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CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(03): 456-461
DOI: 10.1055/s-0045-1808234
Review Article

The Role of Hypertonic Saline in the Management of Acute Traumatic Spinal Cord Injury: A Narrative Review of the Literature

Syed Faisal Nadeem 
1   Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
,
Ahmad Hassan
1   Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
,
Tabinda Tahir
1   Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
,
Luis E. Carelli
2   National Institute of Traumatology and Orthopaedics, INTO Spine Institute of Rio de Janeiro, INCOL, Rio de Janeiro, Brazil
,
Andres M. Rubiano
3   Department of Neurosciences and Neurosurgery, Universidad El Bosque, Bogota, Colombia
4   Department of Surgery, Meditech Foundation, Cali, Colombia
,
Ahsan Ali Khan
1   Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
› Institutsangaben
Funding None.
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Abstract

Traumatic spinal cord injury (TSCI) is a prevalent condition associated with high morbidity and mortality. The pathophysiology of TSCI involves primary injury from the traumatic insult itself and secondary injury (SI) from maladaptive biological processes that serve to aggravate the original insult, such as edema and inflammation, which exacerbate the primary injury and prevent healing and recovery. Research is currently underway to derive therapies to reduce SI-mediated damage. Hypertonic saline (HTS) has emerged as one such therapy. We conducted a literature search for animal and human studies investigating the role of HTS in TSCI on PubMed. Murine studies have shown it to possess antiedema, anti-inflammatory, and vasodilatory properties, which aid in reducing SI and thus improving functional outcomes. Combining HTS with other drugs such as procoagulants, methylprednisolone, and nitroprusside has also been shown to possess greater therapeutic benefit in rodent models of TSCI compared with single therapy with HTS. No human studies have been done till now to assess the benefits of HTS in improving human TSCI outcomes. Future research must focus on determining specific dosing and frequency regimens for HTS in human TSCI patients and on elucidating the extent of benefit it provides to them in improving their outcomes.

Keywords

hypertonic - traumatic - spine - injury - outcome

Authors' Contributions

S.F.N. developed the search string, conducted the literature search, screened the relevant articles, and wrote the final manuscript. A.H. and T.T. were responsible for extracting data and relevant information from the selected articles and also contributed to writing the final manuscript. L.E.C. and A.R. proofread the manuscript to ensure both factual accuracy and linguistic correctness. A.A.K. conceived the research question and provided critical revisions to the final manuscript.




Publikationsverlauf

Artikel online veröffentlicht:
19. Mai 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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