An Evidence-Based Review of Spinal Cord Injury Decompression in Experimental Animals and Human Studies, pp. 635-663
Authors: Vafa Rahimi-Movaghar, Mohammad R Rasouli, Harvey Smith and Alexander R Vaccaro
Abstract: Trauma is one of the highest burdens of disease in the world and traumatic spinal cord injury (SCI) is a major permanent sequelae of trauma. Unfortunately there are no preventative procedures outside of safety and regulatory statutes that influences the incidence of traumatic spinal cord injury. There are many therapeutic approaches to SCI including immobilization, respiratory and hemodynamic stabilization, pharmacologic treatment including high dose methylprednisolone, surgical decompression, stabilization and rehabilitation. A literature review was performed using PUBMED from 1966 to 7th March 2009. Cross referencing of discovered articles were also reviewed. Spinal cord decompression and its value in neurologic recovery is a controversial issue. There have been a series of studies evaluating various physical and medicinal interventions in SCI in both human and animal models. Experimental animal models are designed to recreate patterns of injury to the spinal cord such as contusion models by different weight drop instruments, aneurysmal clip compression, epidural balloon expansion, spinal cord wiring, or mixture of mechanisms resulting in spinal compression. Animal models have included rodents, cats, dogs, and primates. The results of animal studies have shown that aside from the kind of procedure and species, when compression is less severe and of shorter duration, the recovery is significantly better. In severe and long lasting compression, there is no recovery in complete SC injured animals.