scholarly journals Revascularization After Traumatic Spinal Cord Injury

2021 ◽  
Vol 12 ◽  
Author(s):  
Chun Yao ◽  
Xuemin Cao ◽  
Bin Yu
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Vessel ◽  
Vascular System ◽  
Mechanical Damage ◽  
Pathological Process ◽  
Secondary Injury ◽  
Traumatic Spinal Cord Injury ◽  
Physical Stimulation ◽  
Cord Injury

Traumatic spinal cord injury (SCI) is a complex pathological process. The initial mechanical damage is followed by a progressive secondary injury cascade. The injury ruptures the local microvasculature and disturbs blood-spinal cord barriers, exacerbating inflammation and tissue damage. Although endogenous angiogenesis is triggered, the new vessels are insufficient and often fail to function normally. Numerous blood vessel interventions, such as proangiogenic factor administration, gene modulation, cell transplantation, biomaterial implantation, and physical stimulation, have been applied as SCI treatments. Here, we briefly describe alterations and effects of the vascular system on local microenvironments after SCI. Therapies targeted at revascularization for SCI are also summarized.

scholarly journals Hematogenous Macrophages: A New Therapeutic Target for Spinal Cord Injury

2021 ◽  
Vol 9 ◽  
Author(s):  
Yuanzhe Ding ◽  
Di Zhang ◽  
Sheng Wang ◽  
Xiaolei Zhang ◽  
Jingquan Yang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Therapeutic Target ◽  
Pathological Process ◽  
Secondary Injury ◽  
Cord Injury ◽  
Peripheral Monocyte ◽  
Primary Injury ◽  
M1 Type

Spinal cord injury (SCI) is a devastating disease leading to loss of sensory and motor functions, whose pathological process includes mechanical primary injury and secondary injury. Macrophages play an important role in SCI pathology. According to its origin, it can be divided into resident microglia and peripheral monocyte-derived macrophages (hematogenous Mφ). And it can also be divided into M1-type macrophages and M2-type macrophages on the basis of its functional characteristics. Hematogenous macrophages may contribute to the SCI process through infiltrating, scar forming, phagocytizing debris, and inducing inflammatory response. Although some of the activities of hematogenous macrophages are shown to be beneficial, the role of hematogenous macrophages in SCI remains controversial. In this review, following a brief introduction of hematogenous macrophages, we mainly focus on the function and the controversial role of hematogenous macrophages in SCI, and we propose that hematogenous macrophages may be a new therapeutic target for SCI.

scholarly journals Sirtuins: Potential Therapeutic Targets for Defense against Oxidative Stress in Spinal Cord Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Jialiang Lin ◽  
Zhencheng Xiong ◽  
Jionghui Gu ◽  
Zhuoran Sun ◽  
Jiang Shuai ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pathological Process ◽  
Secondary Injury ◽  
Beneficial Effects ◽  
Cord Injury ◽  
Primary Injury ◽  
Antioxidant Mechanisms ◽  
Antioxidant Effects

Spinal cord injury (SCI) is one of the most incapacitating neurological disorders. It involves complex pathological processes that include a primary injury and a secondary injury phase, or a delayed stage, which follows the primary injury and contributes to the aggravation of the SCI pathology. Oxidative stress, a key pathophysiological event after SCI, contributes to a cascade of inflammation, excitotoxicity, neuronal and glial apoptosis, and other processes during the secondary injury phase. In recent years, increasing evidence has demonstrated that sirtuins are protective toward the pathological process of SCI through a variety of antioxidant mechanisms. Notably, strategies that modulate the expression of sirtuins exert beneficial effects in cellular and animal models of SCI. Given the significance and novelty of sirtuins, we summarize the oxidative stress processes that occur in SCI and discuss the antioxidant effects of sirtuins in SCI. We also highlight the potential of targeting sirtuins for the treatment of SCI.

scholarly journals SCING—Spinal Cord Injury Neuroprotection with Glyburide: a pilot, open-label, multicentre, prospective evaluation of oral glyburide in patients with acute traumatic spinal cord injury in the USA

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031329 ◽  
Author(s):  
Amy Janelle Minnema ◽  
A Mehta ◽  
Warren W Boling ◽  
Jan Schwab ◽  
J Marc Simard ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Drug Administration ◽  
Transient Receptor Potential ◽  
Secondary Injury ◽  
Traumatic Spinal Cord Injury ◽  
Open Label ◽  
Transient Receptor Potential Melastatin ◽  
Cord Injury ◽  
Neuroprotective Strategy

