Haller Justin, Bice Miranda, Lawrence Brandon
From the Department of Orthopaedics, Harborview Medical Center, Seattle, WA (Dr. Haller) and the Department of Orthopaedics, University of Utah, Salt Lake City, UT (Dr. Bice and Dr. Lawrence).
J Am Acad Orthop Surg. 2016 Mar;24(3):160-71. doi: 10.5435/JAAOS-D-14-00314.
Spinal cord injury remains a challenging clinical entity with considerable socioeconomic impact on patients, their families, and the healthcare system. Advances in medical care and rehabilitation continue to improve, but treatment outcomes following tissue regeneration for spinal cord injury remain dismal. Therefore, attempts at mediating the secondary effects of spinal cord injury remain the mainstay of current treatment. Recent studies evaluating the timing of decompression suggest improved neurologic recovery with early surgical decompression and the maintenance of mean arterial pressures >85 mm Hg. With systemic and local treatments, including riluzole, minocycline, GM1 ganglioside, BA-210, and granulocyte-colony stimulating factor, remaining in their infancy, randomized controlled trials demonstrating efficacy are needed before adopting their widespread use.
脊髓损伤仍然是一个具有挑战性的临床病症,对患者、其家庭以及医疗保健系统产生相当大的社会经济影响。医疗护理和康复方面的进展持续改善,但脊髓损伤组织再生后的治疗效果仍然不佳。因此,调节脊髓损伤的继发效应仍是当前治疗的主要手段。最近评估减压时机的研究表明,早期手术减压以及维持平均动脉压>85 mmHg可改善神经功能恢复。由于包括利鲁唑、米诺环素、GM1神经节苷脂、BA-210和粒细胞集落刺激因子在内的全身和局部治疗仍处于起步阶段,在广泛应用之前需要进行随机对照试验以证明其疗效。