ABSTRACT
Spinal cord injury (SCI) results in interference with the autonomic nervous system which ultimately affects various systems including respiratory, cardiovascular, genitourinary, gastrointestinal, and sexual function. SCI can be characterized by primary and secondary mechanisms of injury. Primary injury is the initial damage that occurs to the spinal cord as a result of various mechanisms. The initial trauma, damage to cord and/or cord vasculature, can be due to distraction, penetrating trauma, and compression. Following initial injury to the spinal cord, a cascade of events occurs that results in complete/permanent injury. Vascular damage following spinal injury is histologically demonstrated in endothelial cells and appears to be a prime mechanism of damage. Secondary damage, through various mechanisms, results in a variety of electrolyte derangements including high intracellular calcium and sodium concentrations, increased extracellular potassium, and depletion of intracellular magnesium. The effect of SCI on lower urinary tract function is dependent on the level, duration, and completeness of the cord lesion.
