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Georg Mattiassich. 1 Trauma Center Linz, Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria. 2 Ludwig-Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria. 3 Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria.
Maria Gollwitzer. 4 Department of Neurosurgery, Neuromed Campus, Kepler University Linz, Linz, Austria.
Franz Gaderer. 5 Department of Trauma Surgery, Medcampus III, Kepler University Linz, Linz, Austria.
Martina Blocher. 6 Department of Orthopaedics and Traumatology, Paracelsus Medical University Salzburg, Salzburg, Austria.
Michael Osti. 7 Department for Trauma Surgery and Sports Traumatology, Academic Hospital Feldkirch, Feldkirch, Austria.
Markkus Lill. 8 Trauma Center Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria.
Reinhold Ortmaier. 3 Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria. 9 Research Unit for Orthopaedic Sports Medicine and Injury Prevention, ISAG/UMIT, Hall in Tyrol, Austria.
Thomas Haider. 10 Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria.
Wolfgang Hitzl. 11 Research Office of Biostatistics, Paracelsus Medical University Salzburg, Salzburg, Austria.
Herbert Resch. 12 Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria.
Stephanie Aschauer-Wallner. 12 Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria.
Address correspondence to: Georg Mattiassich, MD, Trauma Center Linz-Teaching Hospital of the Paracelsus Medical University Salzburg, Garnisonstrasse 7, 4010 Linz, Austria, E-mail: [email protected]
Introduction
Traumatic spinal cord injury (tSCI) is a personally, socially, and economically catastrophic event. Effective therapies and measures for improving neurological outcome or reducing the extent of tissue destruction after the initial spinal cord trauma are needed.
The pathophysiology of SCI involves the primary mechanical injury, which occurs via the trauma mechanism. Primary injury is triggered by rapid cord compression caused by bone dislocation that directly disrupts axons and blood vessels. The primary mechanical injury initiates a signalling cascade that includes vascular dysfunction, edema formation, ischemia, inflammation, and delayed apoptosis, which comprise the secondary injury phase.1-3
A proposed therapeutic approach for the initial phase to improve the neurological outcome of patients is decreasing the secondary injury via early decompression.4 This approach is based on the goal of promptly reducing...