脊髓损伤管理的当前见解。
Current insights into the management of spinal cord injury.
作者信息
Srikandarajah Nisaharan, Alvi Mohammed Ali, Fehlings Michael G
机构信息
Division of Neurosurgery and Spine Program, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
出版信息
J Orthop. 2023 May 16;41:8-13. doi: 10.1016/j.jor.2023.05.007. eCollection 2023 Jul.
BACKGROUND
Traumatic spinal cord injury (SCI) is a serious disorder that results in severe impairment of neurological function as well as disability, ultimately reducing a patient's quality of life. The pathophysiology of SCI involves a primary and secondary phase, which causes neurological injury.
METHODS
Narrative review on current clinical management of spinal cord injury and emerging therapies.
RESULTS
This review explores the management of SCI through early decompressive surgery, optimizing mean arterial pressure, steroid therapy and focused rehabilitation. These management strategies reduce secondary injury mechanisms to prevent the propagation of further neurological damage. The literature regarding emerging research is also explored in cell-based, gene, pharmacological and neuromodulation therapies, which aim to repair the spinal cord following the primary injury mechanism.
CONCLUSIONS
Outcomes for patients with SCI can be enhanced and improved if primary and secondary phases of SCI can be addressed.
背景
创伤性脊髓损伤（SCI）是一种严重的疾病，会导致神经功能严重受损以及残疾，最终降低患者的生活质量。SCI的病理生理学包括一个原发性和继发性阶段，这会导致神经损伤。
方法
对当前脊髓损伤的临床管理和新兴疗法进行叙述性综述。
结果
本综述探讨了通过早期减压手术、优化平均动脉压、类固醇疗法和针对性康复来管理SCI。这些管理策略减少继发性损伤机制，以防止进一步的神经损伤扩散。还探讨了有关基于细胞、基因、药理学和神经调节疗法等新兴研究的文献，这些疗法旨在在原发性损伤机制后修复脊髓。
结论
如果能够解决SCI的原发性和继发性阶段，SCI患者的治疗结果可以得到增强和改善。
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