A review of the neuropathology of human spinal cord injury with emphasis on special features.

A judicious understanding of the basic neuropathology of spinal cord injuries (SCI) is essential knowledge for the clinician responsible for SCI management. An appreciation of the nature of human SCI is also necessary for the neuroscientist searching for a cure. The neuropathology of human SCI described here is derived from the study of 564 cases of spinal cord trauma held in a tissue bank and database of the Department of Neuropathology, Royal Perth Hospital in Australia. The main features of SCI neuropathology are reviewed and special aspects such as early axonal lesions, traumatic demyelination-remyelination, and quantification of white matter tracts are reported in more detail. One of the remarkable outcomes of this work is the finding that the majority of SCI patients have a proportion of spinal cord white matter maintained across the level of the lesion, an observation that has important therapeutic implications.