Department of Orthopedics, First Affiliated Hospital of Bengbu Medical College, Bengbu, P.R. China.
Department of Orthopedics, First Affiliated Hospital of Bengbu Medical College, Bengbu, P.R. China.
World Neurosurg. 2021 Nov;155:19-31. doi: 10.1016/j.wneu.2021.07.148. Epub 2021 Aug 8.
Spinal cord injury (SCI), as one of the intractable diseases in clinical medicine, affects thousands of human beings, and the pathologic changes after injury have been a hot spot for exploration in clinical medicine. With the development of new treatments, the survival of patients has shown an increasing trend; however, the inflammatory response after injury has not yet been effectively controlled. SCI is divided into primary injury and secondary injury according to the time of injury and pathophysiologic changes. Primary injury occurs immediately and the damage to the injury site is irreversible; however, secondary injury occurs after primary injury and involves pathologic changes at the cellular and molecular levels, which are reversible. Thus, the inflammatory response from secondary injuries has become the main direction of research. In recent years, a complex pathophysiologic mechanism has gradually been unveiled, which has been followed by an upgrade of treatment methods. This article describes the mechanisms of the inflammatory response after SCI and the mainstream treatment modalities. Also, neuroprotective agents and nerve regeneration agent agents are commonly used in the treatment of SCI; the therapeutic mechanism and classification of these agents are reviewed.
脊髓损伤(SCI)作为临床医学中的一种难治性疾病,影响着数以千计的人类,损伤后的病理变化一直是临床医学探索的热点。随着新治疗方法的发展,患者的生存率呈现出上升趋势;然而,损伤后的炎症反应尚未得到有效控制。根据损伤时间和病理生理变化,SCI 分为原发性损伤和继发性损伤。原发性损伤立即发生,损伤部位的损伤是不可逆转的;然而,继发性损伤发生在原发性损伤之后,涉及细胞和分子水平的病理变化,这些变化是可逆的。因此,继发性损伤引起的炎症反应已成为研究的主要方向。近年来,一个复杂的病理生理机制逐渐被揭示出来,随之而来的是治疗方法的升级。本文描述了 SCI 后炎症反应的机制和主流治疗方式。此外,神经保护剂和神经再生剂在 SCI 的治疗中也被广泛应用,本文对这些药物的治疗机制和分类进行了综述。