Pharmacological management of secondary chronic spinal cord injury: a systematic review.

IF 6.7 2区医学 Q1 Medicine

British medical bulletin Pub Date : 2024-09-27 DOI:10.1093/bmb/ldae009

Filippo Migliorini, Federico Cocconi, Luise Schäfer, Francesco Simeone, Madhan Jeyaraman, Nicola Maffulli

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引用次数: 0

Abstract

Introduction: Spinal cord injury (SCI) may bring lifelong consequences for affected patients and a high financial burden to the health care system.

Source of data: Published peer-reviewed scientific articles identified from EMBASE, Google Scholar, PubMed and Scopus.

Areas of agreement: Surgery and blood pressure management are the main targets in acute SCI to avoid secondary damage.

Areas of controversy: The management of secondary chronic SCI is challenging, with unpredictable outcomes.

Growing points: Given the lack of consensus on pharmacological therapy for acute and secondary chronic SCI, the present study analyses the currently available drugs and treatment options to manage secondary chronic SCI.

Areas timely for developing research: Different approaches exist for the pharmacological management of secondary chronic SCI. One of the most investigated drugs, 4-aminopyridine, improves central motor conduction and shows improvement in neurological signs. Positive results in different areas have been observed in patients receiving the anti-spastic drugs tizanidine and baclofen or Granulocyte colony-stimulating factor. Growth hormone showed only minimal or no significant effects, and the therapy of secondary chronic SCI with riluzole has been poorly researched to date.

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继发性慢性脊髓损伤的药物治疗：系统综述。

导言：脊髓损伤（SCI）可能会给患者带来终生的后遗症，并给医疗系统带来沉重的经济负担：数据来源：从 EMBASE、Google Scholar、PubMed 和 Scopus 收录的已发表同行评审科学文章：手术和血压管理是急性 SCI 的主要目标，以避免二次损伤：争议之处：继发性慢性 SCI 的治疗具有挑战性，结果难以预测：本研究分析了目前可用于治疗继发性慢性 SCI 的药物和治疗方案：继发性慢性 SCI 的药物治疗存在不同的方法。研究最多的药物之一是 4-氨基吡啶，它能改善中枢运动传导并改善神经体征。接受抗痉挛药物替扎尼定和巴氯芬或粒细胞集落刺激因子治疗的患者在不同方面都取得了积极的效果。生长激素只显示出极小或无明显效果，而使用利鲁唑治疗继发性慢性 SCI 的研究至今仍很薄弱。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British medical bulletin 医学-医学：内科

CiteScore

13.10

自引率

1.50%

发文量

审稿时长

>12 weeks

期刊介绍： British Medical Bulletin is a multidisciplinary publication, which comprises high quality reviews aimed at generalist physicians, junior doctors, and medical students in both developed and developing countries. Its key aims are to provide interpretations of growing points in medicine by trusted experts in the field, and to assist practitioners in incorporating not just evidence but new conceptual ways of thinking into their practice.