Acute spinal cord injury: Pathophysiology and pharmacological intervention (Review)

Mol Med Rep. 2021 Jun;23(6):417. doi: 10.3892/mmr.2021.12056. Epub 2021 Apr 13.

Abstract

Spinal cord injury (SCI) is one of the most debilitating of all the traumatic conditions that afflict individuals. For a number of years, extensive studies have been conducted to clarify the molecular mechanisms of SCI. Experimental and clinical studies have indicated that two phases, primary damage and secondary damage, are involved in SCI. The initial mechanical damage is caused by local impairment of the spinal cord. In addition, the fundamental mechanisms are associated with hyperflexion, hyperextension, axial loading and rotation. By contrast, secondary injury mechanisms are led by systemic and cellular factors, which may also be initiated by the primary injury. Although significant advances in supportive care have improved clinical outcomes in recent years, a number of studies continue to explore specific pharmacological therapies to minimize SCI. The present review summarized some important pathophysiologic mechanisms that are involved in SCI and focused on several pharmacological and non‑pharmacological therapies, which have either been previously investigated or have a potential in the management of this debilitating injury in the near future.

Keywords: spinal cord injury; primary and secondary damage; systemic factors; local vascular effects; cyclooxygenase inhibitors; minocycline.

Publication types

  • Review

MeSH terms

  • Animals
  • Cyclooxygenase Inhibitors / pharmacology
  • Humans
  • Minocycline / pharmacology
  • Neuroprotective Agents / pharmacology
  • Spinal Cord / drug effects
  • Spinal Cord / pathology
  • Spinal Cord Injuries / drug therapy*
  • Spinal Cord Injuries / pathology*

Substances

  • Cyclooxygenase Inhibitors
  • Neuroprotective Agents
  • Minocycline

Grants and funding

The present study was partly supported by research grants from the National Natural Science Funding of China (grant nos. 81801233 and 81870842) and the Zhejiang Provincial Natural Science Foundation of China (grant no. LQ18H090011).