Advances in the nonoperative management of spinal cord injury

Advances continue in the nonoperative treatment of spinal cord injury. Pharmacologic agents aimed at altering pathologic processes associated with injury to the spinal cord are under active study. Promising results in initial clinical trials have been shown in the use of GM1 and it is currently undergoing additional trials. Agents that directly affect prostaglandins, thromboxanes, excitatory amino acids, and numerous other injury mediators are in various stages of development. Collagen matrices and fetal tissue transplants have proven effective in promoting axonal regeneration and diminishing scar formation in animal models. No application of these modalities in humans has been performed to date. The role of functional electrical stimulation in spinal cord injured patients continues to expand. Its uses include improving function in the extremities, providing an exercise regimen, and preventing complications associated with spinal cord injury.