Promising neuroprotective strategies for traumatic spinal cord injury with a focus on the differential effects among anatomical levels of injury

Traumatic spinal cord injury (SCI) is a devastating condition of motor, sensory, and autonomic dysfunction. The significant cost associated with the management and lifetime care of patients with SCI also presents a major economic burden. This review highlights the most promising neuroprotective and neural reparative therapeutic strategies undergoing clinical assessment, including riluzole, hypothermia, granulocyte colony-stimulating factor, glibenclamide, minocycline, Cethrin (VX-210), and anti-Nogo-A antibody, and emphasizes their efficacy in relation to the anatomical level of injury. Our hope is that more basic research will be conducted in clinically relevant cervical SCI models in order to expedite the transition of important laboratory discoveries into meaningful treatment options for patients with SCI.

• 1
  Early surgical decompression, which aims to realign the spinal column and relieve bony or ligamentous spinal cord compression, has preclinical and clinical success.
• 2
  Riluzole, which inhibits voltage-gated sodium channels and glutamate release, thereby mitigating excitotoxicity, has shown statistically significant improvement compared with the control group in a phase I/IIA clinical trial.
• 3
  Glibenclamide, by blocking NCCa-ATP channels, observed decreased lesion volumes and significant white matter preservation coupled with improved neurobehavioral outcomes.