[Bases for drug therapy of spinal cord injuries]

The initial lesion after spinal cord injury is due to two types of lesions: "primary" and "secondary". Aim of drug treatment is the limitation of the secondary lesion to facilitate recovery at the injury site. Mechanisms involved in the secondary lesion are of two types: a "macroscopic" one due to the compression of the cord and the ischemia due to hypoxia and fall of arterial blood pressure, a "microscopic" one due to biochemical and enzymatic phenomena. In those, glutamate liberation, intracellular calcium modifications, free radical synthesis and lipid peroxidation are the more fashionable. Numerous drug treatments are proposed which will never take the place of immediate resuscitation care and cord decompression.