scholarly journals A new model of spinal cord injury by cryoapplication: Morphodynamics of histological changes of the spinal cord lesion

2020 ◽  
Author(s):  
George B. Telegin ◽  
Alexey N. Minakov ◽  
Aleksandr S. Chernov ◽  
Vitaly A. Kazakov ◽  
Elena A. Кalabina ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Liquid Nitrogen ◽  
High Precision ◽  
Original Design ◽  
Entire Study ◽  
Minimal Invasiveness ◽  
Study Results ◽  
Cord Injury ◽  
Glial Scarring ◽  
Methodological Guidelines

AbstractUp to 500,000 people worldwide suffer from spinal cord injuries (SCI) annually, according to the WHO. Animal models are essential for searching novel methodological guidelines and therapeutic agents for SCI treatment. We developed an original model of posttraumatic spinal cord glial scar in rats using cryoapplication. The method is based on cryodestruction of spinal cord tissue with liquid nitrogen. Thirty six male SD linear rats of SPF category were included in this experimental study. A T13 unilateral hemilaminectomy was performed with an operating microscope, as it was extremely important not to penetrate the dura mater, and liquid nitrogen was applied into the bone defect for one minute. The animals were euthanized at various intervals ranging from 1 to 60 days after inducing cryogenic trauma, their Th12-L1 vertebrae were removed “en bloc” and the segment of the spinal cord exposed to the cryoapplicator was carefully separated for histological examination. The study results demonstrated that cryoapplication of liquid nitrogen, provoking a local temperature of approximately minus 20°C, produced a highly standardized transmural defect which extended throughout the dorsoventral arrangement of the spinal cord and had an “hour-glass” shape. During the entire study period (1-60 post-injury days), the glial scarring process and the spinal cord defect were located within the surgically approached vertebral space (Th13). Unlike other available experimental models of SCI (compression, contusion, chemical, etc.), the present option is characterized by a minimal invasiveness (the hemilaminectomy is less than 1 mm wide), high precision and consistency. Also, there was a low interanimal variability in histological lesions and dimensions of the produced defect. The original design of cryoapplicator used in the study played a major role in achieving these results. The original technique of high-precision cryoapplication for inducing consistent morphodynamic glial scarring could facilitate a better understanding of the self-recovery processes of injured spinal cord and would be helpful for proposing new platforms for the development of therapeutic strategies.

scholarly journals A New Precision Minimally Invasive Method of Glial Scar Simulation in the Rat Spinal Cord Using Cryoapplication

2021 ◽  
Vol 8 ◽  
Author(s):  
Georgii B. Telegin ◽  
Alexey N. Minakov ◽  
Aleksandr S. Chernov ◽  
Vitaly A. Kazakov ◽  
Elena A. Kalabina ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Glial Scar ◽  
Male Rats ◽  
World Health ◽  
Primary Role ◽  
Original Design ◽  
Entire Study ◽  
Minimal Invasiveness ◽  
Time Points ◽  
Cord Injury

According to the World Health Organization, every year worldwide up to 500,000 people suffer a spinal cord injury (SCI). Various animal biomodels are essential for searching for novel protocols and therapeutic approaches for SCI treatment. We have developed an original model of post-traumatic spinal cord glial scarring in rats through cryoapplication. With this method the low-temperature liquid nitrogen is used for the cryodestruction of the spinal cord tissue. Forty-five Sprague Dawley (SD) non-linear male rats of the Specific-pathogen-free (SPF) category were included in this experimental study. A Th13 unilateral hemilaminectomy was performed with dental burr using an operating microscope. A specifically designed cryogenic probe was applied to the spinal cord for one minute through the created bone defect. The animals were euthanized at different time points ranging from 1 to 60 days after cold-induced injury. Their Th12-L1 vertebrae with the injured spinal cord region were removed “en bloc” for histological examination. Our data demonstrate that cryoapplication producing a topical cooling around−20°C, caused a highly standardized transmural lesion of the spinal cord in the dorsoventral direction. The lesion had an “hour-glass” shape on histological sections. During the entire study period (days 1-60 of the post-trauma period), the necrotic processes and the development of the glial scar (lesion evolution) were contained in the surgically approached vertebral space (Th13). Unlike other known experimental methods of SCI simulation (compression, contusion, etc.), the proposed technique is characterized by minimal invasiveness, high precision, and reproducibility. Also, histological findings, lesion size, and postoperative clinical course varied only slightly between different animals. An original design of the cryoprobe used in the study played a primary role in the achieving of these results. The spinal cord lesion's detailed functional morphology is described at different time points (1–60 days) after the produced cryoinjury. Also, changes in the number of macrophages at distinct time points, neoangiogenesis and the formation of the glial scar's fibrous component, including morphodynamic characteristics of its evolution, are analyzed. The proposed method of cryoapplication for inducing reproducible glial scars could facilitate a better understanding of the self-recovery processes in the damaged spinal cord. It would be evidently helpful for finding innovative approaches to the SCI treatment.

