Recommendations for research
The guideline committee has made the following recommendations for research.
Does early treatment with a centrally acting analgesic (for example pregabalin) reduce the frequency or severity of neuropathic pain in people with spinal cord injury?
Neuropathic pain occurs in 40% of people with spinal cord injury. It can be severe and disabling, and in people with spinal cord injury it can lead to further impairment of function. Having neuropathic pain can also result in increased care needs and costs of care, and make it difficult to find employment. It also increases the risk of significant depressive illness and suicide. Research is needed to address whether early treatment of spinal cord injury with a centrally acting analgesic such as pregabalin might reduce the frequency or severity of neuropathic pain.
What is the clinical and cost effectiveness of emergency reduction of cervical spine dislocations following acute traumatic cervical spine injury?
Half of all traumatic spinal cord injuries involve the cervical spinal cord, and a large proportion of these are caused by cervical spine dislocation. Cervical spinal cord injury caused by traumatic cervical spine dislocation produces permanent disability. The greater the permanent neurological impairment the greater the disability. A high level of disability is associated with less independence, fewer opportunities for a full life, reduced prospects for employment and a shorter life expectancy. Any intervention that improves the neurological outcome in this group of people will improve all of these adverse outcomes.
After injury, what is the best method of clinical assessment to determine who needs imaging of the thoracic and lumbar spine to exclude injury to the spinal column or cord, and who is safe to discharge without risk of missing significant injury?
Injuries to the thoracic and lumbar spine are associated with significant morbidity and can be associated with relatively minor mechanisms of injury. This is a particular problem in older people where such injuries can have a significant impact on their mobility, functional status and level of independence.