Department of Neurosurgery, Desert Regional Medical Center, 1150 N. Indian Canyon Drive, Palm Springs, CA92262, USA.
Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.
Rev Neurosci. 2021 Feb 10;32(5):513-530. doi: 10.1515/revneuro-2020-0148. Print 2021 Jul 27.
Spinal cord injury (SCI) is a debilitating condition which often leads to a severe disability and ultimately impact patient's physical, psychological, and social well-being. The management of acute SCI has evolved over the couple of decades due to improved understanding of injury mechanisms and increasing knowledge of disease. Currently, the early management of acute SCI patient includes pharmacological agents, surgical intervention and newly experimental neuroprotective strategies. However, many controversial areas are still surrounding in the current treatment strategies for acute SCI, including the optimal timing of surgical intervention, early versus delayed decompression outcome benefits, the use of methylprednisolone. Due to the lack of consensus, the optimal standard of care has been varied across treatment centres. The authors have shed a light on the current updates on early treatment approaches and neuroprotective strategies in the initial management of acute SCI in order to protect the early neurologic injury and reduce the future disability.
脊髓损伤（SCI）是一种使人虚弱的疾病，通常会导致严重残疾，并最终影响患者的身体、心理和社会福祉。由于对损伤机制的理解不断加深，以及对疾病认识的不断增加，急性 SCI 的治疗在过去几十年中得到了发展。目前，急性 SCI 患者的早期治疗包括药物治疗、手术干预和新的实验性神经保护策略。然而，目前急性 SCI 治疗策略仍存在许多有争议的领域，包括手术干预的最佳时机、早期与延迟减压的结果益处、甲基强的松龙的使用。由于缺乏共识，最佳的治疗标准在不同的治疗中心有所不同。作者探讨了急性 SCI 初始治疗中早期治疗方法和神经保护策略的最新进展，以保护早期神经损伤，减少未来残疾。
