Spinal Cord Injury

Acute Traumatic Spinal Cord Injury: Neurologic Resuscitation and the Perfusion Problem

Early traumatic spinal cord injury care centers on preventing hypoxemia and hypotension, accurately defining the neurologic injury, recognizing persistent compression, and pursuing timely decompression. Current evidence supports avoiding sustained hypotension but not reflexively driving every patient to legacy MAP targets regardless of physiologic cost.

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The Neuro-ICU Course After Acute Spinal Cord Injury: Multisystem Failure From Neural Disconnection

After acute traumatic SCI, neurologic preservation depends on anticipating respiratory failure, bradyarrhythmias, dysautonomia, VTE, bowel and bladder dysfunction, pressure injury, and immobility. Serial bedside physiology and examination should drive individualized airway, hemodynamic, prophylactic, and rehabilitation decisions while acknowledging important limitations in the evidence.

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The Neuro-ICU Course After Acute Spinal Cord Injury: Respiratory Failure, Autonomic Instability, and Preventable Secondary Harm

After stabilization, spinal cord injury care shifts to preventing respiratory failure, dysautonomia, thrombosis, bowel and bladder complications, pressure injury, and delayed rehabilitation. Neurologic level predicts risk, but physiology—not a rigid threshold or timetable—should determine daily treatment.

Neurologic Recovery and Prognostication After Traumatic Spinal Cord Injury

Early ISNCSCI findings, injury level, MRI features, and selected prediction models can refine prognosis after traumatic spinal cord injury, but none determines an individual outcome. Counseling should remain endpoint-specific, conditional, and repeatedly updated as confounders resolve and serial recovery emerges.

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Joshua Lukas, MD (Instagram: @Neurointensivist)

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