Diamond Concept as Principle for the Development of Spinal Cord Scaffold: A Literature Review

INTRODUCTION: Spinal cord injury (SCI) has been bringing detrimental impacts on the affected individuals. However, not only that, it also brings a tremendous effect on the socioeconomic and health-care system. Treatment regimen and strategy for SCI patient have been under further research. DISCUSSION: The main obstacles of regeneration on neuronal structure are the neuroinflammatory process and poor debris clearance, causing a longer healing process and an extensive inflammation process due to this particular inflammatory process. To resolve all of the mentioned significant issues in SCIs neuronal regeneration, a comprehensive model is necessary to analyze each step of progressive condition in SCI. In this review, we would like to redefine a comprehensive concept of the “Diamond Concept” from previously used in fracture management to SCI management, which consists of cellular platform, cellular inductivity, cellular conductivity, and material integrity. The scaffolding treatment strategy for SCI has been widely proposed due to its flexibility. It enables the physician to combine another treatment method such as neuroprotective or neuroregenerative or both in one intervention. CONCLUSION: Diamond concept perspective in the implementation of scaffolding could be advantageous to increase the outcome of SCI treatment.

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Biomaterial-based interventions for neuronal regeneration and functional recovery in rodent model of spinal cord injury: A systematic review

Journal of Spinal Cord Medicine ◽

10.1179/2045772313y.0000000095 ◽

2013 ◽

Vol 36 (3) ◽

pp. 174-190 ◽

Cited By ~ 24

Author(s):

Vibhor Krishna ◽

Sanjay Konakondla ◽

Joyce Nicholas ◽

Abhay Varma ◽

Mark Kindy ◽

...

Keyword(s):

Systematic Review ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Functional Recovery ◽

Rodent Model ◽

Neuronal Regeneration ◽

Cord Injury

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Local injection of bone morphogenetic protein 7 promotes neuronal regeneration and motor function recovery after acute spinal cord injury

Neural Regeneration Research ◽

10.4103/1673-5374.233449 ◽

2018 ◽

Vol 13 (6) ◽

pp. 1054 ◽

Cited By ~ 4

Author(s):

Kuan-Xin Li ◽

Chen Chen ◽

Guang-Chao Bai ◽

Hong-Liang Jin ◽

Kun Lei

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Bone Morphogenetic Protein ◽

Motor Function ◽

Local Injection ◽

Neuronal Regeneration ◽

Bone Morphogenetic Protein 7 ◽

Morphogenetic Protein ◽

Function Recovery ◽

Cord Injury

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E2F4 Promotes Neuronal Regeneration and Functional Recovery after Spinal Cord Injury in Zebrafish

Frontiers in Pharmacology ◽

10.3389/fphar.2016.00119 ◽

2016 ◽

Vol 7 ◽

Cited By ~ 6

Author(s):

Shota Sasagawa ◽

Yuhei Nishimura ◽

Yuka Hayakawa ◽

Soichiro Murakami ◽

Yoshifumi Ashikawa ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Functional Recovery ◽

Neuronal Regeneration ◽

Cord Injury

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Is the Recovery of Stepping Following Spinal Cord Injury Mediated by Modifying Existing Neural Pathways or by Generating New Pathways? A Perspective

Physical Therapy ◽

10.1093/ptj/81.12.1904 ◽

2001 ◽

Vol 81 (12) ◽

pp. 1904-1911 ◽

Cited By ~ 34

Author(s):

Ray D de Leon ◽

Roland R Roy ◽

V Reggie Edgerton

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Spinal Injury ◽

Weight Bearing ◽

Gait Training ◽

Neural Pathways ◽

Neuronal Regeneration ◽

Locomotor Recovery ◽

Cord Injury ◽

Descending Input

Abstract The recovery of stepping ability following a spinal cord injury may be achieved by restoring anatomical connectivity within the spinal cord. However, studies of locomotor recovery in animals with complete spinal cord transection suggest that the adult mammalian spinal cord can acquire the ability to generate stepping after all descending input is eliminated and in the absence of neuronal regeneration. Moreover, rehabilitative gait training has been shown to play a crucial role in teaching existing spinal pathways to generate locomotion and appropriately respond to sensory feedback. This brief review presents evidence that neural networks in the mammalian spinal cord can be modulated pharmacologically and/or with task-specific behavioral training to generate weight-bearing stepping after a spinal injury. Further, the role that spinal learning can play in the management of humans with spinal cord injury is discussed in relation to interventions that are designed primarily to enhance neuronal regeneration.

