholar
  74. Salvador de la Barrera S, Barca-Buyo A, Montoto-Marqués A, et al. Spinal cord infarction: prognosis and recovery in a series of 36 patients. Spinal Cord. 2001;39:520–5.PubMedCrossRefPubMedCentralGoogle Scholar
  75. Sahraian MA, Radue EW, Minagar A. Neuromyelitis optica: clinical manifestations and neuroimaging features. Neurol Clin. 2013;31:139–52.PubMedCrossRefPubMedCentralGoogle Scholar
  76. Samkoff LM, Goodman AD. Symptomatic management in multiple sclerosis. Neurol Clin. 2011;29:449–63.PubMedCrossRefPubMedCentralGoogle Scholar
  77. Scalabrino G. Subacute combined degeneration one century later. The neurotrophic action of cobalamin (vitamin B12) revisited. J Neuropathol Exp Neurol. 2001;60:109–20.PubMedCrossRefGoogle Scholar
  78. Schwendimann RN. Metabolic, nutritional, and toxic myelopathies. Neurol Clin. 2013;31:207–18.PubMedCrossRefGoogle Scholar
  79. Schwendimann RN. Metabolic and toxic myelopathies. Continuum (Minneap Minn). 2018;24:427–40.Google Scholar
  80. Scotti G, Gerevini D. Diagnosis and differential diagnosis of acute transverse myelopathy. The role of neuroradiological investigations and review of the literature. Neurol Sci. 2001;22(Suppl 2):S69–74.PubMedCrossRefGoogle Scholar
  81. Shedid D, Benzel EC. Cervical spondylosis anatomy: pathophysiology and biomechanics. Neurosurgery. 2007;60:S7–13.PubMedPubMedCentralGoogle Scholar
  82. Spetzler RF, Detwiler PW, Riina HA, et al. Modified classification of spinal cord vascular lesions. J Neurosurg. 2002;96(2 Suppl):145–56.PubMedGoogle Scholar
  83. Thakur NA, Daniels AH, Schiller J, et al. Benign tumors of the spine. J Am Acad Orthop Surg. 2012;20:715–24.PubMedGoogle Scholar
  84. Thurnher MM, Cartes-Zumelzu F, Mueller-Mang C. Demyelinating and infectious diseases of the spinal cord. Neuroimaging Clin N Am. 2007;17:37–55.PubMedCrossRefGoogle Scholar
  85. Toledano M, Bartleson JD. Cervical spondylotic myelopathy. Neurol Clin. 2013;31:287–305.PubMedCrossRefPubMedCentralGoogle Scholar
  86. Transverse Myelitis Consortium Working Group. Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 2002;59:499–505.CrossRefGoogle Scholar
  87. Tsutsumimoto T, Shimogata M, Yui M, et al. The natural history of asymptomatic lumbar canal stenosis in patients undergoing surgery for cervical myelopathy. J Bone Joint Surg (Br). 2012;94:378–84.CrossRefGoogle Scholar
  88. Turner MR, Hardiman O, Benatar M, et al. Controversies and priorities in amyotrophic lateral sclerosis. Lancet Neurol. 2013;12:310–22.PubMedPubMedCentralCrossRefGoogle Scholar
  89. Virk SS, Niedermeier S, Yu E, et al. Adjacent segment disease. Orthopedics. 2014;37:547–55.PubMedCrossRefGoogle Scholar
  90. Vloeberghs M, Herregodts P, Stadnik T, et al. Spinal arachnoiditis mimicking a spinal cord tumor: a case report and review of the literature. Surg Neurol. 1992;37:211–5.PubMedCrossRefGoogle Scholar
  91. Vollmann R, Lamperti M, Magyar M, Simbrunner J. Magnetic resonance imaging of the spine in a patient with decompression sickness. Clin Neuroradiol. 2011;21(4):231–3.PubMedCrossRefGoogle Scholar
  92. Wald JT. Imaging of spine neoplasm. Radiol Clin N Am. 2012;50:749–76.PubMedCrossRefGoogle Scholar
  93. Williams TL. Motor neurone disease: diagnostic pitfalls. Clin Med. 2013;13:97–100.CrossRefGoogle Scholar
  94. Wingerchuk DM, Lennon VA, Pittock SJ, et al. Revised diagnostic criteria for neuromyelitis optica. Neurology. 2006;66:1485–9.PubMedCrossRefGoogle Scholar
  95. Wright MH, Denney LC. A comprehensive review of spinal arachnoiditis. Orthop Nurs. 2003;22:215–9.PubMedCrossRefGoogle Scholar
  96. Yadla S, Klimo P Jr, Harrop J. Traumatic central cord syndrome: etiology, management, and outcomes. Top Spinal Cord Inj Rehabil. 2010;15:73–84.CrossRefGoogle Scholar
  97. Yarnell PR, Lammertse DP. Neurorehabilitation of lightning and electrical injuries. Semin Neurol. 1995;15:391–6.PubMedCrossRefGoogle Scholar
  98. Zaina C, Grant R, Johnson C, et al. The effect of cervical rotation on blood flow in the contralateral vertebral artery. Man Ther. 2003;8:103–9.PubMedCrossRefGoogle Scholar
  99. Zairi F, Marinho P, Bouras A, et al. Recent concepts in the management of thoracolumbar spine metastasis. J Neurosurg Sci. 2013;57:45–54.PubMedGoogle Scholar
  100. Zozulya YP, Slin'ko EI, Al-Qashqish II. Spinal arteriovenous malformations: new classification and surgical treatment. Neurosurg Focus. 2006;20:E7.PubMedCrossRefGoogle Scholar

