• Filippo Migliorini, Federico Cocconi, Luise Schäfer, Francesco Simeone, Madhan Jeyaraman, and Nicola Maffulli.
• Department of Life Sciences, Health, and Health Professions, Link Campus University, Via del Casale di S. Pio V, 44, 00165 Rome, Italy.
• Br. Med. Bull. 2024 Sep 27; 151 (1): 496849-68.

IntroductionSpinal cord injury (SCI) may bring lifelong consequences for affected patients and a high financial burden to the health care system.Source Of DataPublished peer-reviewed scientific articles identified from EMBASE, Google Scholar, PubMed and Scopus.Areas Of AgreementSurgery and blood pressure management are the main targets in acute SCI to avoid secondary damage.Areas Of ControversyThe management of secondary chronic SCI is challenging, with unpredictable outcomes.Growing PointsGiven the lack of consensus on pharmacological therapy for acute and secondary chronic SCI, the present study analyses the currently available drugs and treatment options to manage secondary chronic SCI.Areas Timely For Developing ResearchDifferent approaches exist for the pharmacological management of secondary chronic SCI. One of the most investigated drugs, 4-aminopyridine, improves central motor conduction and shows improvement in neurological signs. Positive results in different areas have been observed in patients receiving the anti-spastic drugs tizanidine and baclofen or Granulocyte colony-stimulating factor. Growth hormone showed only minimal or no significant effects, and the therapy of secondary chronic SCI with riluzole has been poorly researched to date.© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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