Effect of Decompression on Complete Spinal Cord Injury in Rats

Rahimi‐Movaghar, Vafa; Yazdi, Atefeh; Karimi, Mehran; Mohammadi, Mehdi; Firouzi, Masoumeh; Zanjani, Leila Oryadi; Nabian, Mohammad Hossein

doi:10.1080/00207450701392340

Cited by 21 publications

(18 citation statements)

References 25 publications

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“…Although 7 decompression studies had quality scores of 5 or more [21,22,29,33,37,40,41], the overall quality of the dataset was modest, with a median quality score of 4 in studies included in the meta-analysis and 2 for those studies excluded. Blinding is a key factor in maintaining the internal validity of an experiment but was only reported in approximately half of decompression studies.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Pre-Clinical Studies of Early Decompression in Acute Spinal Cord Injury: A Battle of Time and Pressure

et al. 2013

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BackgroundThe use of early decompression in the management of acute spinal cord injury (SCI) remains contentious despite many pre-clinical studies demonstrating benefits and a small number of supportive clinical studies. Although the pre-clinical literature favours the concept of early decompression, translation is hindered by uncertainties regarding overall treatment efficacy and timing of decompression.MethodsWe performed meta-analysis to examine the pre-clinical literature on acute decompression of the injured spinal cord. Three databases were utilised; PubMed, ISI Web of Science and Embase. Our inclusion criteria consisted of (i) the reporting of efficacy of decompression at various time intervals (ii) number of animals and (iii) the mean outcome and variance in each group. Random effects meta-analysis was used and the impact of study design characteristics assessed with meta-regression.ResultsOverall, decompression improved behavioural outcome by 35.1% (95%CI 27.4-42.8; I2=94%, p<0.001). Measures to minimise bias were not routinely reported with blinding associated with a smaller but still significant benefit. Publication bias likely also contributed to an overestimation of efficacy. Meta-regression demonstrated a number of factors affecting outcome, notably compressive pressure and duration (adjusted r2=0.204, p<0.002), with increased pressure and longer durations of compression associated with smaller treatment effects. Plotting the compressive pressure against the duration of compression resulting in paraplegia in individual studies revealed a power law relationship; high compressive forces quickly resulted in paraplegia, while low compressive forces accompanying canal narrowing resulted in paresis over many hours.ConclusionThese data suggest early decompression improves neurobehavioural deficits in animal models of SCI. Although much of the literature had limited internal validity, benefit was maintained across high quality studies. The close relationship of compressive pressure to the rate of development of severe neurological injury suggests that pressure local to the site of injury might be a useful parameter determining the urgency of decompression.

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Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Pre-Clinical Studies of Early Decompression in Acute Spinal Cord Injury: A Battle of Time and Pressure

et al. 2013

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“…An understanding of the pathophysiology underlying SCI is important for guiding research efforts and developing clinical treatment strategies (20,21). Upregulation of caspase-12 is important in ER stress-induced cell death in brain ischemia (22), Parkinson’s disease (23), Alzheimer’s disease (24) and SCI (11).…”

Section: Discussionmentioning

confidence: 99%

Bone marrow stromal cells inhibit caspase-12 expression in rats with spinal cord injury

Liu¹,

Ding²,

Zhang³

et al. 2013

Experimental and Therapeutic Medicine

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The mechanisms underlying the potentially beneficial effect of bone marrow stem cells (BMSCs) on spinal cord injury (SCI) are unknown. Therefore, the aim of the present study was to explore the protective effect of BMSCs in rats with SCI. A total of 45 adult male Sprague-Dawley rats were randomly divided into three groups; the SCI group (n=15), the BMSC group (n=15) and the sham-operation group (n=15). In the SCI and BMSC treatment groups, a modified Allen’s weight-drop technique was used to induce SCI. The BMSC treatment group received an injection of BMSCs using a microneedle into the epicenter of the spinal cord 24 h after injury. Rats in the sham-operation group were not subjected to SCI; however, the corresponding vertebral laminae were removed. Seven days after transplantation, a rapid recovery was observed in the Basso, Beattie and Bresnahan (BBB) scores of the BMSC treatment group, whereas the BBB scores in the SCI group remained low (P<0.05). Caspase-12 expression in the SCI group was increased compared with that in the sham-operation group, whereas caspase-12 expression was attenuated 24 h after transplantation in the BMSC treatment group (P<0.05). In conclusion, the transplantation of BMSCs may improve locomotor function and attenuate caspase-12 expression following SCI. Therefore, it is likely to be an effective strategy for preventing severe injury of the spinal cord.

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“…[1][2][3][4][5] Traumatic spinal injuries in children are uncommon, representing only 1% to 10% of all reported spinal injuries. Each year, approximately 1000 new spinal injuries are reported in children.…”

Section: Introductionmentioning

confidence: 98%