This 2010 narrative review from Gupta et al. surveys the pathophysiology of traumatic spinal cord injury and critically evaluates the evidence for acute medical management, surgical decompression timing, pharmacologic neuroprotection (MPSS, GM1, TRH, EPO), and emerging cellular transplantation strategies including Schwann cells, activated macrophages, and stem cells.
When managing acute SCI, prioritize hemodynamic resuscitation (MAP >90 mm Hg) and understand that MPSS use is now a medicolegal habit rather than evidence-based practice — its complication profile is well-documented and its neuroprotective benefit rests on post hoc analysis alone, so any decision to administer it should be deliberate and individualized.
This 2010 narrative review from Gupta et al. surveys the pathophysiology of traumatic spinal cord injury and critically evaluates the evidence for acute medical management, surgical decompression timing, pharmacologic neuroprotection (MPSS, GM1, TRH, EPO), and emerging cellular transplantation strategies including Schwann cells, activated macrophages, and stem cells.
When managing acute SCI, prioritize hemodynamic resuscitation (MAP >90 mm Hg) and understand that MPSS use is now a medicolegal habit rather than evidence-based practice — its complication profile is well-documented and its neuroprotective benefit rests on post hoc analysis alone, so any decision to administer it should be deliberate and individualized.