Study design: Experimental, controlled, animal study. Objectives: To evaluate the functional effect of hyperbaric oxygen therapy administered shortly, one day after, and no intervention (control) in standardized experimental spinal cord lesions in Wistar rats. Setting: São Paulo, Brazil. Methods: In all, 30 Wistar rats with spinal cord lesions were divided into three groups: one group was submitted to hyperbaric oxygen therapy beginning half an hour after the lesion and with a total of 10 one-hour sessions, one session per day, at 2 atm; the second received the same treatment, but beginning on the day after the lesion; and the third received no treatment (control). The Basso, Beattie and Bresnahan scales were used for functional evaluation on the second day after the lesion and then weekly, until being killed 1 month later. Results: There were no significant differences between the groups in the functional analysis on the second day after the lesion. There was no functional difference comparing Groups 1 and 2 (treated shortly after or one day after) in any evaluation moment. On the 7th day, as well as on the 21st and 28th postoperative days, the evaluation showed that Groups 1 and 2 performed significantly better than the control group (receiving no therapy).
INTRODUCTIONClinical and experimental researches on spinal cord trauma have raised several hypotheses with regard to the pathophysiology of secondary injury that occurs immediately after the initial injury (primary). Most current efforts are directed to minimizing this type of injury, by acting directly on its causes. Recent studies 1,2 indicate that the process is characterized by an initial ischemia (affecting mainly the gray matter), extending rostrally and caudally to the lesion. At this point, the decrease in oxygen and nutrients supply to the cells reduces the amount of available ATP, causing a malfunction of the electrolyte pumps in the cell membrane, resulting in changes in the intra-and extracellular ionic concentrations. 3,4 This process is responsible for edema and cell death and for the secretion of aminoacidic neurotransmitters, for example, the glutamate. 5 The decrease in ATP also stimulates the glycolytic pathway, increasing lactate and decreasing the local pH, which results later in vasodilation and increased blood flow, contributing to the formation of free radicals, 6 and causing cell death. Although these processes occur mainly in the gray matter, the release of lytic enzymes and free radicals eventually damages the surrounding white matter. These metabolic products also cause inflammation and demyelination. 1