Recent Advances in the Pathophysiology and Treatment of Acute Spinal Cord Injury

You, Jae Won; Sohn, Hong Moon

Abstract

STUDY DESIGN: This is a literature review
OBJECTIVES
We wanted to provide updated information for spine clinicians on the pathophysiology, medical treatment and the timing of surgical treatment after acute spinal cord injury. SUMMARY OF LITERATURE REVIEW: There are many studies concerned with understanding the mechanisms of injury and improving the neurologic function after acute spinal cord injury. However, methylprednisolone therapy has been used only recently for the treatment of this malady.
MATERIALS AND METHODS
We conducted a literature review, with a particular focus on the development of pathophysiology and the emerging pharmacologic treatment of acute spinal cord injury, and on the effectiveness of performing early decompression.
RESULTS
After primary mechanical impact, a complex cascade of secondary injury follows during acute spinal cord injury. Neuroprotection and axonal regeneration are the main strategies to treat spinal cord injury. Beyond methylprednisolone, a number of other pharmacological treatments have been studied for the acute treatment of spinal cord injury. Animal studies support early decompression of the injured cord. Although there is no standard regarding the timing of decompression, there are many advantages of performing early decompression in human.
CONCLUSION
Although a number of pharmacological therapies seem to have neuroprotective potential, high-dose methyprednisolone therapy is the only clinically approved treatment for acute spinal cord injury. Urgent decompression for acute spinal cord injury remains a reasonable practice option.