Contractions dynamic of “fast” and “slow” rat muscle under spinal shock and modulators of contraction

Aim. To study the dynamics of neuromotor regulation of the contractile function of fast and slow muscles in rodents during spinal shock by spinal cord transection at the level Тh11Тh12. Methods. The experiments were carried out on laboratory rats weighing 140180 g. The animals were divided into two groups: Control (8 rats) and Spinal shock (6 rats). The lower leg muscles, m. soleus and m. extensor digitorum longus (m. EDL), were dissected by partially isolating without disrupting the connection with the body's circulatory system. The sciatic nerve was stimulated with single electrical impulses (10 V, 0.5 ms). Contractions of both muscles caused by electrical stimulation of the sciatic nerve before and after the injection of the substances into the femoral artery tubocurarine (1 mM) or norepinephrine (10 mM) were recorded in animals of both groups. After spinalization, muscle contractions were re-recorded during electrical stimulation of the sciatic nerve before and 10 minutes after the injection of tubocurarine or noradrenaline into the femoral artery in the same concentrations. Results. After spinalization of the animal, the contraction force of the muscle m. EDL fibers increased to 0.430.03 g (p=0.040), but the temporal parameters remained unchanged. M. soleus, on the contrary, showed a decrease in the contraction time to 0.0530.005 s (p=0.045), and no change in the contraction force was observed under these conditions. Intra-arterial administration of norepinephrine in the control group resulted in an increase of m. soleus contractions up to 1.210.17 g (p=0.048), and m. EDL up to 0.570.07 g (p=0.043). The administration of norepinephrine in spinalized animals caused an increase in the contraction of m. soleus up to 1.210.09 g (p=0.047), and m. EDL up to 0.660.05 g (p=0.043). The blocker of postsynaptic cholinergic receptors tubocurarine administration reduced the force of contraction of both muscle types in both control [m. soleus up to 0.390.03 g (p=0.039), m. EDL up to 0.110.02 g (p=0.042)] and spinalized [m. soleus up to 0.340.05 g (p=0.039), m. EDL up to 0.150.04 g (p=0.040)] animals. Conclusion. The data obtained demonstrate the presence of significant differences in the mechanisms of control of contractile activity in the fast and slow skeletal muscles of warm-blooded animals; the persistence of the similar effect of the basic modulators on the contraction of both muscles with such a striking reaction to spinalization highlights the contribution of neurotrophic control to the functioning of fast and slow motor units.

Treatment of unusual hangman’s fracture in cluster region during coronavirus 2019 pandemic

Background: Hangman’s fractures are one of the most frequent types of high cervical spine injuries. Here, we present a quadriplegic patient due to a hangman’s fracture treated during the coronavirus 2019 (COVID-19) pandemic. Case Description: A 19-year-old male was quadriplegic and in spinal shock following a motor vehicle accident. X-rays showed a C2 hangman’s fracture with instability. X-rays and CT studies both confirmed anterior dislocation at C2 on C3 with bilateral pedicle C2 fractures and 5 mm of subluxation. In addition, he had an infiltrate in both lungs consistent with the diagnosis of COVID-19. The patient was intubated for respiratory failure and hemodynamically stabilized for his spinal shock. Unfortunately, before surgical intervention could be undertaken, the patient sustained a fatal cardiorespiratory arrest. Conclusion: Utilizing appropriate personal protective equipment, it was and should be possible to treat patients with spinal injuries in the presence of active COVID infection. However, the risks of treating such spinal urgencies and emergencies should be thoroughly discussed with the entire nonsurgical and surgical treatment teams (e.g., including anesthesiologists, physicians, nurses, and other caregivers).

Intrathecal iodinated contrast-induced transient spinal shock

Transient spinal shock is a previously unreported complication of intrathecal contrast. A 63-year-old man presented with the chief complaint of worsening back pain. Computed topography of lumbar spine without contrast showed a lytic lesion. After international normalized ratio (INR) correction, patient was sent for CT myelogram. After intrathecal contrast injection, the patient dropped his blood pressure profoundly and developed clinical manifestations of spinal shock. Emergent intravenous bolus fluids were initiated resulting in improvement in blood pressure. Patient’s spinal shock resolved within hours. CT myelogram was normal except previously known lytic lesion. It was concluded that the transient shock was most likely due to contrast injection. We believe that this is the first reported case of transient spinal shock following CT myelogram using water-soluble iodinated non-ionic contrast agent administered intrathecally.

Admiral Nelson’s illnesses and injuries

Horatio Nelson is one of the greatest English heroes. His key exploits at the battles of the Nile and Trafalgar, which led to Britain’s maritime supremacy, are well known and celebrated in the 5.5m statue at the summit of Nelson’s column in Trafalgar Square, London. The statue also showcases his most famous injuries, the injury to his right eye and arm amputation. However, as well as these he had a number of other battle injuries and afflictions including recurrent malaria, yellow fever, scurvy, tuberculosis and dysentery, which, although he bore with stoicism, may have affected his professional performance at different times in his career. The exact cause of his death was probably a combination of blood loss, lung injury and spinal shock.

Neuroinflammation as Part of a Possible Neuro-regeneration in a Patient with ASIA-A Scale Using Combinatorial Biologics: Bioquantine® and Allogeneic Mesenchymal Stem Cells

A complete spinal cord injury (SCI) is the complete sensory and motor loss below the site of spinal cord injury following acute or chronic destruction, compression, or ischemia of the spinal cord. Initially, this may present as spinal shock, which is an acute physiological loss or depression of spinal cord function. It presents as a flaccid are flexic paralysis below the level of the injury with autonomic features (e.g., hypotension and bradycardia). After some days to weeks the spinal shock wears off and a complete spinal cord injury may remain. It presents with spastic paresis, hyperreflexia, and continued sensory loss.