Acute spinal cord injury

Best Pract Res Clin Anaesthesiol. 2016 Mar;30(1):27-39. doi: 10.1016/j.bpa.2015.11.003. Epub 2015 Nov 26.

Abstract

Acute spinal cord injury (SCI) is a devastating event with high mortality and, among survivors, a high degree of morbidity due to both motor and sensory deficits. The damage that occurs with a SCI is recognized to be pathophysiologically biphasic: the initial insult to neural tissue can be followed by a secondary process of progressive ischemia that may worsen the severity of dysfunction. The extent of this secondary insult is potentially modifiable, and a variety of interventions have been studied in an attempt to improve motor and sensory outcomes. What follows is a brief review of some such procedural and pharmacologic interventions, including early decompressive surgery, use of methylprednisolone, and blood pressure and respiratory management, which have been proposed to improve outcomes after SCI.

Keywords: GM-1 ganglioside; anesthesia; cervical cord; methylprednisolone; spinal cord compression; spinal cord injuries; trauma, nervous system.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Blood Pressure
  • Humans
  • Ischemia / etiology
  • Methylprednisolone / therapeutic use*
  • Neuroprotective Agents / therapeutic use*
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Injuries / therapy*
  • Trauma Severity Indices

Substances

  • Neuroprotective Agents
  • Methylprednisolone