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Crozier-Shaw et al. Neuroimmunol Neuroinflammation 2020;7:335-44 Neuroimmunology
DOI: 10.20517/2347-8659.2019.005 and Neuroinflammation

Review Open Access

Management strategies in acute traumatic spinal
cord injury: a narrative review

Geoff Crozier-Shaw 1,2,3 , Hazel Denton , Seamus Morris 1,2,3
1,2
1 National Spinal Injuries Unit, Mater Misercordiae University Hospital, Dublin 7, Ireland.
2 University College Dublin (UCD), Dublin 4, Ireland.
3 Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland.

Correspondence to: Dr. Geoff Crozier-Shaw, National Spinal Injuries Unit, Mater Misercordiae University Hospital, Eccles Street,
Dublin 7, Ireland. E-mail: gcrozshaw@hotmail.com
How to cite this article: Crozier-Shaw G, Denton H, Morris S. Management strategies in acute traumatic spinal cord injury: a
narrative review. Neuroimmunol Neuroinflammation 2020;7:335-44. http://dx.doi.org/10.20517/2347-8659.2019.005
Received: 31 Jul 2019 First Decision: 7 Nov 2019 Revised: 20 May 2020 Accepted: 29 May 2020 Available online: 27 Sep 2020

Academic Editor: Swapan Ray Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Worldwide, spinal cord injury (SCI) affects around 500,000 people each year and results in significant morbidity.
The primary insult to the spinal cord occurs at the time of the initial injury, which may result from a contusion,
laceration or more rarely a transection. Secondary damage in SCI is more insidious and subacute; it is the result of
a combination of an inflammatory response, vascular changes and ionic dysregulation. Early clinical intervention
is vital after the acute, primary insult to ensure the best possible outcomes for these patients. Current evidence on
the demographics and mechanisms, underlying basic science and management strategies of spinal cord injuries
are outlined.

Keywords: Spinal cord, trauma, orthopaedics, neurosurgery

INTRODUCTION
Worldwide, spinal cord injury (SCI) is a significant pathology that affects around 500,000 people each year.
The injury itself results in significant morbidity.

These injuries are typically of a traumatic aetiology and carry significant impairment to function and
quality of life. 40.4% are involved in road traffic accidents, 27.9% in falls, 8% are sports injuries, 15% related
to violence and 8.5% are due to tumours or other causes. The burden of these injuries to both the patient

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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