Current and future medical therapeutic strategies for the functional repair of spinal cord injury

World J Orthop, 2015 · DOI: 10.5312/wjo.v6.i1.42 · Published: January 18, 2015

Spinal Cord Injury Pharmacology Regenerative Medicine

Simple Explanation

Spinal cord injury (SCI) leads to social and psychological problems in patients and requires costly treatment and care. In recent years, various pharmacological agents have been tested for acute SCI. Today, the most important problem is ineffectiveness of nonsurgical treatment choices in human SCI that showed neuroprotective effects in animal studies. Recently, attempted cellular therapy and transplantations are promising. This article reviews current evidence for early surgical decompression and nonsurgical treatment options, including pharmacological and cellular therapy, as the treatment choices for SCI.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Early surgical intervention is safe and feasible, can improve clinical and neurological outcomes and reduce health care costs.
2
Early surgical intervention helps minimize the secondary damage caused by compression of the spinal cord after trauma.
3
There is still no accepted pharmacological treatment protocol in SCI.

Research Summary

A number of studies on surgical timing suggest that early surgical intervention is safe and feasible, can improve clinical and neurological outcomes and reduce health care costs, and minimize the secondary damage caused by compression of the spinal cord after trauma. This article reviews current evidence for early surgical decompression and nonsurgical treatment options, including pharmacological and cellular therapy, as the treatment choices for SCI. Recovery of loss of neurological function after acute SCI is one of the most important topics of the neurological sciences.

Practical Implications

Early Surgical Intervention

Consider early surgical intervention in patients without life-threatening polytrauma and without major medical co-morbidities.

Pharmacological Treatment

Further research is needed to establish an accepted pharmacological treatment protocol for SCI.

Cellular Therapy

Cellular treatment studies are continuing and show promise for future SCI treatment.

Study Limitations

1
Lack of Class I clinical trials to guide the timing of surgery.
2
Incomplete understanding of methylprednisolone effectiveness and associated complications.
3
Regeneration of the spinal cord has not yet been demonstrated in humans.

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