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.
