Modern Medical Management of Spinal Cord Injury

AbstractPurpose of ReviewSpinal cord injury (SCI) shows an incidence of 10.4 –83 cases/million/year globally and remains a significant source of morbidity and cost to society. Despite greater understanding of the pathophysiology of SCI, neuroprotective and regenerative approaches to treatment have had limited clinical utility to date. Here, we review the key components of supportive care that are thus the mainstay of therapy and that have improved outcomes for victims of acute SCI in recent decades.Recent StudiesCurrent management strategies for acute SCI involve early surgical decompression and fixation, the use of vasopressor medications for mean arterial blood pressure (MAP) augmentation to improve spinal cord perfusion, and corticosteroids. We highlight recent literature supporting the role of norepinephrine in acute SCI management and also an emerging neurocritical care strategy that seeks to optimize spinal cord perfusion pressure with the assistance of invasive monitoring.SummaryThis review will highlight key pathophysiologic principles and targets for current acute clinical treatments in SCI, which include early surgical decompression, MAP augmentation, and corticosteroids. We discuss anticipated future research in these areas and focus on potential risks inherent to these treatments.
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research

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Conditions:   Spinal Cord Injuries;   Bone Resorption;   Osteoporosis Intervention:   Sponsor:   Yeungnam University Hospital Recruiting
Source: - Category: Research Source Type: clinical trials
AbstractDegradomics is a proteomics sub-discipline whose goal is to identify and characterize protease-substrate repertoires. With the aim of deciphering and characterizing key signature breakdown products, degradomics emerged to define encryptic biomarker neoproteins specific to certain disease processes. Remarkable improvements in structural and analytical experimental methodologies as evident in research investigating cellular behavior in neuroscience and cancer have allowed the identification of specific degradomes, increasing our knowledge about proteases and their regulators and substrates along with their implicatio...
Source: Molecular Neurobiology - Category: Neurology Source Type: research
In the lumbar spinal cord dorsal horn, release of afferent nerve glutamate activates the neurons that relay information about injury pain. Here, we examined the effects of protein tyrosine kinase (PTK) inhibition on NMDA receptor NR1 subunit protein expression and subcellular localization in an acute experimental arthritis model. PTK inhibitors genistein and lavendustin A reduced cellular histological translocation of NMDA NR1 in the spinal cord occurring after the inflammatory insult and the nociceptive behavioral responses to heat. The PTK inhibitors were administered into lumbar spinal cord by microdialysis, and seconda...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Condition:   Spinal Cord Injury Intervention:   Drug: Vitamin D3 Sponsor:   Istanbul Physical Medicine Rehabilitation Training and Research Hospital Not yet recruiting
Source: - Category: Research Source Type: clinical trials
CONCLUSION: Neuronal Nogo-A in the DRG may be involved in regeneration and play a protective role in the CEC model. Whereas Nogo-A, released from the injured axons or expressed by Schwann cells, may act as an inhibiting factor in the process of CEC repairment. Thus, blocking the Nogo-A/NgR signaling pathway can alleviate mechanical allodynia by apoptosis inhibition. PMID: 32446356 [PubMed - in process]
Source: Biochemical and Biophysical Research communications - Category: Biochemistry Authors: Tags: Biochem Biophys Res Commun Source Type: research
STUDY DESIGN: Retrospective statistical analysis of database. OBJECTIVES: Prediction of the Spinal Cord Independence Measure version III Total Score (SCIM-TS) at 6 months after injury based on physical findings at 1 month after injury is an important ind...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Economics of Injury and Safety, PTSD, Injury Outcomes Source Type: news
BACKGROUND: Changes in body representations (body image and/or body schema) have been reported in several chronic musculoskeletal pain syndromes, but rarely in patients with neuropathic pain and never in patients with spinal cord injury (SCI)-related pain....
Source: SafetyLit - Category: International Medicine & Public Health Tags: Economics of Injury and Safety, PTSD, Injury Outcomes Source Type: news
Abstract Nerve transfer surgery (NT) for patients with nerve and spinal cord injuries can result in dramatic functional improvements. As a result, interdisciplinary complex nerve injury programs (CNIPs) have been established in many Canadian centres, providing electrodiagnostic and surgical consultations in a single encounter. We sought to determine which allied health care services are included in Canadian CNIPs, at the 3rd Annual Canadian Peripheral Nerve Symposium. Twenty CNIPs responded to a brief survey and reported access as follows: occupational therapy=60%, physiotherapy=40%, social work=20%, mental health...
Source: The Canadian Journal of Neurological Sciences - Category: Neurology Authors: Tags: Can J Neurol Sci Source Type: research
To examine whether commonly used comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, and the Centers for Medicare and Medicaid Services (CMS) comorbidity tiers) capture comorbidities in the acute traumatic and nontraumatic SCI inpatient rehabilitation population.
Source: Archives of Physical Medicine and Rehabilitation - Category: Rehabilitation Authors: Source Type: research
The aim of this article is to provide an overview of prognosis and outcomes after spinal cord injury (SCI), including variables that have an impact on neurologic assessment, extent and time frame of natural recovery, specific factors having an impact on prognosis of ambulation, the role of imaging and modalities for assessing the injured spinal cord, and strategies on presenting information to patients and families. The ability to predict outcome after spinal cord injury is important not only for individuals who sustained traumatic SCI and their families but also for rehabilitation professionals and researchers.
Source: Physical Medicine and Rehabilitation Clinics of North America - Category: Rehabilitation Authors: Source Type: research
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