The Pressure Distribution of Cerebrospinal Fluid Responds to Residual Compression and Decompression in an Animal Model of Acute Spinal Cord Injury

Jones, Claire F.; Newell, Robyn; Lee, Jae H.T.; Cripton, Peter A.

doi:10.1097/brs.0b013e31826ba7cd

Cited by 36 publications

(30 citation statements)

References 72 publications

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“…Jones et al described two separate studies in 2012 utilizing a porcine model of weight drop and compression SCI followed by decompression surgery 4 h after primary injury (Jones et al, 2012a, 2012b). In one study, the authors investigated the morphological alterations to the dura and spinal cord following persistent compression and surgical decompression in Yucatan pigs.…”

Section: Discussionmentioning

confidence: 99%

Surgical decompression in acute spinal cord injury: A review of clinical evidence, animal model studies, and potential future directions of investigation

Walker

Shields

et al. 2014

Front. Biol.

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The goal for treatment in acute spinal cord injury (SCI) is to reduce the extent of secondary damage and facilitate neurologic regeneration and functional recovery. Although multiple studies have investigated potential new therapies for the treatment of acute SCI, outcomes and management protocols aimed at ameliorating neurologic injury in patients remain ineffective. More recent clinical and basic science research have shown surgical interventions to be a potentially valuable modality for treatment; however, the role and timing of surgical decompression, in addition to the optimal surgical intervention, remain one of the most controversial topics pertaining to surgical treatment of acute SCI. As an increasing number of potential treatment modalities emerge, animal models are pivotal for investigating its clinical application and translation into human trials. This review critically appraises the available literature for both clinical and basic science studies to highlight the extent of investigation that has occurred, specific therapies considered, and potential areas for future research.

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Section: Discussionmentioning

confidence: 99%

Surgical decompression in acute spinal cord injury: A review of clinical evidence, animal model studies, and potential future directions of investigation

Walker

Shields

et al. 2014

Front. Biol.

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“…After SCI, it was shown in human [10] and in experimental settings [47] that a differential in CSF pressure across the injury site may occur. This emphasises the need for measuring CSF pressure caudal and rostral to the lesion.…”

Section: Discussionmentioning

confidence: 99%

“…To circumvent this anatomical limitation, other experimental studies have used bigger animals such as cats [45] or Yucatan miniature pigs [46,47]. Compared to rats, bigger animals like pigs offer the major advantage to have a ratio between volumes of spinal cord and subarachnoidian space very similar to humans.…”

Section: Discussionmentioning

confidence: 99%

Rat model of spinal cord injury preserving dura mater integrity and allowing measurements of cerebrospinal fluid pressure and spinal cord blood flow

et al. 2013

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Purposes Cerebrospinal fluid (CSF) pressure elevation may worsen spinal cord ischaemia after spinal cord injury (SCI). We developed a rat model to investigate relationships between CSF pressure and spinal cord blood flow (SCBF). Methods Male Wistar rats had SCI induced at Th10 (n = 7) or a sham operation (n = 10). SCBF was measured using laser-Doppler and CSF pressure via a sacral catheter. Dural integrity was assessed using subdural methyleneblue injection (n = 5) and myelography (n = 5). Results The SCI group had significantly lower SCBF (p \ 0.0001) and higher CSF pressure (p \ 0.0001) values compared to the sham-operated group. Sixty minutes after SCI or sham operation, CSF pressure was 8.6 ± 0.4 mmHg in the SCI group versus 5.5 ± 0.5 mmHg in the shamoperated group. No dural tears were found after SCI. Conclusion Our rat model allows SCBF and CSF pressure measurements after induced SCI. After SCI, CSF pressure significantly increases.

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“…In an SCI animal model, Jones et al 16 found that an enlarged cord immediately occluded the subarachnoid space in severe SCI, and CSF pressure was only partially decreased by epidural decompressive surgery. 11 Okada et al 17 found that systemically increased intraspinal pressure is involved in the pathogenesis of ascending myelopathy.…”

Section: Discussionmentioning

confidence: 99%

“…Although traditional epidural decompression seems adequate during surgery, postoperative MRI often reveals that the swollen cord has filled the subarachnoid space. 9,10 Obvious cerebrospinal fluid pressure (CSFP) elevation has been shown after SCI in preclinical and clinical studies, [11][12][13] and CSFP elevation may lead to neurological dysfunction. 14 Meagher et al 15 and Planner et al 2 reported that disruption of CSF dynamics was the major cause of SPAM.…”

Section: Discussionmentioning

confidence: 99%

Subacute post-traumatic ascending myelopathy after T12 burst fracture in a 32-year-old male: case report and surgical result of cervical durotomy

Zhang

Wang

Liu

et al. 2016

Spinal Cord Ser Cases

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To draw attention to a rare neurological deterioration after spinal cord injury (SCI) and to discuss evidence supporting an increase in cerebrospinal fluid pressure (CSFP), we present an extremely rare case of subacute post-traumatic ascending myelopathy (SPAM) in which the patient sustained a T12 fracture initially resulting in paraplegia and after undergoing posterior fixation and anterior decompression. The patient was a 32-year-old healthy man who sustained a T12 burst fracture with complete paraplegia after a fall injury. The patient underwent a posterior reduction and short-segment fixation 8 h after the injury and an anterior thoracoscopicassisted decompression on post-traumatic day 8. On post-traumatic day 21, he had a progressive neurological deterioration with dyspnoea and decreased muscle strength of both upper extremities that could not be relieved by conservative intervention. After undergoing a cervical posterior laminectomy and durotomy, the patient exhibited the clinical manifestation of brain herniation. There was no recovery of autonomous respiration, and the patient entered a coma. The patient died on post-traumatic day 25 because of cardiac and respiratory arrest. SPAM is a rare, potentially fatal neurological deterioration after SCI; however, a prompt diagnosis can be made by magnetic resonance imaging. Our observations suggest that an increase in CSFP may be the main cause of SPAM. The paraplegic level should be recorded daily so that neurological deterioration can be recognised as soon as possible.

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The Pressure Distribution of Cerebrospinal Fluid Responds to Residual Compression and Decompression in an Animal Model of Acute Spinal Cord Injury

Cited by 36 publications

References 72 publications

Surgical decompression in acute spinal cord injury: A review of clinical evidence, animal model studies, and potential future directions of investigation

Surgical decompression in acute spinal cord injury: A review of clinical evidence, animal model studies, and potential future directions of investigation

Rat model of spinal cord injury preserving dura mater integrity and allowing measurements of cerebrospinal fluid pressure and spinal cord blood flow

Subacute post-traumatic ascending myelopathy after T12 burst fracture in a 32-year-old male: case report and surgical result of cervical durotomy

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