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A Modeled Analysis of Telehealth Methods for Treating Pressure Ulcers after Spinal Cord Injury

International Journal of Telemedicine and Applications ◽

10.1155/2012/729492 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Mark W. Smith ◽

Michelle L. Hill ◽

Karen L. Hopkins ◽

B. Jenny Kiratli ◽

Ruth C. Cronkite

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Pressure Ulcers ◽

Low Cost ◽

Stage Iv ◽

Treatment Method ◽

Veterans Health ◽

Entire Treatment Period ◽

Clinical Scenarios ◽

Cord Injury

Home telehealth can improve clinical outcomes for conditions that are common among patients with spinal cord injury (SCI). However, little is known about the costs and potential savings associated with its use. We developed clinical scenarios that describe common situations in treatment or prevention of pressure ulcers. We calculated the cost implications of using telehealth for each scenario and under a range of reasonable assumptions. Data were gathered primarily from US Department of Veterans Affairs (VA) administrative records. For each scenario and treatment method, we multiplied probabilities, frequencies, and costs to determine the expected cost over the entire treatment period. We generated low-, medium-, and high-cost estimates based on reasonable ranges of costs and probabilities. Telehealth care was less expensive than standard care when low-cost technology was used but often more expensive when high-cost, interactive devices were installed in the patient’s home. Increased utilization of telehealth technology (particularly among rural veterans with SCI) could reduce the incidence of stage III and stage IV ulcers, thereby improving veterans' health and quality of care without increasing costs. Future prospective studies of our present scenarios using patients with various healthcare challenges are recommended.

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Contralateral Axon Sprouting but Not Ipsilateral Regeneration Is Responsible for Spontaneous Locomotor Recovery Post Spinal Cord Hemisection

Frontiers in Cellular Neuroscience ◽

10.3389/fncel.2021.730348 ◽

2021 ◽

Vol 15 ◽

Author(s):

Yudong Cao ◽

Ya Shi ◽

Zhifeng Xiao ◽

Xi Chen ◽

Bing Chen ◽

...

Keyword(s):

Spinal Cord ◽

Medical Problem ◽

Contralateral Side ◽

Neuronal Regeneration ◽

Lesion Site ◽

Sprague Dawley ◽

Locomotor Recovery ◽

Locomotor Function ◽

Cord Injury ◽

Spinal Cord Hemisection

Spinal cord injury (SCI) usually results in permanent functional impairment and is considered a worldwide medical problem. However, both motor and sensory functions can spontaneously recover to varying extents in humans and animals with incomplete SCI. This study observed a significant spontaneous hindlimb locomotor recovery in Sprague-Dawley rats at four weeks after post-right-side spinal cord hemisection at thoracic 8 (T8). To verify whether the above spontaneous recovery derives from the ipsilateral axonal or neuronal regeneration to reconnect the lesion site, we resected either the scar tissue or right side T7 spinal cord at five weeks post-T8 hemisected injury. The results showed that the spontaneously achieved right hindlimb locomotor function had little change after resection. Furthermore, when T7 left hemisection was performed five weeks after the initial injury, the spontaneously achieved right hindlimb locomotor function was dramatically abolished. A similar result could also be observed when T7 transection was performed after the initial hemisection. The results indicated that it might be the contralateral axonal remolding rather than the ipsilateral axonal or neuronal regeneration beyond the lesion site responsible for the spontaneous hindlimb locomotor recovery. The immunostaining analyses and corticospinal tracts (CSTs) tracing results confirmed this hypothesis. We detected no substantial neuronal and CST regeneration throughout the lesion site; however, significantly more CST fibers were observed to sprout from the contralateral side at the lumbar 4 (L4) spinal cord in the hemisection model rats than in intact ones. In conclusion, this study verified that contralateral CST sprouting, but not ipsilateral CST or neuronal regeneration, is primarily responsible for the spontaneous locomotor recovery in hemisection SCI rats.

