The past, present, and future of traumatic spinal cord injury therapies: a review

Abstract

This review provides a concise outline of the advances made in the care of patients and to the quality of life after a traumatic spinal cord injury (SCI) over the last century. Despite these improvements reversal of the neurological injury is not yet possible. Instead, current treatment is limited to providing symptomatic relief, avoiding secondary insults and preventing additional sequelae. However, with an ever-advancing technology and deeper understanding of the damaged spinal cord, this appears increasingly conceivable. A brief synopsis of the most prominent challenges facing both clinicians and research scientists in developing functional treatments for a progressively complex injury are presented. Moreover, the multiple mechanisms by which damage propagates many months after the original injury requires a multifaceted approach to ameliorate the human spinal cord. We discuss potential methods to protect the spinal cord from damage, and to manipulate the inherent inhibition of the spinal cord to regeneration and repair. Although acute and chronic SCI share common final pathways resulting in cell death and neurological deficits, the underlying putative mechanisms of chronic SCI and the treatments are not covered in this review.

The Outcomes of Robotic Rehabilitation Assisted Devices Following Spinal Cord Injury and the Prevention of Secondary Associated Complications

“…Peripheral neuropathy affects 80% of patients, and 33% of the individuals are unresponsive to therapy [ 52 ]. Pozeg et al (2017) evaluated the effects of VR on psychological aspects and neuropathic pain.…”

Five-year mortality after traumatic central cord syndrome in Wales

“…36 Recent advances in medication and technology have further improved patients' survival and quality of life. 35,37 Almost one-third of our patients had died at a minimum of five years after their injury: 9% of patients had died within one month. The most common cause of death was respiratory arrest or failure.…”

“…36 Recent advances in medication and technology have further improved patients’ survival and quality of life. 35,37…”

“…Following any spinal cord injury, complications such as incontinence, spasticity, pressure sores, and autonomic instability are often inevitable, yet the optimisation of their management can be key in determining the magnitude of their effects on each patient's morbidity and mortality. 34,35 Older age is associated with a predisposition to develop such complications: this is an important consideration in CCS, given its increased prevalence in the older population. 36 Recent advances in medication and technology have further improved patients' survival and quality of life.…”

Anxiety and Depression in Pediatric-Onset Traumatic Spinal Cord Injury: A Systematic Review

“…Pediatric patients are particularly vulnerable as experiencing TSCI during a critical developmental stage can have signi cant short-and long-term implications on their physical, mental, and social function [9,11]. While recent medical and surgical advances have resulted in improved quality of life and prolonged survival among patients with TSCI, and the physical aspects of TSCI have been well-studied [12][13][14][15][16][17][18], the psychological impact of TSCI is not well-documented [19]. The goal of TSCI treatment should not solely focus on the physical but provide holistic care by focusing on the psychological aspect of rehabilitation as well.…”