The basic research will require a variety of clinically relevant models, both in vitro and in vivo, and fortunately many are already available. These models should simulate clinical injuries to all regions of the cord and throughout the time spectrum from acute to chronic, and in both small and large animals. To date, most of the therapeutic interventions for spinal cord injury have been based on attempts to prevent or moderate one or more of the major secondary injury mechanisms that have been identified. Currently, there are approximately 20 important secondary injury mechanisms causing tissue destruction such as post traumatic ischemia, edema and inflammation, and more basic science studies are required to establish more effective ways to overcome these processes through the administration of neuroprotective agents. Similarly, there is a long list of inhibitory mechanisms in the injured spinal cord that impair or block regeneration, and these must be overcome to enhance regeneration. Furthermore, it will probably be most effective to administer both neuroprotective and neuroregenerative therapies, perhaps simultaneously, to maximize effect.
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