IntroductionAcute traumatic spinal cord injury (tSCI) is a devastating neurological disorder with no pharmacological neuroprotective strategy proven effective to date. Progressive haemorrhagic necrosis (PHN) represents an increasingly well-characterised mechanism of secondary injury after tSCI that negatively impacts neurological outcomes following acute tSCI. Preclinical studies evaluating the use of the Food and Drug Administration-approved sulfonylurea receptor 1-transient receptor potential melastatin 4 channel blocker glyburide in rodent models have shown reduced secondary microhaemorrhage formation and the absence of capillary fragmentation, the pathological hallmark of PHN.Methods and analysisIn this initial phase multicentre open-label pilot study, we propose to enrol 10 patients with acute cervical tSCI to primarily assess the feasibility, and safety of receiving oral glyburide within 8 hours of injury. Secondary objectives include pharmacokinetics and preliminary evaluations on neurological recovery as well as blood and MRI-based injury biomarkers. Analysis will be performed using the descriptive and non-parametric statistics.Ethics and disseminationGlyburide has been shown as an effective neuroprotective agent in preclinical tSCI models and in the treatment of ischaemic stroke with the additional risk of a hypoglycaemic response. Given the ongoing secondary injury and the traumatic hyperglycaemic stress response seen in patients with tSCI, glyburide; thus, offers an appealing neuroprotective strategy to supplement standard of care treatment. The study protocol was approved by the Ohio State University Biomedical Institutional Review Board. The protocol was amended in February 2017 with changes related to study feasibility and patient recruitment. Specifically, the route of administration was changed to the oral form to allow for streamlined and rapid drug administration, and the injury-to-drug time window was extended to 8 hours in an effort to further enhance enrolment. Participants or legally authorised representatives are informed about the trial and its anticipated risks orally and in written form using an approved informed consent form prior to inclusion. The findings of this study will be disseminated to the participants and to academic peers through scientific conferences and peer-reviewed journal publications.Trial registration numbersNCT02524379and 2014H0335.

scholarly journals Detection and Analysis of Perfusion Pressure through Measuring Oxygen Saturation and Requirement of Dural Incision Decompression after Laminectomy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jamal Alshorman ◽  
Yulong Wang ◽  
Guixiong Huang ◽  
Tracy Boakye Serebour ◽  
Xiaodong Guo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Flow ◽  
Oxygen Saturation ◽  
Spine Injury ◽  
Secondary Injury ◽  
Traumatic Spinal Cord Injury ◽  
Trauma Patients ◽  
Injury Site ◽  
Cord Injury

Background. Traumatic spinal cord injury (SCI) can continue and transform long after the time of initial injury. Preventing secondary injury after SCI is one of the most significant challenges, and early intervention to return the blood flow at the injury site can minimize the likelihood of secondary injury. Objective. The purpose of this study is to investigate whether laminectomy can achieve the spinal cord blood flow by measuring the spinal blood oxygen saturation intraoperatively without the presence of light. Methods. Between June and August 2021, eight patients were admitted after traumatic spinal cord injury for surgical treatment. We explored the effectiveness of laminectomy and whether the patients required further procedures or not. We used a brain oxygen saturation monitor at the spine injury site under dark conditions. Results. Eight cervical trauma patients, six males and two females, underwent laminectomy decompression. Three patients’ ASIA grade improved by one level, and one patient showed slight motor-sensory improvement. Oxygen saturation was in the normal range. Conclusion. Performing bony decompression can show good results. Therefore, finding an examination method to confirm the improvement of blood perfusion by measuring oxygen saturation at the injury site after laminectomy is essential to avoid other complications.

Neurological Recovery in Traumatic Spinal Cord Injury Patient with Delayed Surgical Intervention

2018 ◽  
Vol 1 (2) ◽  
pp. 34
Author(s):  
Mochamad Targib Alatas
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Intervention ◽  
Case Series ◽  
Spinal Cord Injury Patient ◽  
Traumatic Spinal Cord Injury ◽  
Best Interest ◽  
Score Improvement ◽  
Cord Injury ◽  
Injury Patient

Early surgical treatment for traumatic spinal cord injury (SCI) patients has been proven to yield better improvement on neurological state, and widely practiced among surgeons in this field. However, it is not always affordable in every clinical setting. It is undeniable that surgery for chronic SCI has more challenges as the malunion of vertebral bones might have initiated, thus requires more complex operating techniques. In this case series, we report 7 patients with traumatic SCI whose surgical intervention is delayed due to several reasons. Initial motoric scores vary from 0 to 3, all have their interval periods supervised between outpatient clinic visits. On follow up they demonstrate significant neurological development defined by at least 2 grades motoric score improvement. Physical rehabilitation also began before surgery was conducted. These results should encourage surgeons to keep striving for the patient’s best interest, even when the injury has taken place weeks or even months before surgery is feasible because clinical improvement for these patients is not impossible. 

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