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Single-cell analysis of the cellular heterogeneity and interactions in the injured mouse spinal cord

Journal of Experimental Medicine ◽

10.1084/jem.20210040 ◽

2021 ◽

Vol 218 (8) ◽

Author(s):

Lindsay M. Milich ◽

James S. Choi ◽

Christine Ryan ◽

Susana R. Cerqueira ◽

Sofia Benavides ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Single Cell ◽

Single Cell Analysis ◽

Healing Process ◽

Cellular Heterogeneity ◽

Wound Healing Process ◽

Cellular Interactions ◽

Mouse Spinal Cord ◽

Cord Injury

The wound healing process that occurs after spinal cord injury is critical for maintaining tissue homeostasis and limiting tissue damage, but eventually results in a scar-like environment that is not conducive to regeneration and repair. A better understanding of this dichotomy is critical to developing effective therapeutics that target the appropriate pathobiology, but a major challenge has been the large cellular heterogeneity that results in immensely complex cellular interactions. In this study, we used single-cell RNA sequencing to assess virtually all cell types that comprise the mouse spinal cord injury site. In addition to discovering novel subpopulations, we used expression values of receptor–ligand pairs to identify signaling pathways that are predicted to regulate specific cellular interactions during angiogenesis, gliosis, and fibrosis. Our dataset is a valuable resource that provides novel mechanistic insight into the pathobiology of not only spinal cord injury but also other traumatic disorders of the CNS.

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Comparing natural hydrogels to self-assembling peptides in spinal cord injury treatment: a systematic review

F1000Research ◽

10.12688/f1000research.74087.1 ◽

2022 ◽

Vol 11 ◽

pp. 16

Author(s):

Kurosh Mojtabavi ◽

Morteza Gholami ◽

Zahra Ghodsi ◽

Narges Mahmoodi ◽

Sina Shool ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Data Extraction ◽

Included Study ◽

Cns Injury ◽

Neuronal Regeneration ◽

Self Assembling ◽

Cord Injury ◽

Injury Treatment

Background: In many cases, central nervous system (CNS) injury is unchanging due to the absence of neuronal regeneration and repair capabilities. In recent years, regenerative medicine, and especially hydrogels, has reached a significant amount of attention for their promising results for the treatment of spinal cord injury (SCI) currently considered permanent. Hydrogels are categorized based on their foundation: synthetic, natural, and combination. The objective of this study was to compare the properties and efficacy of commonly used hydrogels, like collagen, and other natural peptides with synthetic self-assembling peptide hydrogels in the treatment of SCI. Methods: Articles were searched in PubMed, Scopus, Web of Science, and Embase. All studies from 1985 until January 2020 were included in the primary search. Eligible articles were included based on the following criteria: administering hydrogels (both natural and synthetic) for SCI treatment, solely focusing on spinal cord injury treatment, and published in a peer-reviewed journal. Data on axonal regeneration, revascularization, elasticity, drug delivery efficacy, and porosity were extracted. Results: A total of 24 articles were included for full-text review and data extraction. There was only one experimental study comparing collagen I (natural hydrogel) and polyethylene glycol (PEG) in an in vitro setting. The included study suggested the behavior of cells with PEG is more expectable in the injury site, which makes it a more reliable scaffold for neurites. Conclusions: There is limited research comparing and evaluating both types of natural and self-assembling peptides (SAPs) in the same animal or in vitro study, despite its importance. Although we assume that the remodeling of natural scaffolds may lead to a stable hydrogel, there was not a definitive conclusion that synthetic hydrogels are more beneficial than natural hydrogels in neuronal regeneration.

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Medical Communication Services after Traumatic Spinal Cord Injury

Journal of Healthcare Engineering ◽

10.1155/2021/4798927 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Jamal Alshorman ◽

Yulong Wang ◽

Fengzhao Zhu ◽

Lian Zeng ◽

Kaifang Chen ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Surgical Intervention ◽

Treatment Method ◽

Traumatic Spinal Cord Injury ◽

Communication Services ◽

Medical Communication ◽

Neurological Outcomes ◽

Appropriate Treatment ◽

Cord Injury

It is difficult to assess and monitor the spinal cord injury (SCI) because of its pathophysiology after injury, with different degrees of prognosis and various treatment methods, including laminectomy, durotomy, and myelotomy. Medical communication services with different factors such as time of surgical intervention, procedure choice, spinal cord perfusion pressure (SCPP), and intraspinal pressure (ISP) contribute a significant role in improving neurological outcomes. This review aims to show the benefits of communication services and factors such as ISP, SCPP, and surgical intervention time in order to achieve positive long-term outcomes after an appropriate treatment method in SCI patients. The SCPP was found between 90 and 100 mmHg for the best outcome, MAP was found between 110 and 130 mmHg, and mean ISP is ≤20 mmHg after injury. Laminectomy alone cannot reduce the pressure between the dura and swollen cord. Durotomy and duroplasty considered as treatment choices after severe traumatic spinal cord injury (TSCI).

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