Integrated Neuro-Orthopedic Trauma Care: From Physiological Prioritization to Regenerative and Precision-Based Strategies
DOI:
https://doi.org/10.64784/160Palavras-chave:
neuro-orthopedic trauma, traumatic brain injury, spinal cord injury, polytrauma, damage control orthopaedics, neuroinflammation, surgical timing, multidisciplinary care, regenerative medicine, functional recoveryResumo
Trauma remains one of the leading causes of morbidity and mortality worldwide, particularly in patients presenting with complex injury patterns involving both the musculoskeletal system and the central nervous system. In recent years, the management of these conditions has undergone a significant transformation, evolving from isolated structural repair toward integrated, systems-based approaches that incorporate physiological prioritization, neuroprotection, and regenerative strategies. This review analyzes current evidence on neuro-orthopedic trauma, focusing on the interaction between traumatic brain injury, spinal cord injury, and orthopedic damage within the context of polytrauma. A structured narrative review was conducted using high-impact literature published from 2020 onward, emphasizing pathophysiological mechanisms, surgical timing, multidisciplinary care, and emerging regenerative concepts. The findings demonstrate that secondary injury processes, including neuroinflammation, oxidative stress, and immune dysregulation, play a central role in determining outcomes, reinforcing the importance of early and physiologically guided intervention. Furthermore, coordinated multidisciplinary management was consistently associated with improved neurological recovery, functional outcomes, and reduced complications. Although regenerative approaches remain in development, their growing presence suggests a shift toward biologically informed recovery models. Overall, neuro-orthopedic trauma is increasingly understood as a unified clinical entity requiring integrated decision-making and patient-centered strategies. This evolution provides a framework for improving trauma care across diverse healthcare settings, including resource-variable environments.
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