Journal of Neurosurgery: Spine features NACTN

Journal of Neurosurgery: Spine September 2012

Clinical trials are being held, or planned, for several promising therapies for spinal cord injury. The translation of research to application requires a coordinated approach, from preclinical data assessment, trial protocols to actual treatment and outcome measures.

The September 2012 edition of the Journal of Neurosurgery: Spine dedicated its entire issue to clinical trial developments in the field of spinal cord research. The publication centered on the activities of the Reeve Foundation North American Clinical Trials Network (NACTN).

NACTN is a network of clinical centers that ushers promising therapies out of the laboratory and into clinical trials to speed the delivery of treatments for spinal cord injury. Proving a therapy safe and effective requires a framework for studying large numbers of patients. That's where NACTN comes in, to provide expertise, infrastructure, and efficiency to run trials and evaluate their results.

The 246-page peer-reviewed journal includes papers related to identifying and evaluating different types of spinal cord trauma, including a characterization of the incidence and severity of acute complications after SCI, based on a large patient database maintained by NACTN. Also, the NACTN decision making process for choosing which therapies to study is evaluated.

A number of the papers summarize evidence for predicting neurological outcome in patients with both cervical and thoracic SCI, identifying gaps in research and making recommendations for future research. The discussion focuses on the development of newer graded assessments to better define the scope and extent of injury, and of recovery.

The journal also features original clinical studies and review articles on current and potential drug-based therapies, including the drug Riluzole, which was tested by NACTN with the Phase I safety study completed. NACTN has now moved forward with a Phase II/III study of the neuroprotective drug called RISCIS (Riluzole in Spinal Cord Injury Study) to measure both safety and efficacy in 351 participants with acute spinal cord injury across 20 clinical centers.

This issue of Journal of Neurosurgery: Spine was an academic collaboration with AOSpine North America (an international community of spine and orthopedic surgeons, neurosurgeons, academics, and other spine care professionals). The supplement was directed by Michael Fehlings, Professor of Neurosurgery at the University of Toronto and Medical Director of the Krembil Neuroscience Centre at the Toronto Western Hospital.