Inflammatory Response to Spinal Cord Injury and Its Treatment

World Neurosurg. 2021 Nov:155:19-31. doi: 10.1016/j.wneu.2021.07.148. Epub 2021 Aug 8.

Abstract

Spinal cord injury (SCI), as one of the intractable diseases in clinical medicine, affects thousands of human beings, and the pathologic changes after injury have been a hot spot for exploration in clinical medicine. With the development of new treatments, the survival of patients has shown an increasing trend; however, the inflammatory response after injury has not yet been effectively controlled. SCI is divided into primary injury and secondary injury according to the time of injury and pathophysiologic changes. Primary injury occurs immediately and the damage to the injury site is irreversible; however, secondary injury occurs after primary injury and involves pathologic changes at the cellular and molecular levels, which are reversible. Thus, the inflammatory response from secondary injuries has become the main direction of research. In recent years, a complex pathophysiologic mechanism has gradually been unveiled, which has been followed by an upgrade of treatment methods. This article describes the mechanisms of the inflammatory response after SCI and the mainstream treatment modalities. Also, neuroprotective agents and nerve regeneration agent agents are commonly used in the treatment of SCI; the therapeutic mechanism and classification of these agents are reviewed.

Keywords: Cell transplantation; Inflammatory cell factor; Nerve regeneration agent; Neuroinflammation; Neuroprotective agents; Spinal cord injury; Surgical.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / administration & dosage*
  • Cell- and Tissue-Based Therapy / methods
  • Humans
  • Immunomodulating Agents / administration & dosage
  • Inflammation Mediators / antagonists & inhibitors
  • Inflammation Mediators / immunology
  • Inflammation Mediators / metabolism*
  • Laminectomy / methods
  • Leukocytes / drug effects
  • Leukocytes / immunology
  • Nerve Regeneration / drug effects
  • Nerve Regeneration / physiology*
  • Neuroprotective Agents / administration & dosage*
  • Spinal Cord Injuries / immunology
  • Spinal Cord Injuries / metabolism*
  • Spinal Cord Injuries / therapy*

Substances

  • Anti-Inflammatory Agents
  • Immunomodulating Agents
  • Inflammation Mediators
  • Neuroprotective Agents