Management of acute spinal cord injuries
Emergency view
Keywords:
Spinal cord injury, acute management, early decompression, neuroprotection, ischemia, inflammation, experimental therapiesAbstract
Background: Acute spinal cord injuries (SCIs) are devastating events often leading to irreversible neurological damage and significant long-term disabilities. SCIs affect young, otherwise healthy individuals, contributing to a considerable economic and quality-adjusted life years (QALY) burden. Aim: This review aims to provide an overview of current acute management strategies for SCI and to explore emerging therapeutic approaches that may mitigate injury progression and improve outcomes. Methods: The study reviewed existing literature on SCI management, including established protocols and experimental therapies. A comprehensive analysis of surgical and medical treatments, such as early decompression, hemodynamic management, and novel interventions targeting ischemia, inflammation, and cytotoxicity, was conducted. Results: Early surgical decompression, within 24 hours of injury, has been shown to enhance neurological recovery, reduce hospital stays, and lower complication rates. Hemodynamic management, aiming to maintain a mean arterial pressure of 85–90 mmHg, was crucial in improving functional outcomes. Experimental treatments such as cerebrospinal fluid diversion, spinal cooling, and minocycline demonstrated promising results, though further clinical trials are necessary to establish efficacy. Conclusion: While significant advances have been made in the surgical management of SCI, challenges remain in optimizing medical treatments.
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References
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