Acute spinal cord injury: pharmacotherapy and drug development perspectives

There are no drugs specifically approved for spinal cord injury that directly address the underlying damage to neural tissue. Immediate treatment with methylprednisolone sodium succinate has been shown to improve outcome from injury in a series of preclinical and clinical studies, and it is now widely used, though the benefits appear to be modest. A variety of other approaches to protecting the injured spinal cord from secondary pathological processes have been examined experimentally, including antioxidants, membrane stabilizers, glutamate antagonists, anti-inflammatories, caspase inhibitors, calpain inhibitors and other compounds of uncertain mechanism. All of these approaches have been supported by positive animal studies but their efficacy relative to the widely used methylprednisolone has not been established.