scholarly journals An observation of the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen in treating acute spinal cord injury

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Huan-xia Li ◽  
Jing Cui ◽  
Jing-shi Fan ◽  
Jian-zhou Tong
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hyperbaric Oxygen ◽  
Clinical Efficacy ◽  
Acute Spinal Cord Injury ◽  
Sensory Function ◽  
Control Group ◽  
Thoracolumbar Fractures ◽  
Cord Injury ◽  
Experimental Group

Objective: To examine the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen therapy in treating thoracolumbar vertebral fracture-induced acute spinal cord injury (ASCI). Methods: From June 2015 to May 2018, 80 patients with thoracolumbar fractures and ASCI who were treated at Baoding First Central Hospital were selected. All patients underwent posterior laminectomy and screw fixation, and they were randomly divided into two groups using a random number table method. The control group received conventional postoperative treatment, while the experimental group was treated with riluzole combined with mannitol and hyperbaric oxygen on the basis of conventional treatment. The recovery of nerve function which included motor function and sensory function, and the changes of serum IL-6, CRP, BDNF, BFGF and other factors before treatment and four weeks after treatment of the two groups of patients were observed and evaluated. Results: After treatment, the motor function scores and sensory function scores of the two groups of patients were improved compared with those before treatment (p<0.05). Compared with the control group, the experimental group improved significantly, and the difference was statistically significant (p<0.05). The levels of IL-6, BDNF and NFGF in the experimental group were significantly lower than those in the control group (p<0.05). Conclusions: For patients with thoracolumbar fractures and ASCI undergoing laminar decompression and fixation, the comprehensive treatment plan of riluzole combined with mannitol and hyperbaric oxygen has certain advantages. Compared with the conventional therapy, it may significantly improve the movement and sensory functions of patients, relieve the inflammatory response of spinal cord, and promote recovery from the injury. doi: https://doi.org/10.12669/pjms.37.2.3418 How to cite this:Li H, Cui J, Fan J, Tong J. An observation of the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen in treating acute spinal cord injury. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3418 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Methylprednisolone or naloxone treatment after acute spinal cord injury: 1-year follow-up data

1992 ◽  
Vol 76 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Michael B. Bracken ◽  
Mary Jo Shepard ◽  
William F. Collins ◽  
Theodore R. Holford ◽  
David S. Baskin ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Function ◽  
Controlled Trial ◽  
Acute Spinal Cord Injury ◽  
Sensory Function ◽  
Content Type ◽  
Cord Injury ◽  
Multicenter Randomized Controlled Trial

✓ The 1-year follow-up data of a multicenter randomized controlled trial of methylprednisolone (30 mg/kg bolus and 5.4 mg/kg/hr for 23 hours) or naloxone (5.4 mg/kg bolus and 4.0 mg/kg/hr for 23 hours) treatment for acute spinal cord injury are reported and compared with placebo results. In patients treated with methylprednisolone within 8 hours of injury, increased recovery of neurological function was seen at 6 weeks and at 6 months and continued to be observed 1 year after injury. For motor function, this difference was statistically significant (p = 0.030), and was found in patients with total sensory and motor loss in the emergency room (p = 0.019) and in those with some preservation of motor and sensory function (p = 0.024). Naloxone-treated patients did not show significantly greater recovery. Patients treated after 8 hours of injury recovered less motor function if receiving methylprednisolone (p = 0.08) or naloxone (p = 0.10) as compared with those given placebo. Complication and mortality rates were similar in either group of treated patients as compared with the placebo group. The authors conclude that treatment with the study dose of methylprednisolone is indicated for acute spinal cord trauma, but only if it can be started within 8 hours of injury.

scholarly journals Zinc Concentration Dynamics Indicate Neurological Impairment Odds after Traumatic Spinal Cord Injury

Antioxidants ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 421
Author(s):  
Raban Arved Heller ◽  
André Sperl ◽  
Julian Seelig ◽  
Patrick Haubruck ◽  
Tobias Bock ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurological Impairment ◽  
Sensory Function ◽  
Control Group ◽  
Binary Logistic Regression Analysis ◽  
Traumatic Spinal Cord Injury ◽  
Zn Concentration ◽  
Cord Injury ◽  
Serum Zn

