Austin H Carroll, Edward Fakhre, Alejandro Quinonez, Oliver Tannous, Addisu Mesfin
{"title":"An Update on Spinal Cord Injury and Current Management.","authors":"Austin H Carroll, Edward Fakhre, Alejandro Quinonez, Oliver Tannous, Addisu Mesfin","doi":"10.2106/JBJS.RVW.24.00124","DOIUrl":null,"url":null,"abstract":"<p><p>» Spinal cord injury is associated with increased lifelong cost and decreased life expectancy.» Current treatment guidelines have been limited to studies of small effect sizes and limited availability of randomized control trials.» Recovery is best correlated with the initial American Spinal Injury Association impairment scale grade with A and B less likely to recover regarding ambulation as compared with C and D grades.» Surgical intervention within less than 24 hours, especially in the cervical spine, has been associated with some motor improvement.» The use of mean arterial pressure goals and steroids to maintain perfusion and decrease secondary injury requires further study to elucidate clearer evidence-based results.</p>","PeriodicalId":47098,"journal":{"name":"JBJS Reviews","volume":"12 10","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JBJS Reviews","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2106/JBJS.RVW.24.00124","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
» Spinal cord injury is associated with increased lifelong cost and decreased life expectancy.» Current treatment guidelines have been limited to studies of small effect sizes and limited availability of randomized control trials.» Recovery is best correlated with the initial American Spinal Injury Association impairment scale grade with A and B less likely to recover regarding ambulation as compared with C and D grades.» Surgical intervention within less than 24 hours, especially in the cervical spine, has been associated with some motor improvement.» The use of mean arterial pressure goals and steroids to maintain perfusion and decrease secondary injury requires further study to elucidate clearer evidence-based results.
""脊髓损伤与终生费用增加和预期寿命缩短有关。"目前的治疗指南仅限于效果规模较小的研究,随机对照试验的可用性有限。康复情况与美国脊髓损伤协会最初的损伤量表等级最相关,与 C 级和 D 级相比,A 级和 B 级在行走方面的康复可能性较小。"在不到 24 小时内进行手术干预,尤其是颈椎手术,与运动能力的改善有一定关系"。使用平均动脉压目标和类固醇来维持血流灌注和减少继发性损伤,还需要进一步的研究来阐明更明确的循证结果。
期刊介绍:
JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.