Stokes Stuart, Drozda Martin, Lee Christopher
Spinal Unit, Department of Neurosurgery, Hull Royal Infirmary, Hull, UK.
Bone Jt Open. 2022 May;3(5):348-358. doi: 10.1302/2633-1462.35.BJO-2021-0177.R1.
This review provides a concise outline of the advances made in the care of patients and to the quality of life after a traumatic spinal cord injury (SCI) over the last century. Despite these improvements reversal of the neurological injury is not yet possible. Instead, current treatment is limited to providing symptomatic relief, avoiding secondary insults and preventing additional sequelae. However, with an ever-advancing technology and deeper understanding of the damaged spinal cord, this appears increasingly conceivable. A brief synopsis of the most prominent challenges facing both clinicians and research scientists in developing functional treatments for a progressively complex injury are presented. Moreover, the multiple mechanisms by which damage propagates many months after the original injury requires a multifaceted approach to ameliorate the human spinal cord. We discuss potential methods to protect the spinal cord from damage, and to manipulate the inherent inhibition of the spinal cord to regeneration and repair. Although acute and chronic SCI share common final pathways resulting in cell death and neurological deficits, the underlying putative mechanisms of chronic SCI and the treatments are not covered in this review.
本综述简要概述了上个世纪以来创伤性脊髓损伤（SCI）患者护理及生活质量方面取得的进展。尽管有这些改善，但神经损伤仍无法逆转。目前的治疗仅限于缓解症状、避免二次损伤和预防其他后遗症。然而，随着技术的不断进步以及对受损脊髓的深入了解，这似乎越来越有可能实现。本文简要介绍了临床医生和科研人员在为日益复杂的损伤开发功能性治疗方法时面临的最突出挑战。此外，损伤在最初损伤数月后仍会持续扩散的多种机制，需要采取多方面的方法来改善人类脊髓状况。我们讨论了保护脊髓免受损伤以及调控脊髓对再生和修复的内在抑制作用的潜在方法。虽然急性和慢性脊髓损伤有着导致细胞死亡和神经功能缺损的共同最终途径，但本综述未涵盖慢性脊髓损伤的潜在机制及治疗方法。