Traumatic Spinal Cord Injury (TSCI) is debilitating and often results in a loss of motor and sensory function caused by an interwoven set of pathological processes. Oxidative stress and inflammatory processes are amongst the critical factors in the secondary injury phase after TSCI. The essential trace element Zinc (Zn) plays a crucial role during this phase as part of the antioxidant defense system. The study aims to determine dynamic patterns in serum Zn concentration in patients with TSCI and test for a correlation with neurological impairment. A total of 42 patients with TSCI were enrolled in this clinical observational study. Serum samples were collected at five different points in time after injury (at admission, and after 4 h, 9 h, 12 h, 24 h, and 3 days). The analysis of the serum Zn concentrations was conducted by total reflection X-ray fluorescence (TXRF). The patients were divided into two groups—a study group S (n = 33) with neurological impairment, including patients with remission (G1, n = 18) and no remission (G0, n = 15) according to a positive AIS (American Spinal Injury Association (ASIA) Impairment Scale) conversion within 3 months after the trauma; and a control group C (n = 9), consisting of subjects with vertebral fractures without neurological impairment. The patient data and serum concentrations were examined and compared by non-parametric test methods to the neurological outcome. The median Zn concentrations in group S dropped within the first 9 h after injury (964 µg/L at admission versus 570 µg/L at 9 h, p < 0.001). This decline was stronger than in control subjects (median of 751 µg/L versus 729 µg/L, p = 0.023). A binary logistic regression analysis including the difference in serum Zn concentration from admission to 9 h after injury yielded an area under the curve (AUC) of 82.2% (CI: 64.0–100.0%) with respect to persistent neurological impairment. Early Zn concentration dynamics differed in relation to the outcome and may constitute a helpful diagnostic indicator for patients with spinal cord trauma. The fast changes in serum Zn concentrations allow an assessment of neurological impairment risk on the first day after trauma. This finding supports strategies for improving patient care by avoiding strong deficits via adjuvant nutritive measures, e.g., in unresponsive patients after trauma.

Promoting Axonal Extension and Repair After Spinal Cord Injury by Inhibiting the Expression of Rho Gene Based on RNA Interference

2020 ◽  
Vol 10 (7) ◽  
pp. 1046-1051
Author(s):  
Bo Yu ◽  
Hongmei Zhang ◽  
Jun Hong ◽  
Yonggang Lu ◽  
Yajun Zhang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Real Time ◽  
Real Time Pcr ◽  
Average Length ◽  
Axon Growth ◽  
Sensory Function ◽  
Control Group ◽  
Central Nervous System Damage ◽  
Cord Injury

Spinal cord injury causes central nervous system damage. Rho inhibits axonal regeneration. This study is intended to analyze the effect of inhibition of Rho expression on axonal repair. The oligodendrocytes were isolated and divided into NC group and shRNA-RhoA group followed by analysis of the average length of axon growth and average microtubule fluorescence density by immunofluorescence, Nogo, MAG and RhoA expression were by Real time PCR. Wistar rats were separated into control group; SCI group and shRNA-RhoA group followed by analysis of the BBB scores and the Reuter score of sensory function, RhoA expression by Real time PCR and Western blot, Caspase3 activity as well as Nogo and MAG expression by Real time PCR. Compared with NC group, shRNA-RhoA group showed significantly increased average length of axon growth and average microtubule fluorescence density at the distal axon and reduced expression of RhoA, Nogo and MAG (P < 0 05). In comparison to control group, SCI group presented significantly increased RhoA expression, decreased BBB score, increased Reuter score and Caspase3 activity as well as elevated Nogo and MAG expression (P < 0 05). The shRNA-RhoA group significantly decreased RhoA expression, increased BBB score, decreased Reuter score and Caspase3 activity, and reduced Nogo and MAG expression compared with SCI group (P < 0 05). Inhibiting RhoA expression can promote axon extension and regenerative repair. Targeting RhoA reduces axon growth inhibitory factor expression, inhibits apoptosis and effectively alleviates SCI.

scholarly journals Magnetic resonance diffusion tensor imaging of acute spinal cord injury in spinal trauma

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Radwa Mohamed Diaa Eldeen Abd Alsam Alkadeem ◽  
Mohammad Hassan Rashad El-Shafey ◽  
Ali Ebrahim Mohammad Seif Eldein ◽  
Hanan Ahmad Nagy
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Structural Changes ◽  
Diffusion Tensor ◽  
Acute Spinal Cord Injury ◽  
Spinal Trauma ◽  
Control Group ◽  
Adc Value ◽  
Cord Injury ◽  
The Mean

Abstract Background It was important to develop a non-invasive imaging technique for early evaluation of spinal cord integrity after injury; MRI was the method of choice for evaluation of any cord abnormalities. However, some patients have symptoms with no detectable abnormalities by MRI. The purpose of our study was to assess the role of diffusion tensor MRI in evaluating the integrity of spinal cord fibers in case of spinal trauma. Results Out of the studied 30 patients, conventional MRI revealed abnormalities in the spinal cord in 23 patients (76.67%), diffusion tensor tractography revealed abnormalities in the spinal cord in 27 patients (90%), the mean FA value at the level of injury (0.326±0.135) was less than the mean FA value (0.532 ± 0.074) in control group (p value < 0.001), and the mean ADC value at the level of injury (1.319 ± 0.378) was less than the mean ADC value (1.734 ± 0.768) in the control group. FA was sensitive than ADC in the detection of the spinal cord abnormalities with a sensitivity of 93.33% versus 67.66% respectively. Conclusion DTI can be used to detect structural changes of spinal cord white matter fibers in acute spinal cord injury. A significant decrease of fractional anisotropy and apparent diffusion coefficient has been found at the site of spinal cord injury.

scholarly journals Method of Decompression by durotomy and duroplasty for cervical spinal cord injury in patients without fracture or dislocation

