Clinical management of complications after chronic spinal cord injury: a review of recent advances
Abstract
Introduction: Chronic spinal cord injury (SCI) is a severe neurological disorder resulting from trauma or disease, characterized by persistent motor, sensory, and autonomic deficits below the level of the lesion. As the condition becomes long-standing, the management of multisystem complications - particularly those affecting motor, respiratory, cardiovascular, gastrointestinal, and urinary functions - emerges as a major clinical challenge. These complications not only impair quality of life but also contribute to increased rates of rehospitalization and impose significant economic burdens on healthcare systems.
Discussion: Although no curative therapy is currently available, treatment strategies have evolved into a comprehensive, multilayered framework incorporating rehabilitation, pharmacological interventions, neuromodulation techniques, and surgical procedures. Nevertheless, existing management approaches remain predominantly reactive and symptom-oriented, with notable limitations in long-term effectiveness, accessibility, and sustained patient engagement. This review synthesizes recent advances in understanding the pathophysiology of chronic SCI complications and critically evaluates current therapeutic limitations. A fundamental paradigm shift is urgently required - one that moves beyond traditional reactive models toward proactive, patient-centered care grounded in multidisciplinary collaboration and individualized treatment plans.
Conclusion: Given the numerous…
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