Pharmacologic and Acute Management of Spinal Cord Injury in Adults and Children

被引:17
作者
Thomas, Ajay X. [1 ,2 ]
Riviello, James J., Jr. [1 ]
Davila-Williams, Daniel [1 ]
Thomas, Sruthi P. [3 ,4 ]
Erklauer, Jennifer C. [1 ,5 ]
Bauer, David F. [4 ]
Cokley, Jon A. [6 ]
机构
[1] Baylor Coll Med, Dept Pediat, Div Pediat Neurol & Dev Neurosci, Houston, TX 77030 USA
[2] Texas Childrens Hosp, Jan & Duncan Neurol Res Inst, Houston, TX 77030 USA
[3] Baylor Coll Med, Dept Phys Med & Rehabil, Div Pediat Phys Med & Rehabil, Houston, TX 77030 USA
[4] Baylor Coll Med, Dept Neurosurg, Div Pediat Neurosurg, Houston, TX 77030 USA
[5] Baylor Coll Med, Dept Pediat, Div Pediat Crit Care Med, Houston, TX 77030 USA
[6] Baylor Coll Med, Dept Pharm, Houston, TX 77030 USA
关键词
Spinal cord injury; Surgical management of vertebral fracture; MAP management; Spinal shock; Autonomic dysreflexia; Rehabilitation; SURGICAL DECOMPRESSION; VENOUS THROMBOEMBOLISM; AUTONOMIC DYSREFLEXIA; CEREBRAL-ISCHEMIA; METHYLPREDNISOLONE; PATHOPHYSIOLOGY; EPIDEMIOLOGY; MULTICENTER; MINOCYCLINE; EXPRESSION;
D O I
10.1007/s11940-022-00720-9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose of Review This review provides guidance for acute spinal cord injury (SCI) management through an analytical assessment of the most recent evidence on therapies available for treating SCI, including newer therapies under investigation. We present an approach to the SCI patient starting at presentation to acute rehabilitation and prognostication, with additional emphasis on the pediatric population when evidence is available. Recent Findings Further studies since the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS) demonstrated a potential functional outcome benefit with ultra-early surgical intervention <= 8 h post-SCI. Subsequent analysis of the National Acute Spinal Cord Injury Study (NASCIS) II and NASCIS III trials have demonstrated potentially serious complications from intravenous methylprednisolone with limited benefit. Newer therapies actively being studied have demonstrated limited or no benefit in preclinical and clinical trials with insufficient evidence to support use in acute SCI treatment. Care for SCI patients requires a multi-disciplinary team. Immediate evaluation and management are focused on preventing additional injury and restoring perfusion to the affected cord. Rapid assessment and intervention involve focused neurological examination, targeted imaging, and surgical intervention when indicated. There are currently no evidence-based recommendations for pathomechanistically targeted therapies.
引用
收藏
页码:285 / 304
页数:20
相关论文
共 91 条
  • [51] First-in-Man Intrathecal Application of Neurite Growth-Promoting Anti-Nogo-A Antibodies in Acute Spinal Cord Injury
    Kucher, Klaus
    Johns, Donald
    Maier, Doris
    Abel, Rainer
    Badke, Andreas
    Baron, Hagen
    Thietje, Roland
    Casha, Steven
    Meindl, Renate
    Gomez-Mancilla, Baltazar
    Pfister, Christian
    Rupp, Ruediger
    Weidner, Norbert
    Mir, Anis
    Schwab, Martin E.
    Curt, Armin
    [J]. NEUROREHABILITATION AND NEURAL REPAIR, 2018, 32 (6-7) : 578 - 589
  • [52] Lakra C, PRACT NEUROL, V21, P5328
  • [53] HEMODYNAMIC PARAMETERS IN PATIENTS WITH ACUTE CERVICAL CORD TRAUMA - DESCRIPTION, INTERVENTION, AND PREDICTION OF OUTCOME
    LEVI, L
    WOLF, A
    BELZBERG, H
    TATOR, CH
    MAIMAN, DJ
    [J]. NEUROSURGERY, 1993, 33 (06) : 1007 - 1017
  • [54] Delayed paraplegia after thoracic and thoracoabdominal aneurysm repair: A continuing risk
    Maniar, HS
    Sundt, TM
    Prasad, SM
    Chu, CM
    Camillo, CJ
    Moon, MR
    Rubin, BG
    Sicard, GA
    [J]. ANNALS OF THORACIC SURGERY, 2003, 75 (01) : 113 - 119
  • [55] Cerebrospinal Fluid Drainage and Induced Hypertension Improve Spinal Cord Perfusion After Acute Spinal Cord Injury in Pigs
    Martirosyan, Nikolay L.
    Kalani, M. Yashar S.
    Bichard, William D.
    Baaj, Ali A.
    Gonzalez, L. Fernando
    Preul, Mark C.
    Theodore, Nicholas
    [J]. NEUROSURGERY, 2015, 76 (04) : 461 - 468
  • [56] BRADYCARDIA AND CARDIAC-ARREST DURING TRACHEAL SUCTION - MECHANISMS IN TETRAPLEGIC PATIENTS
    MATHIAS, CJ
    [J]. EUROPEAN JOURNAL OF INTENSIVE CARE MEDICINE, 1976, 2 (04): : 147 - 156
  • [57] Vertebral Artery Injury with Coinciding Unstable Cervical Spine Trauma: Mechanisms, Evidence-based Management, and Treatment Options
    Merrill, Sarah
    Clifton, William
    Valero-Moreno, Fidel
    Damon, Aaron
    Rahmathulla, Gazanfar
    [J]. CUREUS JOURNAL OF MEDICAL SCIENCE, 2020, 12 (03)
  • [58] Meshkini A, ASIAN J NEUROSURG, V13, P6569
  • [59] Riluzole as a Neuroprotective Drug for Spinal Cord Injury: From Bench to Bedside
    Nagoshi, Narihito
    Nakashima, Hiroaki
    Fehlings, Michael G.
    [J]. MOLECULES, 2015, 20 (05): : 7775 - 7789
  • [60] Long-term experience with diaphragm pacing for traumatic spinal cord injury: Early implantation should be considered
    Onders, Raymond P.
    Elmo, Maryjo
    Kaplan, Cindy
    Schilz, Robert
    Katirji, Bashar
    Tinkoff, Glen
    [J]. SURGERY, 2018, 164 (04) : 705 - 711