Pharmacological management of secondary chronic spinal cord injury: a systematic review

Migliorini, Filippo; Cocconi, Federico; Schäfer, Luise; Simeone, Francesco; Jeyaraman, Madhan; Maffulli, Nicola

Abstract

Introduction Spinal cord injury (SCI) may bring lifelong consequences for affected patients and a high financial burden to the health care system. Source of data Published peer-reviewed scientific articles identified from EMBASE, Google Scholar, PubMed and Scopus. Areas of agreement Surgery and blood pressure management are the main targets in acute SCI to avoid secondary damage. Areas of controversy The management of secondary chronic SCI is challenging, with unpredictable outcomes. Growing points Given the lack of consensus on pharmacological therapy for acute and secondary chronic SCI, the present study analyses the currently available drugs and treatment options to manage secondary chronic SCI. Areas timely for developing research Different approaches exist for the pharmacological management of secondary chronic SCI. One of the most investigated drugs, 4-aminopyridine, improves central motor conduction and shows improvement in neurological signs. Positive results in different areas have been observed in patients receiving the anti-spastic drugs tizanidine and baclofen or Granulocyte colony-stimulating factor. Growth hormone showed only minimal or no significant effects, and the therapy of secondary chronic SCI with riluzole has been poorly researched to date.

Citation

Migliorini, F., Cocconi, F., Schäfer, L., Simeone, F., Jeyaraman, M., & Maffulli, N. (2024). Pharmacological management of secondary chronic spinal cord injury: a systematic review. British Medical Bulletin, 151(1), 49–68. https://doi.org/10.1093/bmb/ldae009

• Journal Article Type: Article
• Acceptance Date: Aug 20, 2024
• Online Publication Date: Sep 2, 2024
• Publication Date: Sep 2, 2024
• Deposit Date: Nov 21, 2024
• Journal: British Medical Bulletin
• Print ISSN: 0007-1420
• Electronic ISSN: 1471-8391
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 151
• Issue: 1
• Article Number: ldae009
• Pages: 49–68
• DOI: https://doi.org/10.1093/bmb/ldae009
• Keywords: secondary spinal cord injury, SCI, chronic, pharmacological therapy
• Public URL: https://keele-repository.worktribe.com/output/920852