Abstract
Purpose of Review
Spinal cord injury (SCI) shows an incidence of 10.4–83 cases/million/year globally and remains a significant source of morbidity and cost to society. Despite greater understanding of the pathophysiology of SCI, neuroprotective and regenerative approaches to treatment have had limited clinical utility to date. Here, we review the key components of supportive care that are thus the mainstay of therapy and that have improved outcomes for victims of acute SCI in recent decades.
Recent Studies
Current management strategies for acute SCI involve early surgical decompression and fixation, the use of vasopressor medications for mean arterial blood pressure (MAP) augmentation to improve spinal cord perfusion, and corticosteroids. We highlight recent literature supporting the role of norepinephrine in acute SCI management and also an emerging neurocritical care strategy that seeks to optimize spinal cord perfusion pressure with the assistance of invasive monitoring.
Summary
This review will highlight key pathophysiologic principles and targets for current acute clinical treatments in SCI, which include early surgical decompression, MAP augmentation, and corticosteroids. We discuss anticipated future research in these areas and focus on potential risks inherent to these treatments.
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We would like to thank Kristin Kraus, MSc, for her editorial assistance with this paper.
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Michael Karsy and Gregory Hawryluk each declare no potential conflicts of interest.
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Karsy, M., Hawryluk, G. Modern Medical Management of Spinal Cord Injury. Curr Neurol Neurosci Rep 19, 65 (2019). https://doi.org/10.1007/s11910-019-0984-1
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DOI: https://doi.org/10.1007/s11910-019-0984-1