Key Intervention Strategies for the treatment of spinal cord injury

Acute intervention strategies to limit degeneration that occurs immediately after an injury.

More long-term intervention strategies involve regenerative and reconstructive approaches to promote rebuilding and reconnection of the injured cord.

1) Limit initial degeneration
primary necrosis, excitotoxicity, and apoptosis.

2) Treat inflammation
need to treat the inflammation response after spinal cord injury, which may contribute to secondary injury. Swelling and inflammation may foster secondary damage to the cord after the initial injury.

enhancement of axonal regrowth, the correct targeting of axons (path finding), the formation of functional neuronal connections (synapses), and remyelination.

3) Stimulate axonal growth
Neurotrophins such as NT-3 and BDNF can both promote cell survival by blocking apoptosis and stimulate axonal growth. Each neurotrophin has very specific target cell functions.

(4) Substrate or guidance molecules to promote new growth

These proteins act as highway road maps to steer axons to the correct targets. Even if axons do survive, it is important that they reconnect with the correct targets.

(5) Block endogenous inhibition of regeneration
There are molecules within the brain and spinal cord which prevent neurons from dividing and axons from growing.

(6) Supply new cells to replace lost ones
Stem cells, which are isolated from the CNS and can divide to form new cells, may make it feasible to replace lost neurons and glia.

(7) Build bridges to span the lesion cavity
Bridges may be needed to reconnect severed regions of the injured spinal cord.