scholarly journals Development and Effectiveness Testing of “Punsook”: A Smartphone Application for Intermittent Urinary Catheter Users with Spinal Cord Injury

2021 ◽  
Vol 72 (2) ◽  
pp. 99-107
Author(s):  
Kamontip Harnphadungkit
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
User Satisfaction ◽  
Urinary Catheter ◽  
Smartphone Application ◽  
Ease Of Use ◽  
Second Phase ◽  
Urinary Leakage ◽  
Study Results ◽  
Cord Injury

Objective: To develop and evaluate effectiveness of a smartphone application to assist the self-management of intermittent urinary catheter users Methods: This is experimental clinical research as part of a medical device trial. In phase 1, 10 intermittent urinary catheter users were recruited from spinal cord injury (SCI) patients who had been admitted to a rehabilitation ward at Siriraj Hospital. They used the preliminary version of “Punsook”, a web-based application (app) for a smartphone, alongside usual intermittent urinary catheterization (IC), and gave feedback on their experiences. Their qualitative opinions were used to further develop a second version of the “Punsook” app. In phase 2, the new version was used by 35 participants, who were asked to complete an effectiveness questionaire after using the app, including providing details on their history of urinary tract infection (UTI), urinary leakage, and catheterization-related pain. This information was gathered at the end of first and third months in the second phase of the study. Results: More than half the participants agreed at the end of the first month that every part of the app was acceptably pleasant. They liked the simplicity and ease of use of the app, accessibility, ease of return to use, and interest in the program. No statistically significant changes in urinary leakage, UTI, or pain were found. Conclusion: The app was considered effective in terms of the positive user satisfaction with all aspects of the app. However, despite this positive reception, the app may not have contributed to an improvement in participant bladder control.

scholarly journals DEPENDENCE OF THE RESTORATIVE EFFECT OF MACROPOROUS POLY(N-[2-HYDROXYPROPYL]-METHACRYLAMIDE HYDROGEL ON THE SEVERITY OF EXPERIMENTAL LACERATIVE SPINAL CORD INJURY

2021 ◽  
Vol 127 (4) ◽  
pp. 8-21
Author(s):  
Ibrahim Abdallah ◽  
Volodymyr Мedvediev ◽  
Nataliya Draguntsova ◽  
Nana Voitenko ◽  
Vitaliy Tsymbaliuk
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Function ◽  
Severe Trauma ◽  
Individual Characteristics ◽  
Male Rats ◽  
Study Results ◽  
Cord Injury ◽  
Hydroxypropyl Methacrylamide ◽  
Immediate Implantation

