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Natural Course of Disease of Spinal Cord Injury

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Neurological Aspects of Spinal Cord Injury

Abstract

The natural course of disease in spinal cord injury is well known for traumatic etiologies. In the following chapter, this will be illustrated with respect to anatomical and physiological adaptations in the central and peripheral nervous system. Disease course is described for functional recovery in the domains relevant for spinal cord injury (SCI). Underlying mechanisms of adaptation are addressed in the context of neurological and functional recovery. The role and disease course of etiologies, other than traumatic, are discussed together with the effects of treatment, where treatment is available.

In a final outlook, recovery mechanisms are discussed in the context of incipient clinical trials to cure traumatic SCI. A key issue in this context is to distinguish treatment effects from natural recovery, in order to deal with the difficulty of determining potential efficacy of an intervention. In this context, understanding of the disease course may require additional knowledge of underlying neurophysiological and pathophysiological adaptations that are not clinically evident but require technical examinations. This may help in the process of trial design and therapy development. Stratification and prediction strategies are crucial in this process.

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Authors and Affiliations

  1. Spinal Cord Injury Center, University Clinic, Forchstrasse 340, Zuerich, Switzerland

    Martin Schubert

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  1. Martin Schubert
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Correspondence to Martin Schubert .

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  1. Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany

    Norbert Weidner

  2. Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany

    Rüdiger Rupp

  3. Methodist Rehabilitation Center, University of Mississippi Medical Center, Veterans Administration Medical Center, Jackson, Mississippi, USA

    Keith E. Tansey

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Schubert, M. (2017). Natural Course of Disease of Spinal Cord Injury. In: Weidner, N., Rupp, R., Tansey, K. (eds) Neurological Aspects of Spinal Cord Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-46293-6_4

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