Diagnosis and Acute Management of Spinal Cord Injury: Current Best Practices and Emerging Therapies

Author:

Martin Allan R.,Aleksanderek Izabela,Fehlings Michael G.

Publisher

Springer Science and Business Media LLC

Subject

Rehabilitation,Orthopedics and Sports Medicine,Surgery

Reference91 articles.

1. Rowland JW, Hawryluk GW, Kwon B, Fehlings MG. Current status of acute spinal cord injury pathophysiology and emerging therapies: promise on the horizon. Neurosurg Focus. 2008;25, E2.

2. American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS), Section on Disorders of the Spine and Peripheral Nerves. Guidelines for the management of acute cervical spine and spinal cord injuries. 2013. Provides numerous updates to the previous 2002 publication of evidence-based management guidelines. Unfortunately, no recommendations are made regarding timing of surgery, and the guideline for methylprednisolone is changed to “treatment not recommended” in contrast to a Cochrane review that recently demonstrated modest efficacy.

3. Brain Trauma Foundation Website. Guidelines for the management of severe traumatic brain injury. 3rd ed. http://www.braintrauma.org/pdf/protected/Guidelines_Management_2007w_bookmarks.pdf Accessed on December 4, 2014.

4. Bromberg WJ, Collier BC, Diebel LN, et al. Blunt cerebrovascular injury. J Trauma. 2010;68(2):471–7.

5. Fehlings MG, Vaccaro A, Wilson JR, et al. Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PLoS One. 2012;7, e32037. Provides numerous updates to the previous 2002 publication of evidence-based A prospective non-randomized study of 313 cervical SCI patients showing that decompressive surgery within the first 24 hours (mean 14.2 h) confers a 2.83 times (95% CI 1.10–7.28) higher chance of a 2-grade AIS improvement compared with after 24 h (mean 48.3 h), with no difference in complication rates (early 24% vs. late 30%, p = 0.21).

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