Critical Care Management of Acute Spinal Cord Injury-Part II: Intensive Care to Rehabilitation

Abstract

Spinal cord injury is devastating to those affected due to the loss of motor and sensory function, and, in some cases, cardiovascular collapse, ventilatory failure, and bowel and bladder dysfunction. Primary trauma to the spinal cord is exacerbated by secondary insult from the inflammatory response to injury. Specialized intensive care of patients with acute spinal cord injury involves the management of multiple systems and incorporates evidence-based practices to reduce secondary injury to the spinal cord. Patients greatly benefit from early multidisciplinary rehabilitation for neurologic and functional recovery. Treatment of acute spinal cord injury may soon incorporate novel molecular agents currently undergoing clinical investigation to assist in neuroprotection and neuroregeneration.

Keywords: autonomic dysreflexia; blunt cerebrovascular injury; hemodynamic monitoring; neurogenic shock; neuropathic pain therapy; neuroprotection; neuroregeneration; spinal cord injury; spinal cord rehabilitation; tracheostomy.