Experimental Treatments of Acute Spinal Cord Injury

Abstract

LTHOUGH physicians have a choice of treating acute injuries of the spinal cord by realignment of the spinal column, surgical decompression, or measures that alter neuronal metabolism and prevent or reduce edema of the cord, or by combinations of these methods, the relative merits of these procedures appear to be unknown because they have not been evaluated comparatively. There is no known experimental model to assess bony alignment, but Freeman and Wright s have described an experimental spinal cord concussion-contusion in which sufficient threshold trauma produces at least a moderately prolonged paraplegia and possibly a lasting neurological deficit and by which the relative efficacy of most current treatments could be compared. Using a similar experimental model, we evaluated standard dural decompression, direct local cord hypothermia, intramuscular dexamethasone, and intrathecal methylprednisolone.