Suggested Reading

  1. Campbell WW. DeJong’s the neurologic examination. 7th ed. New York: Wolters Kluwer Lippincott Williams & Wilkins; 1992.Google Scholar
  2. Cardenas DD, Dalal K, editors. Spinal cord injury rehabilitation. Phys Med Rehabil Clin N Am. Philadelphia: Elsevier; 2014.Google Scholar
  3. Crossman A, Neary D. Neuroanatomy: an illustrated colour test. 5th ed. Philadelphia: Elsevier; 2015.Google Scholar
  4. Green D, Olson DA, editors. Medical management of long-term disability. 2nd ed. Boston: Butterworth-Heinemann; 1996.Google Scholar
  5. Mtuid E, Gruener G, Dockery P. Fitzgerald’s clinical neuroanatomy and neuroscience. 7th ed. Philadelphia: Elsevier; 2016.Google Scholar
  6. Passias PG, editor. Cervical myelopathy. Philadelphia: Jaypee Brothers Medical Publishers (P) Ltd; 2016.Google Scholar
  7. Vinken PJ, Bruyn GW, editors. Injuries of the spine and spinal cord. Part I, Handbook of clinical neurology, vol. 25. Oxford: North-Holland Publishing Company; 1976.Google Scholar
  8. Vinken PJ, Bruyn GW, editors. Injuries of the spine and spinal cord. Part II, Handbook of clinical neurology, vol. 25. Oxford: North-Holland Publishing Company; 1976.Google Scholar
  9. Vogel LC, Zebracki K, Betz RR, Mulcahey MJ, editors. Spinal cord injury in the child and young adult. London: Mac Keith Press; 2014.Google Scholar
  10. Weidner N, Rupp R, Taney KE, editors. Neurological aspects of spinal cord injury. Cham: Springer; 2017.Google Scholar
  11. Windle WF. The spinal cord and its reaction to traumatic injury. In: Bousquet WF, Palmer RF, editors. Modern pharmacology-toxicology: a series of monographs and textbooks. New York: Marcel Dekker, Inc.; 1980.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Hyun-Yoon Ko
    • 1
  1. 1.Department of Rehabilitation MedicineRehabilitation Hospital, Pusan National University Yangsan Hospital, Pusan National University School of MedicineYangsanSouth Korea

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