Introduction. Acute spinal cord injury

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Acute spinal cord injury (SCI) is a life-changing event. The treatment of SCI has evolved over the last few decades. High-dose steroids, once a standard of care, are now known to potentially cause more harm than benefit.2 In spite of numerous clinical trials over the decades, there remains controversy surrounding the treatment of acute SCI.

While the care of patients with acute SCI was long plagued by nihilism, emerging research is showing that even patients with the most devastating injuries may have improved neurological function if they receive state-of-the-art care.3

There remains an opportunity to advance the field to treat these potentially devastating injuries. Physicians have debated issues, including the optimal timing of surgery and the use of various perioperative therapies—drugs, blood pressure management, and antithrombotic treatments—to minimize secondary cord injury after the primary traumatic events, as well as regenerative strategies that involve the use of stem cells to reconstitute neural connections.1–4 This issue of Neurosurgical Focus is meant to highlight the evolution of how SCI is managed, from diagnostic imaging biomarkers to novel therapeutic interventions. The issue provides the reader with a broad overview of the latest surgical and therapeutic options for the diagnosis and treatment of acute SCI. It also covers novel therapies in the pipeline that represent promising future strategies to treat SCI.

We owe a sincere thanks to all the authors who have contributed to this effort on this very important topic for spine surgeons.

Disclosures

Dr. Dhall reports work as a consultant for DePuy Synthes and Globus Medical. Dr. Mummaneni reports work as a consultant for DePuy Spine, Globus, and Stryker; stock ownership in Spinicity/ISD; support of non–study-related clinical or research efforts that he oversees from ISSG and NREF; royalties from DePuy Spine, Springer, and Thieme; and honoraria from Spineart and AOSpine.

References

  • 1

    Burke JFYue JKNgwenya LBWinkler EATalbott JFPan JZ: Ultra-early (<12 hours) surgery correlates with higher rate of American Spinal Injury Association Impairment Scale conversion after cervical spinal cord injury. Neurosurgery [epub ahead of print] 2018

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  • 2

    Hurlbert RJHadley MNWalters BCAarabi BDhall SSGelb DE: Pharmacological therapy for acute spinal cord injury. Neurosurgery 76 (Suppl 1):S71S832015

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  • 3

    Levi ADAnderson KDOkonkwo DOPark PBryce TNKurpad SN: Clinical outcomes from a multi-center study of human neural stem cell transplantation in chronic cervical spinal cord injury. J Neurotrauma [epub ahead of print] 2018

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  • 4

    Walters BCHadley MNHurlbert RJAarabi BDhall SSGelb DE: Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery 60:82912013

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Article Information

Correspondence Sanjay Dhall: sanjaydhall@gmail.com.

INCLUDE WHEN CITING DOI: 10.3171/2019.1.FOCUS1912.

Disclosures Dr. Dhall reports work as a consultant for DePuy Synthes and Globus Medical. Dr. Mummaneni reports work as a consultant for DePuy Spine, Globus, and Stryker; stock ownership in Spinicity/ISD; support of non–study-related clinical or research efforts that he oversees from ISSG and NREF; royalties from DePuy Spine, Springer, and Thieme; and honoraria from Spineart and AOSpine.

© AANS, except where prohibited by US copyright law.

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References

  • 1

    Burke JFYue JKNgwenya LBWinkler EATalbott JFPan JZ: Ultra-early (<12 hours) surgery correlates with higher rate of American Spinal Injury Association Impairment Scale conversion after cervical spinal cord injury. Neurosurgery [epub ahead of print] 2018

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Hurlbert RJHadley MNWalters BCAarabi BDhall SSGelb DE: Pharmacological therapy for acute spinal cord injury. Neurosurgery 76 (Suppl 1):S71S832015

    • Search Google Scholar
    • Export Citation
  • 3

    Levi ADAnderson KDOkonkwo DOPark PBryce TNKurpad SN: Clinical outcomes from a multi-center study of human neural stem cell transplantation in chronic cervical spinal cord injury. J Neurotrauma [epub ahead of print] 2018

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Walters BCHadley MNHurlbert RJAarabi BDhall SSGelb DE: Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery 60:82912013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

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