METHODS FOR NEURAL REPAIR AFTER SPINAL CORD INJURY

摘要

Based on the pathophysiology of events that occur after spinal cord injury (SCI) it is likely that single drug intervention would not be effective. Treatment to reverse primary injury does not currently exist and it is the assortment of pathophysiological processes that occur during the period of secondary injury that are considered the target for pharmaceutical intervention. In SCI, the period of secondary injury can be divided into three therapeutic windows The first 48 hours after acute spinal cord injury are dominated by the vascular and biochemical changes that occur within the spinal cord. The second period is a result of the effects of inflammatory cells that occurs within hours of injury and peaks around four days after injury. The third period occurs approximately one week after injury and is characterized by axonal regeneration and lesion repair. The goals of treatment are to stop the cascade of cellular events initiated by the traumatic insult, to protect spared neural tissue, and to promote regeneration. Surgical intervention is warranted when there is need for stabilization, fracture repair, or evidence of a compressive lesion, however, is not routine practice. The use of medical treatment to stabilize the patient should always be instituted before surgery is performed.