Clinical Trials in Traumatic Spinal Cord Injury

Neurotherapeutics, 2018 · DOI: https://doi.org/10.1007/s13311-018-0632-5 · Published: May 7, 2018

Spinal Cord Injury Neurorehabilitation Research Methodology & Design

Simple Explanation

Traumatic spinal cord injury (SCI) often leads to permanent neurological impairments, affecting health and quality of life. Researchers are exploring various treatments, but effective therapies for nerve regeneration and functional recovery remain limited. Current strategies mainly focus on reducing secondary damage after the initial injury. Current clinical trials are investigating drugs, cell-based therapies, physiological approaches, and rehabilitation to reduce secondary injury and promote recovery. Future treatments will likely combine these strategies for better outcomes. This article reviews past, present, and emerging neurological and rehabilitation therapies for adults with traumatic SCI.

Study Duration

Not specified

Participants

Adults with traumatic SCI

Evidence Level

Review of clinical trials

Key Findings

1
Early surgical decompression (less than 24 hours after SCI) may improve outcomes in cervical SCI, but evidence is still debated and more studies are needed.
2
The use of methylprednisolone (MP) in acute SCI remains controversial, with debates over its benefits and risks. Some studies suggest motor recovery with MP, but concerns exist regarding side effects and methodology.
3
Maintaining adequate blood pressure is critical in the acute phase after SCI. Guidelines recommend specific MAP ranges, but some question the efficacy of arbitrarily elevated MAP goals.

Research Summary

Traumatic SCI has significant impacts on individuals' health, function, and economic well-being. While advances have been made, treatments specifically targeting neurologic function remain limited. Current research is exploring various therapeutic approaches, including pharmacological, cell-based, physiological, and rehabilitation interventions, to improve outcomes after SCI. Future treatments are likely to be tailored to specific patient populations using advanced imaging and biochemical markers, combining multiple strategies for significant benefits.

Practical Implications

Surgical Timing

Further research is needed to determine the optimal timing for surgical decompression in different SCI scenarios.

Personalized Medicine

Tailoring treatments based on individual patient characteristics and injury profiles may improve outcomes.

Combined Therapies

Integrating multiple therapeutic approaches (e.g., pharmacological, rehabilitation, stimulation) could enhance recovery.

Study Limitations

1
Many interventions studied have not led to changes in the standard of care.
2
Heterogeneity of SCI patients complicates the interpretation of clinical trial results.
3
Methodological weaknesses exist in some clinical trials.

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