Pharmacologic Therapy for Spinal Cord Injury

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2024-09-12 DOI:10.1097/bsd.0000000000001695

Brandon A. Sherrod, Ken Porche, Chad K. Condie, Andrew T. Dailey

引用次数: 0

Abstract

Neuroprotective strategies aimed at preventing secondary neurologic injury following acute spinal cord injury remain an important area of clinical, translational, and basic science research. Despite recent advancement in the understanding of basic mechanisms of primary and secondary neurologic injury, few pharmacologic agents have shown consistent promise in improving neurologic outcomes following SCI in large randomized clinical trials. The authors review the existing literature and clinical guidelines for pharmacologic therapy investigated for managing acute SCI, including corticosteroids, GM-1 ganglioside (Sygen), Riluzole, opioid antagonists, Cethrin, minocycline, and vasopressors for mean arterial pressure augmentation. Therapies for managing secondary effects of SCI, such as bradycardia, are discussed. Current clinical trials for pharmacotherapy and cellular transplantation following acute SCI are also reviewed. Despite the paucity of current evidence for clinically beneficial post-SCI pharmacotherapy, future research efforts will hopefully elucidate promising therapeutic agents to improve neurologic function.

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脊髓损伤的药物治疗

旨在预防急性脊髓损伤后继发性神经损伤的神经保护策略仍然是临床、转化和基础科学研究的一个重要领域。尽管近年来人们对原发性和继发性神经损伤的基本机制有了更深入的了解，但在大型随机临床试验中，很少有药物能持续改善脊髓损伤后的神经功能预后。作者回顾了现有文献和临床指南中关于治疗急性 SCI 的药物疗法的研究，包括皮质类固醇、GM-1 神经节苷脂（Sygen）、利鲁唑、阿片类拮抗剂、Cethrin、米诺环素和用于增加平均动脉压的血管加压药。此外，还讨论了控制 SCI 继发性影响（如心动过缓）的疗法。此外，还回顾了急性 SCI 后药物治疗和细胞移植的当前临床试验。尽管目前对 SCI 后药物治疗有临床益处的证据不足，但未来的研究工作有望阐明有希望改善神经功能的治疗药物。

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

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.