[Inseparable prognostic value of spinothalamic and corticospinal functions in severe spinal cord injuries]

In severe spinal cord trauma with initial complete paraplegia or tetraplegia, even the smallest recovery of sensibility to pain or motor function has an obvious prognostical value as it results from the study of 112 spinal injuries. For the motor aspect it is well known from experimental work and in man that even a small part of a single pyramidal tract in the spinal cord can take in charge the bilateral motricity of the limbs. It remains exceptional in severe spinal cord injury that recovery of motricity is not followed by a return of pain sens. In the lateral funiculus of the cord the sensitive and pyramidal tracts belongs to a same anastomotic vascular area between the central and peripherical circulatory streams. In physiological conditions this intermediate circulatory stream is poorly functional. But in severe spinal cord trauma with reduction of central blood flow the adjacent spinothalamic and corticospinal tracts survive in couple on the basis of the same anastomotic vascular area: from this results the prognostical unity that belongs to pain sens and motricity.