Pharmacologic and Regenerative Cell Therapy for Spinal Cord Injury: WFNS Spine Committee Recommendations

Neurospine, 2020 · DOI: https://doi.org/10.14245/ns.2040408.204 · Published: December 1, 2020

Spinal Cord Injury Pharmacology Regenerative Medicine

Simple Explanation

This review examines drug and cell-based therapies for spinal cord injury (SCI). It looks at studies from the last 10 years, focusing on treatments that might help recovery after SCI. The review discusses various medications like methylprednisolone and riluzole, and cell therapies using stem cells. It also covers different ways to deliver these treatments to the injured spinal cord. Ultimately, the article highlights the need for more research to find effective ways to treat SCI. It emphasizes the importance of clinical trials to determine which therapies are safe and truly beneficial for patients.

Study Duration

10 years (literature search period)

Participants

Literature review, consensus meetings with WFNS Spine Committee members

Evidence Level

Review article and expert consensus

Key Findings

1
Clinical studies of methylprednisolone for SCI have not shown clear benefits, and other drugs like Rho inhibitors and riluzole have also lacked significant positive outcomes.
2
Regenerative cell therapies using stem cells show promise but have limitations. Research continues to identify the best cell sources, transplantation methods, and scaffolds.
3
The WFNS Spine Committee reached a consensus that there's no high-level evidence to recommend any specific pharmacologic or regenerative cell therapy for acute SCI.

Research Summary

This review summarizes current knowledge on pharmacologic and regenerative cell therapies for spinal cord injury (SCI). It highlights the limitations of existing treatments and the need for further research. Clinical trials of methylprednisolone have not shown significant benefits, and other drugs have also yielded disappointing results. Regenerative cell therapies are promising but require further investigation. The WFNS Spine Committee recommends against routine use of high-dose methylprednisolone for acute SCI and states that there is insufficient evidence to recommend stem cell therapy at this time.

Practical Implications

Clinical Practice

Clinicians should exercise caution when considering methylprednisolone for acute SCI, carefully weighing potential risks and benefits.

Research Direction

Further research is needed to identify effective pharmacologic and regenerative cell therapies for SCI, with a focus on rigorous clinical trials.

Patient Expectations

Patients should be informed about the limited evidence supporting current SCI treatments and the experimental nature of many regenerative cell therapies.

Study Limitations

1
Exclusion of non-English language papers may have introduced bias.
2
The review relies on published literature, potentially overlooking unpublished data or ongoing research.
3
The expert consensus reflects the opinions of the WFNS Spine Committee, which may not represent the views of all experts in the field.

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