restoration of the spinal cord function presents a most severe biomedical issue nowadays. The aim of the study was to detect the macroporous poly(N-[2-hydroxypropyl]-methacrylamide hydrogel (PHPMA-hydrogel, HG) restorative effect dependence on the severity of the laceration spinal cord injury in young organisms. The male rats sample (~1-month-old, ~50 g, inbred Wistar line) was represented with 4 experimental groups: 1) spinal cord lateral hemisection at the level of ~Т12–Т13 segments (Sect; n=11); 2) spinal cord lateral hemiexcision ~1 mm long at the similar level (Exc; n=8); 3) spinal cord lateral hemisection at the similar level with immediate implantation of the hydrogel fragment into the trauma region (HGsect; n=11); 4) spinal cord lateral hemiexcision at the similar level with immediate implantation of the hydrogel fragment into the affected region (HGexс; n=6). The motor function and spasticity of the paretic hindlimb was estimated respectively by the technically modified Basso–Beattie–Bresnahan (ВВВ) and Ashworth, conditionally blinded to individual characteristics of all operated animals and previous study results. The observation lasted for ~5 months. The criteria of non-inclusion were as follows: the ipsilateral hindlimb function level in a week after the injury >9 points ВВВ, and the contralateral hindlimb function level during prolonged period ≤14 points ВВВ. The results were interpreted and presented according to the standardized time scale with interpolatory representation of the motor function and spasticity individual level in certain cases. Asymptotic stage differences between the studied groups and subgroups were stated during the first three weeks as well as in 8 weeks and 3 months after the injury. We found out that in a week after injury the motor function level in group Exc made up 0.9±0.5 points ВВВ, in group HGexc — 3.6±1.2 points, in group Sect — 5.9±1.1 points, in group HGsect — 6.0±1.0 points. In 5 months the motor function level in group Sect made up 9.5±1.0 points ВВВ, in group HGsect — 9.5±1.1 points, in group Exc — 0.8±0.3 points, in group HGexc — 4.5±1.8 points. At the same study stage the spasticity level in groups Sect and HGsect was, respectively, 0.8±0.2 and 0.8±0.3 points Ashworth, in group HGexc — 1.8±0.7 points, in group Exc — 3.6±0.3 points. Throughout the study no significant differences in groups Sect and HGsect have been detected, and in groups Exc і HGexc such differences were detected only in 5 weeks after the injury. The considerable difference of spasticity in groups Sect and HGsect was noted in 1 week after the injury, in groups HGexc and Exc — during first 2 months of the experiment. In groups Sect and Exc reliable difference of both motor function and spasticity level was found at all study stages. In groups HGsect and HGexc considerable difference of the motor function level was characteristic at all stages, except for the end of the 1st and 7th weeks, whereas spasticity level differences throughout the study remained insignificant. So, the tested hydrogel in young organisms shows positive effect only with severe trauma stages accompanied with extensive spinal cord defect.

scholarly journals Why Does COVID-19 Affect Patients with Spinal Cord Injury Milder? A Case-Control Study: Results from Two Observational Cohorts

2020 ◽  
Vol 10 (4) ◽  
pp. 182
Author(s):  
Enrique Calvo ◽  
Nerea Corbacho-Alonso ◽  
Tamara Sastre-Oliva ◽  
Estefania Nuñez ◽  
Patricia Baena-Galan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
General Population ◽  
Differential Analysis ◽  
Global Challenge ◽  
Number Of Patients ◽  
Study Results ◽  
Cord Injury ◽  
Viral Respiratory Infection ◽  
Isobaric Tags

The COVID-19 pandemic represents an unprecedented global challenge in this century. COVID-19 is a viral respiratory infection, yet the clinical characteristics of this infection differ in spinal cord injury patients from those observed in the general population. Cough and asthenia are the most frequent symptoms in this population. Moreover, infected spinal cord injury patients rarely present complications that require admission to an Intensive Care Unit, in contrast to the general population. Thus, there is a clear need to understand how COVID-19 affects spinal cord injury patients from a molecular perspective. Here, we employed an -omics strategy in order to identify variations in protein abundance in spinal cord injury patients with and without COVID-19. After a quantitative differential analysis using isobaric tags and mass spectrometry and a verification phase, we have found differences mainly related to coagulation and platelet activation. Our results suggest a key role of heparin in the response of spinal cord injury patients to COVID-19 infection, showing a significant correlation between these proteins and heparin dose. Although the number of patients is limited, these data may shed light on new therapeutic options to improve the management these patients and, possibly, those of the general population as well.

