Curbing the Challenges in Recent Treatment Guideline for Early Management of Individuals with Traumatic Spinal Cord Injury: Recommendation for Therapeutic Hypothermia
Stephen Sunday Ede *
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria. and Department of Physiotherapy, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
Chigozie Ikenna Uchenwoke
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria.
Kayode Israel Oke
Department of Physiotherapy, University of Benin, Benin City, Edo State, Nigeria.
Chigozie Okwudili Obaseki
Department of Physiotherapy, University of Benin Teaching Hospital,Benin City, Edo State, Nigeria and Department of Physiotherapy, University of Benin, Benin City, Edo State, Nigeria.
Franklin Onyedinma Irem
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: There has been little prognosis in improving function after a complete spinal lesion. The viewpoint that little can be done to improve motor function after complete SCI seems conceptually and scientifically part of the past. With advance in medicine, better neurological outcome is long expected.
Objectives: The purpose of this review is to explore the challenges in recent treatment guidelines’ for early management of patient with TSCI and to draw recommendation for Therapeutic hypothermia.
Methods: We conducted a scoping study review comprising 28 studies (2010 to 2020) to identify and examine the research literature related to challenges’ in recent treatment guidelines’ for early management of patient with TSCI.
Findings: 28 studies were reviewed. Most cited challenges were surgical timing (26%), followed by controversy on the application of MPS (28.6%). In each of the studies, various challenges of acute stage interventions were outline with poor common standards and recommendations for clinical practices. Surgical decompression (16 papers) was the most cited intervention. Generally, result showed that despite the progress that has been made in the acute management of patients with SCI, neurological outcomes have not improved significantly in recent decades.
Conclusion: Key early interventions are increasingly being recognized; combined Neuroprotective and neuroregenerative care are probably more effective and they inspire current and future research. We concluded that an evidence based guidelines for TH would help reduce the doom experience around complete SCIs. Thus there is a need to better define the beneficial effect of TH on the injured SCI.
Keywords: Traumatic spinal cord injury, emergency care, treatment guideline, therapeutic hypothermia.