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Biofluid Biomarkers of Acute Traumatic Spinal Cord Injury: A Systematic Review
Ericka A Schaeffer1,2, Adam S Levy1, Emily L Errante1,2
1Department of Neurological Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA.
Journal of Neurotrauma
|December 3, 2025
Summary
Biomarker tests for traumatic spinal cord injury (TSCI) show promise for diagnosis and prognosis. This review identified 116 markers, with over 66% linked to TSCI, aiding clinical decisions.
Area of Science:
- Neuroscience
- Biomarker Discovery
- Clinical Diagnostics
Background:
- Traumatic spinal cord injury (TSCI) causes complex symptoms and secondary inflammation.
- Current prognostic methods like MRI have limitations in resolution and practicality.
- Developing biofluid-based prognostic tests is crucial for clinical management of TSCI.
Purpose of the Study:
- To systematically review existing biomarker studies in acute traumatic spinal cord injury (within 24 hours).
- To identify and evaluate potential biomarkers for diagnostic, severity, and prognostic applications in TSCI.
- To highlight discrepancies and recommend biomarkers for clinical utility.
Main Methods:
- Systematic literature review across four major databases (PubMed/MEDLINE, Cochrane, Web of Science, Scopus).
- Screening of 702 articles by two independent reviewers.
- Inclusion of 32 studies examining a total of 116 biomarkers.
Main Results:
- Over 66% of the 116 examined biomarkers were associated with traumatic spinal cord injury.
- Identified biomarkers demonstrated utility in diagnosis, assessing injury severity, and prognosis.
- Discrepancies were noted between different biofluid types, impacting biomarker recommendations.
Conclusions:
- Biomarker discovery in acute TSCI is advancing, offering potential for improved clinical prognostication.
- Further research is needed to correlate acute biomarkers with long-term outcomes using predictive modeling.
- Establishing a clinical TSCI database is essential for optimizing preventative and interventional strategies.
