Pharmacological Neuroprotection for Acute Spinal Cord Injury

Traumatic spinal cord injury (SCI) is a major problem in clinical medicine. Etiology depends on several factors such as mechanism of injury and level of injury. The result is a very heterogeneous population of SCI patients. The characteristics of this pathology make for high levels of inter-patient variability. The validation of pharmacological neuroprotective therapy in the acute phase of traumatic SCI has been a treacherous road. Today, there are no FDA-approved therapies for medical management of acute SCI. The clinician depends on recommendations from the AANS/CNS suggesting that the use of methylprednisolone or GM-1 ganglioside is permissible but no real benefits have been observed. Several poorly designed prospective randomized controlled trials have obscured the real value of these promising therapies. This review systematically revises the current treatment protocols while also analyzing the validity and feasibility of the most cutting-edge basic and clinical treatment strategies. With this in mind, the objective is to inform healthcare providers of the present state of acute SCI pharmacological neuroprotective treatment and where is it going in the future.

Keywords: Antioxidants, Apoptosis inhibitors, ATI355, Calpain inhibitors, Cethrin, Erythropoietin, Indometacin, Immunophilin ligands, Memantine, Methylprednisolone, Minocycline, Naloxone, Paraplegia, Riluzole, Steroid hormones, Tirilazad mesylate, Thyrotropin.