2018 ◽  
Vol 1 (1) ◽  
pp. 158-164 ◽  
Author(s):  
Dionne Telemacque ◽  
Fengzhao Zhu ◽  
Kaifang Chen ◽  
Lin Chen ◽  
Zhengwei Ren ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spinal Cord ◽  
Control Group ◽  
Cord Injury ◽  
Prevention And Treatment ◽  
The Mean ◽  
Spinal Cord Decompression ◽  
Experimental Group

Introduction:We developed the method of cervical spinal cord decompression through durotomy followed by duroplasty and analyzed its efficacy.Purpose:To develop a tactic of decompression durotomy and duroplasty for the treatment of severe spinal cord injury(SCI) with extensive edema of the spinal cord and without intramedullary hematoma, and to demonstrate the effectiveness of this method.Methods:From October 2016 to January 2018, 17 decompression operations were performed in the cervical spine in patients with SCI. Decompression laminectomy was done without durotomy in the first group of patients. In the second group, duroplasty of the spinal cord was performed after decompression durotomy. A total of 17 patients, 16 males (94%) and 1 female (6%), were operated on (ages from 32 to 66 years). The patients were divided into two groups: a control group and an experimental group. We used the ASIA scale for assessing the patients. The mean follow up time is 12 months (8−24 months).Results:The first group, i.e., the control group consisted of 10 patients who underwent decompression laminectomy without durotomy. The second group, i.e., the experimental group consisted of 7 patients who underwent durotomy followed by duroplasty. In this group, the positive dynamics were observed in 6 patients. Out of 2 patients with ASIA grade “A”, one showed improvement to ASIA grade “C”, and one improved to ASIA “D”. Two patients with ASIA grade “B” showed recovery to ASIA “D”. Two patients with ASIA grade “C” improved to grade “D” while one patient showed no change from ASIA “C”. Durotomy and duroplasty was effective in the experimental group.Conclusion:The performance of durotomy and duroplasty is an efficient method for the full-scale decompression of the spinal cord and the prevention of edema. This method aims at decreasing intraspinal pressure, as well as preventing ischemia and apoptosis, which is possible for the prevention and treatment of the spinal cord compartment syndrome or spinal cord intramedullary hypertension.

scholarly journals Effects of A 12-Week Rebound Therapy Exercise on Energy Consumption and Body Mass Index in Patients With Spinal Cord Injury

2020 ◽  
Vol 12 (1) ◽  
pp. 201-206
Author(s):  
Morteza Sadeghi ◽  
◽  
Gholam Ali Ghasemi ◽  
Mohammad Taghi Karimi ◽  
◽  
...  
Keyword(s):  
Body Mass Index ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Energy Consumption ◽  
Body Mass ◽  
Repeated Measures ◽  
Control Group ◽  
Cost Index ◽  
Cord Injury ◽  
Experimental Group

Introduction: Energy Consumption (EC) and Body Mass Index (BMI) are the major complications associated with Spinal Cord Injury (SCI), which can be improved by exercise rehabilitation. Thus, the present study aimed to evaluate the efficiency of using rebound therapy (exercise on a trampoline) on EC and BMI in individuals with SCI. Materials and Methods: Sixteen individuals with SCI (ASIA classification: A=6, B=6, C=2, D=2) were selected and randomly divided into two groups of experimental (rebound exercise) and control. The experimental group performed the exercise program by a modified trampoline for 12 weeks (10-30 minutes; 3 sessions a week). EC was measured by the Physiological Cost Index (PCI) and BMI was calculated by standard formula before and after the exercise intervention. Finally, the obtained data were analyzed by Repeated-Measures Analysis of Variance (RM-ANOVA) in SPSS. Results: The results of RM-ANOVA revealed significant interaction in both criteria (P<0.01). In other words, the experimental group changes were substantial, compared to that of the control group. Conclusion: The collected results indicated that rebound therapy could, in effect, improve the SCI individuals’ EC and BMI. Furthermore, it was suggested that rebound exercise can be a useful sports rehabilitation method for patients with SCI.

scholarly journals Critical Care Management of Acute Spinal Cord Injury—Part II: Intensive Care to Rehabilitation

2019 ◽  
Vol 06 (03) ◽  
pp. 222-235
Author(s):  
Amanda Sacino ◽  
Kathryn Rosenblatt
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Intensive Care ◽  
Clinical Investigation ◽  
Acute Spinal Cord Injury ◽  
Sensory Function ◽  
Multiple Systems ◽  
Secondary Insult ◽  
Cord Injury ◽  
Primary Trauma

AbstractSpinal cord injury is devastating to those affected due to the loss of motor and sensory function, and, in some cases, cardiovascular collapse, ventilatory failure, and bowel and bladder dysfunction. Primary trauma to the spinal cord is exacerbated by secondary insult from the inflammatory response to injury. Specialized intensive care of patients with acute spinal cord injury involves the management of multiple systems and incorporates evidence-based practices to reduce secondary injury to the spinal cord. Patients greatly benefit from early multidisciplinary rehabilitation for neurologic and functional recovery. Treatment of acute spinal cord injury may soon incorporate novel molecular agents currently undergoing clinical investigation to assist in neuroprotection and neuroregeneration.

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