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Modern Medical Management of Spinal Cord Injury

  • Neurotrauma (D. Sandsmark, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

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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Acknowledgments

We would like to thank Kristin Kraus, MSc, for her editorial assistance with this paper.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA

    Michael Karsy

  2. Section of Neurosurgery, GB1 - Health Sciences Centre, University of Manitoba, 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada

    Gregory Hawryluk

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Correspondence to Gregory Hawryluk.

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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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