Spinal Cord Injury: A Systematic Review of Current Treatment Options

Spinal cord injury (SCI) often leads to permanent neurologic deficits. Researchers are studying secondary mechanisms of injury to improve recovery. Three strategies are highlighted: riluzole, a sodium-glutamate antagonist; Cethrin, a Rho inhibitor; and early surgical decompression. Each is under clinical investigation. Riluzole blocks sodium channels and antagonizes glutamate release, showing neuroprotective properties. Rho antagonists, like Cethrin, prevent neuronal apoptosis and promote axonal regeneration. Early surgical decompression aims to control ischemic and excitotoxic mechanisms in damaged neural tissue. This systematic review examines preclinical and clinical evidence for riluzole and Rho antagonists. It also investigates evidence for early surgical decompression after SCI. The goal is to translate discoveries into therapies that benefit patients with SCI.

• 1
  Riluzole, a neuroprotective agent, has shown promise in preclinical studies by protecting local tissue and aiding functional neurologic recovery. It is now in human clinical trials.
• 2
  Rho antagonists, specifically Cethrin, have demonstrated positive results in animal models by reducing damaged tissue, promoting cell sprouting, and improving locomotor ability. Cethrin is currently undergoing human clinical trials.
• 3
  Early surgical decompression after SCI shows evidence from animal studies suggesting improved neurologic outcomes. However, human clinical trials have yielded mixed results, with recent studies suggesting potential benefits in specific injury types.