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Module 8: Spine & Spinal Cord Injuries

Segment 6: SCI Critical Care & Spinal Stabilization

References labeled PEDS contain a pediatric element or primary focus.

Topic: Non-surgical management of the SCI patient

  • Ceto S, Sekiguchi KJ, Takashima Y, et al. Neural stem cell grafts form extensive synaptic networks that integrate with host circuits after spinal cord injury. Cell Stem Cell. 2020;doi: 10.1016/j.stem.2020.07.007 https://pubmed.ncbi.nlm.nih.gov/32758426/.
  • Chau T, Colosimo C, Delic J, et al. Enteral midodrine for intravenous vasopressor weaning in acute traumatic spinal cord injury patients. Hosp Pharm. 2024;doi: 10.1177/00185787241306278 https://pubmed.ncbi.nlm.nih.gov/39703770/.
  • Fehlings MG, Martin AR, Tetreault LA, et al. A clinical practice guideline for the management of patients with acute spinal cord injury: Recommendations on the role of baseline magnetic resonance imaging in clinical decision making and outcome prediction. Global Spine J. 2017;7(3 Suppl):221s-230s. doi: 10.1177/2192568217703089 https://pubmed.ncbi.nlm.nih.gov/29164028/.
  • Fehlings MG, Tetreault LA, Wilson JR, et al. A clinical practice guideline for the management of patients with acute spinal cord injury and central cord syndrome: Recommendations on the timing (≤24 hours versus >24 hours) of decompressive surgery. Global Spine J. 2017;7(3 Suppl):195s-202s. doi: 10.1177/2192568217706367 https://pubmed.ncbi.nlm.nih.gov/29164024/.
  • Fehlings MG, Tetreault LA, Wilson JR, et al. A clinical practice guideline for the management of acute spinal cord injury: Introduction, rationale, and scope. Global Spine J. 2017;7(3 Suppl):84s-94s. doi: 10.1177/2192568217703387 https://pubmed.ncbi.nlm.nih.gov/29164036/.
  • Fehlings MG, Wilson JR, Harrop JS, et al. Efficacy and safety of methylprednisolone sodium succinate in acute spinal cord injury: A systematic review. Global Spine J. 2017;7(3 Suppl):116s-137s. doi: 10.1177/2192568217706366 https://pubmed.ncbi.nlm.nih.gov/29164020/.
  • Fehlings MG, Wilson JR, Tetreault LA, et al. A clinical practice guideline for the management of patients with acute spinal cord injury: Recommendations on the use of methylprednisolone sodium succinate. Global Spine J. 2017;7(3 Suppl):203s-211s. doi: 10.1177/2192568217703085 https://pubmed.ncbi.nlm.nih.gov/29164025/.
  • Hirano T, Minami S, Taniguchi H, et al. Delta ROX index as a dynamic predictor of respiratory exacerbation in acute cervical spinal cord injury: A retrospective study. Injury. 2026;57(6):113262. doi: 10.1016/j.injury.2026.113262 https://pubmed.ncbi.nlm.nih.gov/41997094/.
  • Ji R, Hao Z, Wang H, et al. Application of injectable hydrogels as delivery systems in spinal cord injury. Gels. 2023;9(11) doi: 10.3390/gels9110907 https://pubmed.ncbi.nlm.nih.gov/37998998/.
  • Karsy M, Hawryluk G. Modern medical management of spinal cord injury. Curr Neurol Neurosci Rep. 2019;19(9):65. doi: 10.1007/s11910-019-0984-1 https://pubmed.ncbi.nlm.nih.gov/31363857/.
