Spinal cord injury is a serious global public health problem that often leaves patients with devastating permanent disabilities. Although advances in supportive care have improved outcome in recent decades, there remains great need for a safe and efficacious medical treatment that improves neurologic outcome. This article reviews pharmacologic treatments evaluated or in the process of development in humans. Cellular transplantation strategies are briefly reviewed especially where they have been evaluated with pharmacologic treatments. There is great hope that one or more of these new therapeutics will be successfully translated and improve the neurologic recovery of patients in the near future.
Key points
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The recognition of delayed, progressive damage to the spinal cord after injury, termed secondary injury, provides a rationale for therapeutic intervention.
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Methylprednisolone is the most extensively studied therapeutic agent for acute spinal cord injury, and it remains a treatment option despite controversy.
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Numerous neuroprotective or regeneration-stimulating agents are in human trials and hold great promise for improving neurologic recovery after acute spinal cord injury.

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