Pharmacologic neuroprotection in patients with spinal cord injury and the efficacy of early decompressive surgery

Kornelis A. Poelstra; Alexander R. Vaccaro; Sonaly Rao; Alpesh Patel; Peter Whang; Mark F. Kurd; Gordon Stock

doi:10.1310/C73A-3UAC-8DFF-H3VU

Pharmacologic neuroprotection in patients with spinal cord injury and the efficacy of early decompressive surgery

Kornelis A. Poelstra^*, Alexander R. Vaccaro, Sonaly Rao, Alpesh Patel, Peter Whang, Mark F. Kurd, Gordon Stock

^*Corresponding author for this work

Orthopaedic Surgery

Research output: Contribution to journal › Review article › peer-review

1 Scopus citations

Abstract

Traumatic spinal cord injury (SCI) is characterized histopathologically by primary and secondary injury cascades. To lessen the severity of the latter, various therapeutic agents and surgical strategies have been recommended. This article reviews the efficacy of various pharmacologic agents as well as the timing of surgical decompression on neurological recovery following SCI. Based on the current understood levels of evidence, the use of methylprednisolone given within 8 hours of injury should be considered a practice option due to the lack of definitive evidence supporting its efficacy in terms of neural preservation and recovery. Additionally, early surgical decompression (<24 hours) has not been shown to improve neurologic recovery in the setting of a traumatic SCI.

Original language	English (US)
Pages (from-to)	63-76
Number of pages	14
Journal	Topics in spinal cord injury rehabilitation
Volume	12
Issue number	2
DOIs	https://doi.org/10.1310/C73A-3UAC-8DFF-H3VU
State	Published - Sep 2006

Keywords

Bilateral cervical facet dislocation
GM-1
MP
Methylprednisolone
Secondary injury
Surgical decompression

ASJC Scopus subject areas

General Medicine

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10.1310/C73A-3UAC-8DFF-H3VU

Cite this

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title = "Pharmacologic neuroprotection in patients with spinal cord injury and the efficacy of early decompressive surgery",

abstract = "Traumatic spinal cord injury (SCI) is characterized histopathologically by primary and secondary injury cascades. To lessen the severity of the latter, various therapeutic agents and surgical strategies have been recommended. This article reviews the efficacy of various pharmacologic agents as well as the timing of surgical decompression on neurological recovery following SCI. Based on the current understood levels of evidence, the use of methylprednisolone given within 8 hours of injury should be considered a practice option due to the lack of definitive evidence supporting its efficacy in terms of neural preservation and recovery. Additionally, early surgical decompression (<24 hours) has not been shown to improve neurologic recovery in the setting of a traumatic SCI.",

keywords = "Bilateral cervical facet dislocation, GM-1, MP, Methylprednisolone, Secondary injury, Surgical decompression",

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AU - Vaccaro, Alexander R.

AU - Rao, Sonaly

AU - Patel, Alpesh

AU - Whang, Peter

AU - Kurd, Mark F.

AU - Stock, Gordon

PY - 2006/9

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N2 - Traumatic spinal cord injury (SCI) is characterized histopathologically by primary and secondary injury cascades. To lessen the severity of the latter, various therapeutic agents and surgical strategies have been recommended. This article reviews the efficacy of various pharmacologic agents as well as the timing of surgical decompression on neurological recovery following SCI. Based on the current understood levels of evidence, the use of methylprednisolone given within 8 hours of injury should be considered a practice option due to the lack of definitive evidence supporting its efficacy in terms of neural preservation and recovery. Additionally, early surgical decompression (<24 hours) has not been shown to improve neurologic recovery in the setting of a traumatic SCI.

AB - Traumatic spinal cord injury (SCI) is characterized histopathologically by primary and secondary injury cascades. To lessen the severity of the latter, various therapeutic agents and surgical strategies have been recommended. This article reviews the efficacy of various pharmacologic agents as well as the timing of surgical decompression on neurological recovery following SCI. Based on the current understood levels of evidence, the use of methylprednisolone given within 8 hours of injury should be considered a practice option due to the lack of definitive evidence supporting its efficacy in terms of neural preservation and recovery. Additionally, early surgical decompression (<24 hours) has not been shown to improve neurologic recovery in the setting of a traumatic SCI.

KW - Bilateral cervical facet dislocation

KW - GM-1

KW - MP

KW - Methylprednisolone

KW - Secondary injury

KW - Surgical decompression

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Pharmacologic neuroprotection in patients with spinal cord injury and the efficacy of early decompressive surgery

Abstract

Keywords

ASJC Scopus subject areas

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