Penetrating injuries spinal cord

Patients disabled by penetrating head and spinal cord injuries are estimated to constitute more than 1 1000 of the population of North America (Office of Technology Assessment, USA, 1990 see Logan and Berry 1993). Following the discovery that FGF-1 and FGF-2 have neurotrophic potential (Morrison et al., 1986 Walicke et al., 1986 Unsicker et al., 1987) and are widely distributed in the central nervous system (for review, see Unsicker et al., 1993), numerous studies therefore started to address the regulation of FGF expression in brain injuries and the possible involvement of FGFs in the response to injury. 

When a force is applied to the posterosuperior quadrant of the head or when a crown impact is administered while the head is in flexion, the neck is subjected to a combined load of axial compression and forward bending. Anterior wedge frartures of vertebral bodies are commonly seen, but with increased load, burst fractures and fracture-dislocations of the facets can result. The latter two conditions are unstable and tend to disrupt or injure the spinal cord, and the extent of the injury depends on the penetration of the vertebral body or its fragments into the spinal canal. Recent experiments by Pin tar et al. [1989, 1990] indicate that burst fractures of lower cervical vertebrae can be reproduced in cadaveric specimens by a crown impact to a flexed cervical spine. A study by Nightingale et al. [1993] showed that fracture-dislocations of the cervical spine occur very early in the impact event (within the first 10 ms) and that the subsequent motion of the head or bending of the cervical spine cannot be used as a reliable indicator of the mechanism of injury. 

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