Clinical Neurorestorative Therapeutic Guidelines for Spinal Cord Injury (IANR/CANR version 2019)

Journal of Orthopaedic Translation, 2020 · DOI: https://doi.org/10.1016/j.jot.2019.10.006 · Published: November 11, 2019

Spinal Cord Injury Healthcare Regenerative Medicine & Stem Cells

Simple Explanation

These guidelines introduce methods for restoring damaged neurological structure and functions following spinal cord injury (SCI). They focus on various neurorestorative strategies applicable in the acute, subacute, and chronic phases of SCI to maximize functional recovery and improve the quality of life for patients. The guidelines offer comprehensive management strategies for SCI, including evaluation, diagnosis, pre-hospital first aid, treatments, rehabilitation training, and management of complications. Promising neurorestorative strategies identified through preclinical research are highlighted for their potential to advance SCI treatments in the future.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Early decompression and stabilization (within 24 hours) after acute SCI can improve neurological outcomes, shorten hospitalization, and reduce complications.
2
Cell therapy is identified as a promising therapeutic option for SCI, offering mechanisms such as axonal remyelination, neuroprotection, and immunomodulation.
3
Task-specific training with epidural stimulation may reactivate silent neural circuits and promote plasticity in patients with chronic SCI.

Research Summary

The Clinical Neurorestorative Therapeutic Guidelines for Spinal Cord Injury (IANR/CANR version 2019) aim to provide a therapeutic standard for clinicians and researchers to restore functions in patients with SCI. The guidelines emphasize the importance of comprehensive management strategies, including evaluation, diagnosis, treatments, and rehabilitation, for SCI patients. Combination therapies, such as cell therapy with neurorehabilitation or functional electrical stimulation, show promise for higher functional recovery in chronic SCI.

Practical Implications

Clinical Practice

The guidelines serve as a reference standard for SCI clinical neurorestorative treatment, aiding clinicians in making informed decisions.

Research Advancement

The guidelines encourage the translation of positive preclinical research findings into clinical studies for SCI treatment.

Rehabilitation Strategies

The guidelines emphasize the importance of early occupational and physical therapies after neurorestorative therapy to maximize functional neurorestoration.

Study Limitations

1
The methods in the guidelines can only restore function to some extent, indicating much remains to be achieved for full functional restoration.
2
There is insufficient evidence to support the routine application of high-dose methylprednisolone therapy in acute SCI.
3
The guidelines note a lack of prospective randomized controlled clinical trials for certain interventions like myelotomy.

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