ORC ID , Zheng-Xue Quan MD 2 ORC ID , Gao-Ju Wang3, Tao He2, Zhi-Yu Chen2, Qiao-Chu Li2, Jin Yang3, Qing Wang MS 3 ORC ID ">
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REVIEW
Year : 2022  |  Volume : 17  |  Issue : 8  |  Page : 1703-1710

Elevated intraspinal pressure in traumatic spinal cord injury is a promising therapeutic target


1 Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province; Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
2 Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
3 Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China

Correspondence Address:
Chao-Hua Yang
Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province; Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing
China
Qing Wang
Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province
China
Zheng-Xue Quan
Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing
China
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Source of Support: This work was supported by a grant from Chongqing Yingcai Plan Project, No. cstc2021ycjh-bgzxm0041 (to ZXQ), Conflict of Interest: None


DOI: 10.4103/1673-5374.332203

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The currently recommended management for acute traumatic spinal cord injury aims to reduce the incidence of secondary injury and promote functional recovery. Elevated intraspinal pressure (ISP) likely plays an important role in the processes involved in secondary spinal cord injury, and should not be overlooked. However, the factors and detailed time course contributing to elevated ISP and its impact on pathophysiology after traumatic spinal cord injury have not been reviewed in the literature. Here, we review the etiology and progression of elevated ISP, as well as potential therapeutic measures that target elevated ISP. Elevated ISP is a time-dependent process that is mainly caused by hemorrhage, edema, and blood-spinal cord barrier destruction and peaks at 3 days after traumatic spinal cord injury. Duraplasty and hypertonic saline may be promising treatments for reducing ISP within this time window. Other potential treatments such as decompression, spinal cord incision, hemostasis, and methylprednisolone treatment require further validation.


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