  • Kwon WK, Ham CH, Byun J, et al. Surgical and neurointensive management for acute spinal cord injury: A narrative review. Korean J Neurotrauma. 2024;20(4):225-233. doi: 10.13004/kjnt.2024.20.e44 https://pubmed.ncbi.nlm.nih.gov/39803341/.
  • LaRiccia A, Doris S, Shah B, et al. Does mean arterial pressure augmentation improve neurological recovery of blunt spinal cord injuries: an EAST multicenter trial. Trauma Surg Acute Care Open. 2025;10(3) doi: 10.1136/tsaco-2025-001768 https://pubmed.ncbi.nlm.nih.gov/40831772/.
  • Lee HD, Chung NS, Chung HW, et al. Acute spinal cord injury: contemporary management and novel therapies. Asian Spine J. 2026;doi: 10.31616/asj.2025.0878 https://pubmed.ncbi.nlm.nih.gov/41928443/.
  • Lee YS, Kim KT, Kwon BK. Hemodynamic management of acute spinal cord injury: A literature review. Neurospine. 2021;18(1):7-14. doi: 10.14245/ns.2040144.072 https://pubmed.ncbi.nlm.nih.gov/33211951/.
  • Marchesini N, Dange RM, Demetriades AK, et al. BOOTStrap-SCI: Beyond One Option of Treatment for Spinal Trauma and Spinal Cord Injury: Consensus-based stratified protocols for intensive care and surgical management. World Neurosurg. 2025;200doi: 10.1016/j.wneu.2025.124099 https://pubmed.ncbi.nlm.nih.gov/40383265/.
  • Mensah EO, Chalif JI, Johnston BR, et al. Traumatic spinal cord injury: a review of the current state of art and future directions - what do we know and where are we going? N Am Spine Soc J. 2025;22:100601. doi: 10.1016/j.xnsj.2025.100601 https://pubmed.ncbi.nlm.nih.gov/40256049/.
  • Park J, Zhang Y, Saito E, et al. Intravascular innate immune cells reprogrammed via intravenous nanoparticles to promote functional recovery after spinal cord injury. Proc Natl Acad Sci U S A. 2019;116(30):14947-14954. doi: 10.1073/pnas.1820276116 https://pubmed.ncbi.nlm.nih.gov/31285339/.
  • Puvanesarajah V, Goheer HE, Botros M, et al. Duration of intensive care unit admission to maintain mean arterial pressure goals following acute traumatic spinal cord injury. Injury. 2026;57(6):113283. doi: 10.1016/j.injury.2026.113283 https://pubmed.ncbi.nlm.nih.gov/41985389/.
  • Ransom SC, Brown NJ, Pennington ZA, et al. Hypothermia therapy for traumatic spinal cord injury: An updated review. J Clin Med. 2022;11(6) doi: 10.3390/jcm11061585 https://pubmed.ncbi.nlm.nih.gov/35329911/.
  • Sherman BC, Schmidt Read M, Hoh DJ, et al. Combining therapeutic strategies to treat the injured spinal cord: A translational perspective. J Neurotrauma. 2025;42(23-24):2129-2148. doi: 10.1177/08977151251371710 https://pubmed.ncbi.nlm.nih.gov/40929022/.
  • Simon DW, McGeachy MJ, Bayir H, et al. Neuroinflammation in the evolution of secondary injury, repair, and chronic neurodegeneration after traumatic brain injury. Nat Rev Neurol. 2017;13(3):171-191. doi: 10.1038/nrneurol.2017.13 https://pubmed.ncbi.nlm.nih.gov/28186177/.
  • Tokunaga S, Miyakoshi A, Sato S, et al. Complete liberation from mechanical ventilation using diaphragm pacing in a patient with traumatic spinal cord injury despite persistent unilateral diaphragmatic paralysis. NMC Case Rep J. 2026;13:55-61. doi: 10.2176/jns-nmc.2025-0231 https://pubmed.ncbi.nlm.nih.gov/41859525/.

