Effect of aspirin on spinal cord injury: an experimental study

Aspirin is an anti-inflammatory drug, peroxyl radical scavenger, and antioxidant agent that inhibits phospholipases, nitric oxide synthetases, and cyclooxygenase enzymes. The existing literature contains no studies on the effects of various doses of aspirin on spinal cord injury [SCI]. Therefore, we sought to investigate the putative effects of aspirin on experimental SCI. The weight-drop injury model was used to produce SCI in 100 albino Wistar rats. The animals were allocated to five groups: a control group, where the rats did not undergo any surgical or medical intervention except for anesthesia; a sham-treated group, where laminectomy was performed without SCI and no further therapy was administered; and three other groups, where the rats with SCI received low-dose aspirin [20 mg/kg], high-dose aspirin [80 mg/kg], and a vehicle, respectively. Half of the rats were sacrificed 24 hours later, and their spinal cords were excised for biochemical studies. The other rats were subjected to Basso, Beattie, and Bresnahan [BBB] locomotor rating scale scoring once a week for 6 consecutive weeks. Aspirin decreased lipid peroxidation following SCI as the mean [ +/- standard error] catalase level was significantly higher in the high-dose aspirin group [46.10 +/- 12.01] than in the sham-treated group [16.07 +/- 2.42] and the vehicle-treated group [15.31 +/- 3.20] [P<0.05; P<0.05, respectively]. Both of the groups treated with high-dose and low-dose aspirin demonstrated a higher mean BBB score than did the control group [P<0.001] and the sham-treated group [P<0.001]. Our data provide evidence in support of the potential effects of aspirin in biochemical and neurobehavioral recovery after SCI

Correlation of clinical presentation with intraoperative level diagnosis in lower lumbar disc herniation

Little evidence exists on the diagnostic values of concomitant symptoms and signs in the level diagnosis of patients with lower lumbar disc herniation. We assessed the diagnostic value of the clinical presentation of fifth lumbar and first sacral root dysfunction due to disc herniation. We examined 139 consecutive candidates for lower lumbar discectomy. A number of clinical symptom and signs referred to fifth lumbar and first sacral root dysfunction were collected for each patient by an independent observer. Intraoperatively, all patients were assessed for the level of disc herniation [gold standard]. Among the 83 men and 56 women [mean age, 41.6 years, range, 18-75 years], 72 had L4-L5 and 67 had L5-S1 disc herniation. The sensitivity and specificity for concomitant presentation of monoradicular pain, toe weakness [dorsiflexion], normal ankle reflex and straight leg rising [SLR] positive test for the level of fourth lumbar disc herniation were 41.5% and 95.5%, respectively. Positive and negative predictive values for these symptom and signs in the fourth level were 90% and 62.7%, respectively [P<0.0001, relative risk=2.41, odds ratio=15.16]. Sensitivity, specificity, positive and negative predictive values for concomitant presentation of monoradicular pain, toe weakness [plantarflexion], impaired ankle reflex and SLR positive test for the level of the first sacral disc herniation were 60.5%, 98.7%, 95.8% and 83.1%, respectively [P<0.0001, relative risk=5.68, odds ratio=113.4]. The diagnostic value of clinical features of herniated fifth lumbar disc herniation is more reliable than fourth lumbar disc herniation. The value of clinical presentation in the level diagnosis of lower lumbar disc herniation is highly specific, but rather insensitive