Division of Neurosurgery, University of Toronto, and Neural Repair and Regeneration, Spinal Program, University Health Network, Toronto Western Hospital, Toronto, ON, Canada.
Clin Orthop Relat Res. 2011 Mar;469(3):732-41. doi: 10.1007/s11999-010-1674-0.
Spinal cord injury (SCI) is a devastating event often resulting in permanent neurologic deficit. Research has revealed an understanding of mechanisms that occur after the primary injury and contribute to functional loss. By targeting these secondary mechanisms of injury, clinicians may be able to offer improved recovery after SCI.
QUESTIONS/PURPOSES: In this review, we highlight advances in the field of SCI by framing three questions: (1) What is the preclinical evidence for the neuroprotective agent riluzole that has allowed this agent to move into clinical trials? (2) What is the preclinical evidence for Rho antagonists that have allowed this group of compounds to move into clinical trials? (3) What is the evidence for early surgical decompression after SCI?
We conducted a systematic review of MEDLINE and EMBASE-cited articles related to SCI to address these questions.
As a result of an improved understanding of the secondary mechanisms of SCI, specific clinical strategies have been established. We highlight three strategies that have made their way from bench to bedside: the sodium-glutamate antagonist riluzole, the Rho inhibitor Cethrin, and early surgical decompression. Each of these modalities is under clinical investigation. We highlight the fundamental science that led to this development.
As our understanding of the fundamental mechanisms of SCI improves, we must keep abreast of these discoveries to translate them into therapies that will hopefully benefit patients. We summarize this process of bench to bedside with regard to SCI.
脊髓损伤（SCI）是一种破坏性事件，常导致永久性神经功能缺损。研究揭示了对原发性损伤后发生的机制的理解，并有助于功能丧失。通过针对这些继发性损伤机制，临床医生可能能够提供 SCI 后更好的恢复。
问题/目的：在本综述中，我们通过提出三个问题来突出 SCI 领域的进展：（1）神经保护剂利鲁唑的临床前证据是什么，使该药物能够进入临床试验？（2）Rho 拮抗剂的临床前证据是什么，使这组化合物能够进入临床试验？（3）SCI 后早期手术减压的证据是什么？
我们对 MEDLINE 和 EMBASE 引用的与 SCI 相关的文章进行了系统回顾，以回答这些问题。
由于对 SCI 继发性机制的理解有所提高，已经制定了特定的临床策略。我们重点介绍了三种从实验室到临床的策略：谷氨酸盐拮抗剂利鲁唑、Rho 抑制剂 Cethrin 和早期手术减压。这些方法都在临床研究中。我们强调了导致这些发展的基础科学。
随着我们对 SCI 基本机制的理解的提高，我们必须了解这些发现，将其转化为有望使患者受益的治疗方法。我们总结了 SCI 从实验室到临床的这一过程。
