Introduction

Any insult to the spinal cord temporarily or permanently affecting its function can be defined as a spinal cord injury (SCI). Motor vehicle incidents are currently the most common reason for SCI ( ). Approximately, a third of all new SCI is attributable to this single preventable cause ( ). This is particularly upsetting because, depending on the location (i.e., level) and severity of insult, SCI may significantly impair autonomic, sensory, and/or motor function. As such, SCI often afflicts young people and results in permanent, life-changing, and devastating disabilities.

The first documented reports of patients with SCI are contained in the Edwin Smith Papyrus which arises from around 2500 years BC ( ). Indeed, it is important to note that this seminal document states that SCI is “an ailment not to be treated” ( ; ). Nearly 5000 years ago, most SCI was probably related to injuries sustained in combat ( ). In that setting, it was probably appropriate to triage the scare resources available on the battlefield to those patients with injuries which would not prevent a return to active military service ( ). Yet, regrettably, in the 21st century, besides those few specialists in neurorehabilitation, many clinicians still approach SCI with a significant degree of therapeutic nihilism.

Until relatively recently, the limited clinical literature on SCI focused purely on the feasibility and appropriateness of surgical intervention ( ). This was in part because developments in the field of anesthesia facilitated surgery for SCI. Regardless, technological advances such as advanced orthotic devices ( ) and powered wheelchairs ( ) allow those who are managed conservatively (i.e., without surgery) to have a good quality of life.

Perhaps the most internationally renowned clinician for the rehabilitation of patients with SCI was Sir Ludwig Guttmann ( ). He is most widely recognized as the founder of the Stoke-Mandeville Games which subsequently became the Paralympics ( ). Yet his contribution to improving the outcomes of SCI is equally important. A neurosurgeon appointed to lead the SCI unit at Stoke-Mandeville Hospital, Buckinghamshire, England in 1944; he advocated a holistic approach to this cohort and highlighted the importance of their physicians focusing on rehabilitation rather than acting as single organ “ologists” ( ; ). The National Spinal Injuries Centre (NSIC) at Stoke-Mandeville Hospital became a role-model for the handful of centers which subsequently blossomed worldwide.

The NSIC continues to advocate for this complex cohort. It is important to prevent insidious neglect from the misconception that the outcomes of patients with SCI are poor. Indeed, a recent series of patients with SCI admitted to the intensive care unit at Stoke-Mandeville Hospital found that survival to hospital discharge is very good (78%; ). Thus, although, as yet, there is no cure for SCI, therapeutic nihilism is unwarranted.

The inability of victims of SCI to regain neurological function has been thought (for over 100 years) to be due to the failure of the neurons of the central nervous system to regenerate ( ). Thus, considerable resources have focused on attempts to stimulate neuronal regeneration. As a consequence, novel tools for the study of SCI have recently become available. Our understanding of the neuroscience of SCI has advanced, although more slowly than desired. Importantly, the neurons of the central nervous system have been shown to have greater plasticity and greater capacity to regenerate than originally thought ( ).

Although the promise of being able to initiate neuronal regeneration looms elusively on the horizon, extensive further research is required for SCI to become an ailment that can be cured. Regardless, it even experienced scientists struggle to remain up to date. To assist colleagues who are interested in understanding more about the neuroscience of spinal cord injury, we have therefore produced tables containing up-to-date resources in this chapter. The experts who assisted with the compilation of these tables of resources are acknowledged below.

Resources

Tables 1–5 list the most up-to-date information on the regulatory bodies ( Table 1 ), journals ( Table 2 ), books ( Table 3 ), professional societies ( Table 4 ), research groups, and centers emerging technologies, platforms, and other resources ( Table 5 ) that are relevant to an evidence-based approach to the neuroscience of spinal cord injury. Some organizations are listed in more than one table as they occasional fulfill more than one role.

Table 2

Relevant journals publishing original research and review articles related to the neuroscience of spinal cord injury.

Spinal Cord

Journal of Spinal Cord Medicine

World Neurosurgery

Journal of Neurotrauma

Neural Regeneration Research

Archives of Physical Medicine and Rehabilitation

Experimental Neurology

Scientific Reports

Spinal Cord Series and Cases

PLoS One

Topics in Spinal Cord Injury Rehabilitation

Chinese Journal of Tissue Engineering Research

Spine

Neuroscience Letters

International Journal of Molecular Sciences

Journal of Neurosurgery Spine

Disability and Rehabilitation

European Spine Journal

Neurourology and Urodynamics

Journal of Neuroscience

Spine Journal

Molecular Neurobiology

Neuroscience

Frontiers in Neuroscience

Journal of Neuroinflammation

Frontiers in Neurology

Global Spine Journal

Frontiers in Cellular Neuroscience

American Journal of Physical Medicine and Rehabilitation

Medicine United States

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