Topic: Secondary cord injuries

  • Araujo AQC. Lost in translation: why pharmacological trials keep failing in acute spinal cord injury. Arq Neuropsiquiatr. 2026;84(8):1-9. doi: 10.1055/s-0046-1827054 https://pubmed.ncbi.nlm.nih.gov/42595311/.
  • Baroudi M, Rezk A, Daher M, et al. Management of traumatic spinal cord injury: A current concepts review of contemporary and future treatment. Injury. 2024;55(6) doi: 10.1016/j.injury.2024.111472 https://pubmed.ncbi.nlm.nih.gov/38460480/.
  • Hosseini SM, Borys B, Karimi-Abdolrezaee S. Neural stem cell therapies for spinal cord injury repair: an update on recent preclinical and clinical advances. Brain. 2024;147(3):766-793. doi: 10.1093/brain/awad392 https://pubmed.ncbi.nlm.nih.gov/37975820/.
  • Peng S, Zeng L, Lu B, et al. Application of hyperbaric oxygen therapy in the treatment of spinal cord injury: insights from preclinical to clinical evidence. Med Gas Res. 2025;16(1):33-40. doi: 10.4103/mgr.MEDGASRES-D-24-00111 https://pubmed.ncbi.nlm.nih.gov/40580186/.
  • Routkevitch D, Jiang K, Weber-Levine C, et al. Spinal cord vascular autoregulation: key concepts and opportunities to improve management. Spinal Cord. 2026;64(1):14-28. doi: 10.1038/s41393-025-01126-5 https://pubmed.ncbi.nlm.nih.gov/41366092/.
  • Seblani M, Decherchi P, Brezun JM. Edema after CNS trauma: A focus on spinal cord injury. Int J Mol Sci. 2023;24(8) doi: 10.3390/ijms24087159 https://pubmed.ncbi.nlm.nih.gov/37108324/.
  • Weidner N, Abel R, Maier D, et al. Safety and efficacy of intrathecal antibodies to Nogo-A in patients with acute cervical spinal cord injury: a randomised, double-blind, multicentre, placebo-controlled, phase 2b trial. Lancet Neurol. 2025;24(1):42-53. doi: 10.1016/s1474-4422(24)00447-2 https://pubmed.ncbi.nlm.nih.gov/39706632/.

