Acute Spinal Cord Injury

  title={Acute Spinal Cord Injury},
  author={Christopher D. Witiw and Michael G. Fehlings},
  journal={Journal of Spinal Disorders and Techniques},
  • C. WitiwM. Fehlings
  • Published 1 July 2015
  • Medicine, Biology
  • Journal of Spinal Disorders and Techniques
Our understanding of the pathophysiological processes that comprise the early secondary phases of spinal cord injury such as spinal cord ischemia, cellular excitotoxicity, ionic dysregulation, and free-radical mediated peroxidation is far greater now than ever before, thanks to substantial laboratory research efforts. These discoveries are now being translated into the clinical realm and have led to targeted upfront medical management with a focus on tissue oxygenation and perfusion and include… 

Fibroblast growth factors in the management of spinal cord injury

This review focuses on the therapeutic capacity and pitfalls of the FGF family and its clinical application for treating SCI, including the signalling component ofThe FGF pathway and the role in the central nervous system, the pathophysiology of SCI and the targets for FGF treatment.

Biomarkers in Spinal Cord Injury: Prognostic Insights and Future Potentials

An extensive literature review was performed covering literature, published in English, until February 2018 using the Medline/PubMed database, and observed two methods that may lead to the appearance of biomarkers for SCI.

Pharmacological and Nonpharmacological Therapeutic Strategies Based on the Pathophysiology of Acute and Chronic Spinal Cord Injury

This chapter will review a wide range of pharmacological and nonpharmacological therapeutic strategies in preclin- ical and clinical phases, each targeting different pathological mechanisms ofSCI in acute and chronic stages of SCI; taking into account limitations, advances, scope, and new trends.

Acute Spinal Cord Injury: A Systematic Review Investigating miRNA Families Involved

Investigating the pathology and degree of clinical diagnosis and treatment strategies, the animal models that have allowed us to better understand this entity and the role of new diagnostic and prognostic tools such as miRNA could improve the ability to manage this pathological entity.

Differential Neuroproteomic and Systems Biology Analysis of Spinal Cord Injury*

Systems biology approach was utilized to determine the critical biochemical pathways and interactome in the pathogenesis of SCI and candidate biomarkers identified can be used to correlate with disease progression or to identify potential SCI therapeutic targets.

Cell therapy for the treatment of spinal cord injury with focus on stem cells: A review

A number of different cell therapies have been evaluated in both pre-clinical and clinical trials and here a review of these studies that evaluated the following types of cell therapies discusses the advantages and disadvantages of each cell type and their specific role in functional improvement.

Ultrasound in Traumatic Spinal Cord Injury: A Wide-Open Field.

This review suggests that studies that evaluate the benefits and risks of ultrasound in SCI are severely lacking and the understanding of the technology's potential impact remains poorly understood.

Improving the therapeutic efficacy of neural progenitor cell transplantation following spinal cord injury

The authors discuss the challenges of NPC transplantation with respect to different populations of NPCs of glial and neuronal lineages, the timing of treatment relative to acute and chronic injury, and the progress in ongoing clinical trials.



Current status of acute spinal cord injury pathophysiology and emerging therapies: promise on the horizon.

Cell-based strategies including using neural stem cells to remyelinate spared axons are an attractive emerging approach and Regenerative approaches to block inhibitory signals including Nogo and the Rho-Rho-associated kinase pathways have shown promise and are in early stages of clinical evaluation.

Cardiovascular complications after acute spinal cord injury: pathophysiology, diagnosis, and management.

The authors summarize the neural regulation of the cardiovascular system as well as the pathophysiology, diagnosis, and management of major cardiovascular complications that can occur following acute (up to 30 days) traumatic SCI.

Results of a phase II placebo-controlled randomized trial of minocycline in acute spinal cord injury.

The minocycline regimen established in this study proved feasible, safe and was associated with a tendency towards improvement across several outcome measures, which are encouraging and warrant further investigation in a multi-centre phase III trial.

Minocycline neuroprotects, reduces microgliosis, and inhibits caspase protease expression early after spinal cord injury

The results support reports that modulating apoptosis, caspases, and microglia provide promising therapeutic targets for prevention and/or limiting the degree of functional loss after CNS trauma and minocycline, and more potent chemically synthesized tetracyclines, may find a place in the therapeutic arsenal to promote recovery early after SCI in humans.

A phase I/IIa clinical trial of a recombinant Rho protein antagonist in acute spinal cord injury.

The observed motor recovery in this open-label trial suggests that BA-210 may increase neurological recovery after complete SCI, and further clinical trials with Cethrin in SCI patients are planned, to establish evidence of efficacy.

Magnesium chloride in a polyethylene glycol formulation as a neuroprotective therapy for acute spinal cord injury: preclinical refinement and optimization.

An "optimized" regimen of MgCl(2) within PEG conferred greater tissue neuroprotection and improved locomotor recovery compared to methylprednisolone, and a 4 hour time window of histologic and behavioral efficacy was established.

Basic Fibroblast Growth Factor (bFGF) Enhances Functional Recovery Following Severe Spinal Cord Injury to the Rat

In summary, intrathecal infusion of bFGF following severe SCI significantly restores gross hindlimb motor function that is not correlated with significant tissue sparing, indicating that yet undefined mechanisms contribute to the enhanced functional recovery following bF GF treatment.

Early versus Delayed Decompression for Traumatic Cervical Spinal Cord Injury: Results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS)

Decompression prior to 24 hours after SCI can be performed safely and is associated with improved neurologic outcome, defined as at least a 2 grade AIS improvement at 6 months follow-up.

Pharmacological therapy for acute spinal cord injury.

Clinicians considering MP therapy should bear in mind that the drug is not Food and Drug Administration approved for this application, and there is no Class I or Class II medical evidence supporting the clinical benefit of MP in the treatment of acute SCI.

Injury severity as primary predictor of outcome in acute spinal cord injury: retrospective results from a large multicenter clinical trial.

  • W. ColemanF. Geisler
  • Medicine
    The spine journal : official journal of the North American Spine Society
  • 2004