An Update on Spinal Cord Injury and Current Management.

JBJS Rev · Oct 01 2024 · Review

Carroll AH, Fakhre E, Quinonez A, Tannous O, Mesfin A

Department of Orthopaedic Surgery, MedStar Georgetown University Hospital, Washington

Spine

SUMMARY — THE REDUCTIONThis review updates spinal cord injury management, noting that early surgery (under 24 hours) may aid motor recovery while evidence for blood pressure goals and steroids remains limited.
Abstract, as published

» Spinal cord injury is associated with increased lifelong cost and decreased life expectancy.» Current treatment guidelines have been limited to studies of small effect sizes and limited availability of randomized control trials.» Recovery is best correlated with the initial American Spinal Injury Association impairment scale grade with A and B less likely to recover regarding ambulation as compared with C and D grades.» Surgical intervention within less than 24 hours, especially in the cervical spine, has been associated with some motor improvement.» The use of mean arterial pressure goals and steroids to maintain perfusion and decrease secondary injury requires further study to elucidate clearer evidence-based results.

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