Topic: Spinal stabilization: early & late

  • Ackland HM, Cooper DJ, Malham GM, et al. Factors predicting cervical collar-related decubitus ulceration in major trauma patients. Spine. 2007;32(4):423-8. doi: 10.1097/01.brs.0000255096.52871.4e https://pubmed.ncbi.nlm.nih.gov/17304132/.
  • Anderson GA, Kashikar A, Inaba K. Cervical spine clearance in adult trauma patients: What youneed to know. J Trauma Acute Care Surg. 2026;doi: 10.1097/ta.0000000000005025 https://pubmed.ncbi.nlm.nih.gov/42224714/.
  • Behnammoghadam M, Alimohammadi N, Riazi A, et al. Incidence of cervical collar-related pressure injury in patients with head and neck trauma: A scoping review study. J Educ Health Promot. 2023;12:252. doi: 10.4103/jehp.jehp_41_23 https://pubmed.ncbi.nlm.nih.gov/37727424/.
  • Bloemers F, Jug M, Nau C, et al. Thoracolumbar injuries: operative treatment: indications, techniques, timing and implant removal. Current practice. Eur J Trauma Emerg Surg. 2024;50(5):1959-1968. doi: 10.1007/s00068-024-02602-y https://pubmed.ncbi.nlm.nih.gov/39190064/.
  • Browne LR, Ward CE, Harding M, et al. Performance of the PECARN cervical spine injury prediction rule based on EMS clinician observations. J Trauma Acute Care Surg. 2025;doi: 10.1097/ta.0000000000004772 https://pubmed.ncbi.nlm.nih.gov/40836370/.
  • Chan D, Goldberg R, Tascone A, et al. The effect of spinal immobilization on healthy volunteers. Ann Emerg Med. 1994;23(1):48-51. doi: 10.1016/s0196-0644(94)70007-9 https://pubmed.ncbi.nlm.nih.gov/8273958/.
  • Cucci F, Marasciulo D, Lupo R, et al. Prehospital spinal immobilization and motion restriction strategies: A scoping review of the literature. Injury. 2026;57(3):113024. doi: 10.1016/j.injury.2026.113024 https://pubmed.ncbi.nlm.nih.gov/41547085/.
  • Fischer PE, Perina DG, Delbridge TR, et al. Spinal motion restriction in the trauma patient: A joint position statement. Prehosp Emerg Care. 2018;22(6):659-661. doi: 10.1080/10903127.2018.1481476 https://pubmed.ncbi.nlm.nih.gov/30091939/.
  • Guan Y, Zheng L, Zhu Y. Incidence and risk factors for orthopedic device-related pressure injuries: A systematic review and meta-analysis. J Trauma Nurs. 2025;32(1):38-45. doi: 10.1097/jtn.0000000000000831 https://pubmed.ncbi.nlm.nih.gov/39879271/.
  • Kitzen J, Jacobs E, Buckley R. Should a spinal orthosis be used for thoracolumbar fractures that are minimally displaced and stable? Injury. 2024;55(10) doi: 10.1016/j.injury.2024.111752 https://pubmed.ncbi.nlm.nih.gov/39088926/.
  • Larson S, Delnat AU, Moore J. The use of clinical cervical spine clearance in trauma patients: A literature review. J Emerg Nurs. 2018;44(4):368-374. doi: 10.1016/j.jen.2017.10.013 https://pubmed.ncbi.nlm.nih.gov/29203049/.
  • Mahmood S, Asim M, El-Menyar A, et al. Early versus late tracheostomy in traumatic spinal injury: A narrative review. Neurol Int. 2026;18(5) doi: 10.3390/neurolint18050085 https://pubmed.ncbi.nlm.nih.gov/42188685/.
  • Millin MG, Innes JC, King GD, et al. Prehospital trauma compendium: Prehospital management of spinal cord injuries—A NAEMSP comprehensive review and analysis of the literature. Prehosp Emerg Care. 2025:1-13. doi: 10.1080/10903127.2025.2541258 https://pubmed.ncbi.nlm.nih.gov/40736221/.
  • Morag S, Kieninger M, Eissnert C, et al. Comparison of different techniques for prehospital cervical spine immobilization: Biomechanical measurements with a wireless motion capture system. PLoS One. 2023;18(11):e0292300. doi: 10.1371/journal.pone.0292300 https://pubmed.ncbi.nlm.nih.gov/38015902/.
  • Mugesh Kanna R, Prasad Shetty A, Rajasekaran S. Timing of intervention for spinal injury in patients with polytrauma. J Clin Orthop Trauma. 2021;12(1):96-100. doi: 10.1016/j.jcot.2020.10.003 https://pubmed.ncbi.nlm.nih.gov/33716434/.
  • Mühlenfeld N, Obid P, Sommer A, et al. Emergency spinal stabilization in polytrauma: A clinical marker for tracheostomy rather than an independent risk factor for prolonged ventilation. Injury. 2026;57(4):113152. doi: 10.1016/j.injury.2026.113152 https://pubmed.ncbi.nlm.nih.gov/41850132/.
  • Murphy H, Schroeder GD, Shi WJ, et al. Management of Hangman’s fractures: A systematic review. J Orthop Trauma. 2017;31 Suppl 4:S90-s95. doi: 10.1097/bot.0000000000000952 https://pubmed.ncbi.nlm.nih.gov/28816880/.
  • Reichert MM, Rheaume EM, Skoch JM, et al. Improving cervical spine clearance documentation in the pediatric trauma patient: A quality improvement project. J Trauma Nurs. 2025;32(2):108-113. doi: 10.1097/jtn.0000000000000840 https://pubmed.ncbi.nlm.nih.gov/40053554/. PEDS
  • Sarro A, Magtoto R, Maurceri J, et al. Living with your halo vest. 2020:14. https://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/Living_with_Halo_Vest.pdf.
  • Srikandarajah N, Hejrati N, Alvi MA, et al. Prevention, diagnosis, and management of intraoperative spinal cord injury in the setting of spine surgery: A proposed care pathway. Global Spine J. 2024;14(3_suppl):166s-173s. doi: 10.1177/21925682231217980 https://pubmed.ncbi.nlm.nih.gov/38526925/.
  • Teuben MPJ, Veenstra A, Pape HC. Acute management of spinal fractures: What you need to know. J Trauma Acute Care Surg. 2026;doi: 10.1097/ta.0000000000004916 https://pubmed.ncbi.nlm.nih.gov/41879862/.
  • Valdez-Resendiz I, Salgado-Camarillo EN, Hernández-Morales F, et al. Perioperative management in acute and chronic spinal cord injury, narrative review. J Anesth Analg Crit Care. 2025;5(1):33. doi: 10.1186/s44158-025-00252-z https://pubmed.ncbi.nlm.nih.gov/40551217/.
  • Wilson JR, Tetreault LA, Kwon BK, et al. Timing of decompression in patients with acute spinal cord injury: A systematic review. Global Spine J. 2017;7(3 Suppl):95s-115s. doi: 10.1177/2192568217701716 https://pubmed.ncbi.nlm.nih.gov/29164038/.