Spinal cord injury (SCI) is a devastating event that often leads to profound
disability. Traditionally, the treatment for such injury consisted of steroids, spinal
decompression and stabilization surgery, and physical therapy. Despite all these
treatments, however, prognoses for meaningful functional recovery remained grim.
Recently, laboratory-based advancements in our understanding of central nervous
system injuries at the cellular and molecular levels have ushered in new drug treatment
strategies for neuroprotection and regeneration following SCI. Emerging strategies
include pharmacotherapy to reduce spinal cord ischemia, cellular excitotoxicity,
demyelination, and free radical-mediated peroxidation and ensuing cell death. In this
chapter, we review traditional avenues of drug therapy following traumatic SCI
including methylprednisolone, naloxone, and monosialotetrahexosyl (GM-1)
ganglioside. We also discuss pharmacotherapy options currently under investigation for
the treatment of SCI, with attention given to those that are actively under human
clinical trials: riluzole, minocycline, Rho protein antagonist, magnesium chloride in
polyethylene glycol formulation, granulocyte colony stimulating factor (G-CSF), and
fibroblast growth factor (FGF), and lithium. Far more work remains to be done to
further characterize the efficacy, safety, and practicability of these pharmaceutical
therapies.
Keywords: Antioxidation, Blood spinal cord barrier, Corticosteroid,
Excitotoxicity, GM-1, Gacyclidine, Ganglioside, Granulocyte colony stimulating
factor, Growth factor, Immunomodulation, Lipid peroxidation, Lithium,
Magnesium, Methylprednisolone, Minocycline, NASCIS, Naloxone,
Neuroprotection, Nimodipine, RISCIS, Rho antagonist, Riluzole, Spinal cord
injury, Thyrotropin releasing hormone, Tirilazad.
