• Users Online: 202
  • Print this page
  • Email this page
SYMPOSIUM: CERVICAL SPINE TRAUMA
Year : 2022  |  Volume : 5  |  Issue : 1  |  Page : 47-68

Controversies in cervical spine trauma: The role of timing of surgical decompression and the use of methylprednisolone sodium succinate in spinal cord injury. A narrative and updated systematic review


1 Division of Genetics and Development, Krembil Research Institute, University Health Network, Toronto, ON, Canada
2 Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
3 Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada

Correspondence Address:
Michael G Fehlings
Toronto Western Hospital, 399 Bathurst Street, Suite 4W-449, Toronto ON M5T 2S8.
Canada
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ISJ.ISJ_26_21

Rights and Permissions

Traumatic spinal cord injuries (SCIs) have devastating physical, social, and financial consequences for both patients and their families. SCIs most frequently occur at the cervical spine level, and these injuries are particularly prone to causing debilitating functional impairments. Unfortunately, no effective neuroregenerative therapeutic approaches capable of reversing lost neurologic and functional impairments exist, resulting in a large number of patients living with the persistent disability caused by a chronic cervical SCI. Over the past decades, a multitude of nonpharmacologic and pharmacologic neuroprotective strategies have been intensely investigated, including the timing of surgical decompression and the role of methylprednisolone sodium succinate (MPSS) in patients with acute SCI. These strategies have been the source of vibrant debate surrounding their potential risks and benefits. Our aim in this combined narrative and updated systematic review is to provide an assessment on the timing of surgical decompression as well as the role of high-dose MPSS treatment in patients with traumatic SCIs, with a special emphasis on the cervically injured subpopulation. Based on the current literature, there is strong evidence to support early surgical decompression within 24 h of injury to promote enhanced neurologic recovery. Meanwhile, moderate evidence supports the early initiation of a 24-h high-dose MPSS treatment within 8 h of injury, particularly in patients with a cervical SCI.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed466    
    Printed8    
    Emailed0    
    PDF Downloaded52    
    Comments [Add]    

Recommend this journal