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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 3/2011

01-03-2011 | Symposium: Current Concepts in Cervical Spine Surgery

Spinal Cord Injury: A Systematic Review of Current Treatment Options

Authors: David W. Cadotte, MSc, MD, Michael G. Fehlings, MD, PhD, FRCSC, FACS

Published in: Clinical Orthopaedics and Related Research® | Issue 3/2011

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Abstract

Background

Spinal cord injury (SCI) is a devastating event often resulting in permanent neurologic deficit. Research has revealed an understanding of mechanisms that occur after the primary injury and contribute to functional loss. By targeting these secondary mechanisms of injury, clinicians may be able to offer improved recovery after SCI.

Questions/purposes

In this review, we highlight advances in the field of SCI by framing three questions: (1) What is the preclinical evidence for the neuroprotective agent riluzole that has allowed this agent to move into clinical trials? (2) What is the preclinical evidence for Rho antagonists that have allowed this group of compounds to move into clinical trials? (3) What is the evidence for early surgical decompression after SCI?

Methods

We conducted a systematic review of MEDLINE and EMBASE-cited articles related to SCI to address these questions.

Results

As a result of an improved understanding of the secondary mechanisms of SCI, specific clinical strategies have been established. We highlight three strategies that have made their way from bench to bedside: the sodium-glutamate antagonist riluzole, the Rho inhibitor Cethrin, and early surgical decompression. Each of these modalities is under clinical investigation. We highlight the fundamental science that led to this development.

Conclusions

As our understanding of the fundamental mechanisms of SCI improves, we must keep abreast of these discoveries to translate them into therapies that will hopefully benefit patients. We summarize this process of bench to bedside with regard to SCI.
Appendix
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Metadata
Title
Spinal Cord Injury: A Systematic Review of Current Treatment Options
Authors
David W. Cadotte, MSc, MD
Michael G. Fehlings, MD, PhD, FRCSC, FACS
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 3/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1674-0

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