Spinal cord trauma and the molecular point of no return

Acute or chronic compressive radiculopathies and/or myelopathies are associated with a wide range of transitory or permanent neurological disturbances [1,2]. Less commonly, as a result of these traumatic events, the development and progression of pain, loss of power and muscle wasting can be observed over time. These neurological features are more typical of amyotrophic neuralgias, neuromuscular disorders better known as idiopathic or genetically-induced conditions [3]. Different modalities of neurotraumas have also been linked to the development of either localised muscle wasting (focal amyotrophy), or to the development of a more widespread form of muscle weakness and wasting which become clinically indistinguishable from motor neuron disease (MND), an irreversible and generally fatal neurodegenerative disorder associated with a survival of approximately 3 to 5 years from disease onset and to the loss of motor cells in the cortex, brain stem and spinal cord [4]. Case studies have indicated how amyotrophic lateral sclerosis (ALS), a clinical form of MND, may have a higher occurrence in individuals exposed to hard physical contact, including mechanical traumas to the head, neck or back [5-18]. The potential role of trauma in engendering ALS also emerges in association with other stressors, like bone fractures and surgical intervention [19,20].From a molecular perspective, the clinical observations reported above suggest that a neurotrauma may mobilise molecular processes leading to a progressive neurodegenerative disorder normally occurring as an idiopathic or genetically-induced condition. The development of a progressive neurodegenerative disorder following spinal cord injury (SCI) may be facilitated by a genetic trait which renders certain individuals more vulnerable to the pre-existence of a sub-clinical degenerative process in the affected tissue, which is more likely to be present with aging and to be made worse and/or precipitated by neurotrauma. The recognit