Fischer Gregor, Bättig Linda, Stienen Martin N, Curt Armin, Fehlings Michael G, Hejrati Nader
Department of Neurosurgery, Cantonal Hospital St.Gallen, Medical School of St.Gallen, St.Gallen, Switzerland.
Spine Center of Eastern Switzerland, Cantonal Hospital St.Gallen, Medical School of St.Gallen, St.Gallen, Switzerland.
Front Neurosci. 2024 May 15;18:1372920. doi: 10.3389/fnins.2024.1372920. eCollection 2024.
Traumatic spinal cord injuries (SCIs) continue to be a major healthcare concern, with a rising prevalence worldwide. In response to this growing medical challenge, considerable scientific attention has been devoted to developing neuroprotective and neuroregenerative strategies aimed at improving the prognosis and quality of life for individuals with SCIs. This comprehensive review aims to provide an up-to-date and thorough overview of the latest neuroregenerative and neuroprotective therapies currently under investigation. These strategies encompass a multifaceted approach that include neuropharmacological interventions, cell-based therapies, and other promising strategies such as biomaterial scaffolds and neuro-modulation therapies. In addition, the review discusses the importance of acute clinical management, including the role of hemodynamic management as well as timing and technical aspects of surgery as key factors mitigating the secondary injury following SCI. In conclusion, this review underscores the ongoing scientific efforts to enhance patient outcomes and quality of life, focusing on upcoming strategies for the management of traumatic SCI. Each section provides a working knowledge of the fundamental preclinical and patient trials relevant to clinicians while underscoring the pathophysiologic rationale for the therapies.
创伤性脊髓损伤(SCI)仍然是一个重大的医疗保健问题,在全球范围内其患病率呈上升趋势。为应对这一日益严峻的医学挑战,科学界投入了大量精力来开发神经保护和神经再生策略,旨在改善脊髓损伤患者的预后和生活质量。本综述旨在全面、及时地概述目前正在研究的最新神经再生和神经保护疗法。这些策略包括多方面的方法,如神经药理学干预、基于细胞的疗法以及其他有前景的策略,如生物材料支架和神经调节疗法。此外,本综述还讨论了急性临床管理的重要性,包括血流动力学管理的作用以及手术的时机和技术方面,这些都是减轻脊髓损伤后继发性损伤的关键因素。总之,本综述强调了为提高患者预后和生活质量而持续进行的科学努力,重点关注创伤性脊髓损伤管理的未来策略。每个部分都为临床医生提供了与基础临床前研究和患者试验相关的实用知识,同时强调了这些疗法的病理生理原理。