*4.1.1 Rho-ROCK inhibitor*

*Paraplegia*

for SCI.

publication [41].

*3.1.4 GM-1 ganglioside*

*3.1.5 Fibroblast growth factor-analogue*

*3.1.6 Granulocyte colony-stimulating factor*

*3.1.7 Hepatocyte growth factor*

*3.2.1 Therapeutic hypothermia*

*3.2.2 Cerebrospinal fluid drainage*

**4. Neuroregenerative strategies**

regenerative medicine [49].

**3.2 Non-pharmacological therapies**

Cord", which has been planned to assess efficacy [25].

has been completed with results pending publication.

clinical trial with results pending publication [25].

GM-1 is a glycosphingolipid found in cell membranes with the ability to enhance neurite growth and nerve regeneration [34]. However, clinical trials in SCI patients

Fibroblast growth factor (FGF) is a protein found to be neuroprotective against excitotoxicity [36]. A FGF analogue called SUN 13837 was evaluated in a phase I/II

Granulocyte colony-stimulating factor (G-CSF) is found to promote cell survival and inhibit inflammatory cytokine expression [37]. Two recent nonrandomized phase I/IIa clinical trials showed great results in SCI outcomes [38, 39]; however, randomized clinical trials are required to establish the efficacy of G-CSF

Hepatocyte growth factor (HGF) increases neuronal survival in SCI models [40]. A phase I/II randomized clinical trial is now underway with results pending

Therapeutic hypothermia (TH; 32°-34° C) reduces the basal metabolic rate and energy demands of the CNS [42]. TH is effective in reducing the extent of CNS injury in neonatal hypoxic ischemic encephalopathy as well as after cardiac arrest [43, 44]. Small studies in SCI patients exposed to TH showed a trend towards neurological recovery [45, 46]. Therefore, these promising results led to a phase II/ III clinical trial named "The Acute Rapid Cooling Therapy for Injuries of the Spinal

Cerebrospinal fluid drainage objective is to prevent spinal cord hypoperfusion in the postinjury period by lowering the intrathecal pressure [47]. A phase IIb clinical trial evaluating mean arterial pressure elevation with cerebrospinal drainage in SCI

Neuroregenerative strategies aim to restore neurological function [48]. Chronic SCI sets an excellent example because there are currently no interventions to restore body functions after injury. However, due to the inherent and limited ability of the CNS to regenerate, chronic SCI involves a great challenge for

found no statistically significant improvement with GM-1 [35].

**6**

Cethrin/VX-210 is a direct Rho inhibitor applied intraoperatively using a fibrin carrier to the epidural space [50]. A phase I/IIa clinical trial of patients with cervical or thoracic acute SCI found a significant improvement in long-term motor recovery for cervical patients [51].