scholarly journals Promoting factors and barriers to participation in working life for people with spinal cord injury

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Christian Sturm ◽  
Andrea Bökel ◽  
Christoph Korallus ◽  
Veronika Geng ◽  
Yorck B. Kalke ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Labour Market ◽  
Occupational Activity ◽  
Cross Sectional ◽  
Self Disclosure ◽  
Gainful Employment ◽  
Self Confidence ◽  
Study Results ◽  
Cord Injury

Abstract Background It is still difficult for people with physical impairments to be and remain equally integrated into the labour market. For this reason, the question of occupational activity has explicitly been examined by the German Spinal Cord Injury Survey (GerSCI) in order to identify barriers and facilitators for labour market participation. Methods Cross-sectional explorative observational study. The GerSCI survey is the German part of the International Spinal Cord Injury Survey (InSCI). Using survey data from persons recruited at eight specialised SCI-centres in Germany. Participants: 1.479 persons with Spinal Cord Injury (SCI) aged 18 years and older. Results In a self-disclosure questionnaire, persons with SCI show themselves as a professionally well-educated and highly motivated group with most of them aiming at gainful employment and considering themselves fit for work. Many changeable and non-changeable factors have been found, which showed a high correlation with the return to work after acquired SCI. Conclusion Education and pain belong to the most critical factors and thereby possible approaches to increase the level of employment, which is essential and highly relevant not only for earning money but also for self-confidence and social integration. SCI has many dimensions in itself; support also should be multidimensional. Study results might help to improve participation.

scholarly journals Preliminary Assessment of Muscle Activity and Muscle Characteristics during Training with Powered Robotic Exoskeleton: A Repeated-Measures Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1003
Author(s):  
Sung-Hyeon Kim ◽  
Ho-Jin Shin ◽  
Hwi-Young Cho
Keyword(s):  
Spinal Cord ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Spinal Cord Injuries ◽  
Standing Position ◽  
Robotic Exoskeleton ◽  
Sit To Stand ◽  
Study Results ◽  
Cord Injury ◽  
Locomotion Training

A variety of robotic exoskeletons have been developed for patients with spinal cord injuries. However, the optimal training method and period for using a robotic exoskeleton have been uncertain until now. The purpose of this study is to determine the minimum training period for using a robotic exoskeleton with minimal muscle activity by investigating the changes in muscle activity and muscle characteristics of healthy adults during robotic exoskeleton training. A total of 16 people participated in the study. The robotic exoskeleton locomotion training consisted of three 50-min sessions a week for 7 weeks. The assessment consisted of sitting, standing, wide standing, sit-to-stand, and stand-to-sit where muscle activity and muscle characteristics were measured during each motion. All measurements were performed in the first session and every five sessions. Participants showed decreased muscle activity up to 10 sessions of training in the standing position, and 15 sessions in sit-to-stand and stand-to-sit motions. Upper extremity muscles showed decreased muscle activity, tone, stiffness, and logarithmic decrement up to the 15th session. The study results show that at least 15 training sessions are required to use the robotic exoskeleton with minimal load on the musculoskeletal system, and longer training is required for patients with spinal cord injury.

Poster 210 Urine Study Results of Persons with Spinal Cord Injury Presenting for Annual Evaluation

PM&R ◽  
2016 ◽  
Vol 8 (9) ◽  
pp. S229-S230
Author(s):  
Felicia M. Skelton ◽  
Larisa Grigoryan ◽  
Jun Ying ◽  
Sally A. Homes ◽  
Barbara Trautner
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Study Results ◽  
Cord Injury

scholarly journals Upper Limb Robotic Rehabilitation for Patients With Cervical Spinal Cord Injury: A Comprehensive Review

2021 ◽  
Author(s):  
Giovanni Morone ◽  
Alessandro De Sire ◽  
Alex Martino Cinnera ◽  
Matteo Paci ◽  
Luca Perrero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Cochrane Library ◽  
Functional Impairments ◽  
Robotic Assisted ◽  
Study Results ◽  
Cord Injury

The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on "Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin" (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The 5-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results; therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury.

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