Low-Level Laser Therapy and Spinal Cord Injury: Effects of 3 Different Fluences in the Intermediate Period of Repair in an Experimental Model in Rats

Abstract The aim of this study was to evaluate the effectiveness of 3 different fluences of low-level laser therapy (LLLT) in intermediate period of spinal cord repair using an experimental model in rats. Thirty two rats were randomly divided into four experimental groups: Control Group (CG); Laser treated group 500 J/cm² (L-500); Laser treated group 750 J/cm² (L-750) and Laser treated group 1000 J/cm² (L-1000). Spinal cord injury (SCI) was performed by an impactor equipment (between 9th and 10th thoracic vertebrae), with a pressure of 150 kdyn. Afterwards, the injured region was irradiated daily for 14 consecutive sessions, using an 808 nm laser, at the respective fluence of each experimental groups. Locomotor function and tactile sensitivity were performed on days 1 and 15 post-surgery. Animals were euthanized 15 days post-surgery and samples were retrieved for histological and immunohistochemistry analysis. Functional behavior and tactile sensitivity were improved after laser irradiation. Moreover, higher fluencies of LLLT reduced the volume of injury. Additionally, LLLT produced a decreased CD-68 expression. These results demonstrated that, for an intermediate period of SCI repair, LLLT at higher fluences, was effective in promoting functional recovery and modulating the inflammatory process in the spinal cord of rats after traumatic SCI.

Evaluation of the effects of erythropoietin and interleukin-6 in rats submitted to acute spinal cord injury

OBJECTIVE: To evaluate the effects of interleukin-6 (IL-6) and erythropoietin (EPO) in experimental acute spinal cord injury (SCI) in rats. METHODS: Using standardized equipment, namely, a New York University (NYU) Impactor, a SCI was produced in 50 Wistar rats using a 10-g weight drop from a 12.5-mm height. The rats were divided into the following 5 groups of 10 animals each: "Group EPO", treated with erythropoietin only; "Group EPO + IL-6", treated with both substances; "Group IL-6", receiving IL-6 administration only; "Group Placebo", receiving a placebo solution; and "Group Sham", submitted to an incomplete procedure (only laminectomy, without SCI). All drugs and the placebo solution were administered intraperitoneally for three weeks. The animals were followed up for 42 days. Functional motor recovery was monitored by the Basso, Beattie, and Bresnahan (BBB) scale on days 2, 7, 14, 21, 28, 35 and 42. Motor-evoked potential tests were performed on the 42nd day. Histological analysis was performed after euthanasia. RESULTS: The group receiving EPO exhibited superior functional motor results on the BBB scale. IL-6 administration alone was not superior to the placebo treatment, and the IL-6 combination with EPO yielded worse results than did EPO alone. CONCLUSIONS: Using EPO after acute SCI in rats yielded benefits in functional recovery. The combination of EPO and IL-6 showed benefits, but with inferior results compared to those of isolated EPO; moreover, isolated use of IL-6 resulted in no benefit.

Histological and immunohistochemical effects of neuroectodermal cells transplantation after spinal cord injury in rats / Efectos histológicos e inmunohistoquímicos del trasplante de células neuroectodérmicas tras una lesión de la médula espinal en ratas

SUMMARY: In spinal cord injury, radical treatment is still a persistent hope for patients and clinicians. Our study aimed to determine the different histological changes in central, cranial and caudal sites of compressed spinal cord as a result of neuroectodermal stem cells (NESCs) transplantation in rats. For extraction of NESCs, future brains were extracted from mice embryos (10-days old) and cultured. Eighty, male rats were divided randomly into control, sham (20 rats each); while 40 rats were subjected to compressed spinal cord injury (CSCI). Seven days after spinal cord injury, rats were subdivided into 2 groups (20 rats each); an untreated and treated with NESCs injected cranial and caudal to the site of the spinal cord injury. Rats were sacrificed 4 weeks after transplantations of NESCs and specimens from the spinal cord at the central, cranial and caudal to site of spinal cord injury were proceeded to be stained with haematoxylin & eosin, osmic acid and Immunohistochemistry of glial fibrillary acidic protein (GFAP). Sections of CSCI revealed areas of hemorrhages, necrosis and cavitation limited by reactive astrocytosis, with upregulation of GFAP expression. Evidence of remyelination and mitigation of histopathological features, reactive astrocytosis in CSCI sections were more pronounced in cranial than in caudal region. NESCs transplantation ameliorated the pathological changes, promoted remyelination.

RESUMEN: En la lesión de la médula espinal, el tratamiento radical aún sigue siendo el tratamiento preferente para los pacientes y los médicos. El objetivo de este estudio fue determinar los diferentes cambios histológicos en los sitios centrales, craneales y caudales de la médula espinal comprimida, como resultado del trasplante de células madre neuroectodérmicas (NESCs) en ratas. Para la extracción de NESCs, se extrajeron y cultivaron los cerebros de embriones de ratones de 10 días de edad. Se dividieron 80 ratas macho aleatoriamente en grupos control, simulado (20 ratas cada una); mientras que 40 ratas fueron sometidas a lesión de la médula espinal comprimida (CSCI). Siete días después de la lesión de la médula espinal, las ratas se subdividieron en 2 grupos (20 ratas cada uno); un grupo no tratado y un grupo tratado con NESCs inyectado craneal y caudal en el sitio de la lesión. Las ratas fueron sacrificadas 4 semanas después de los trasplantes de NESCs y las muestras de la médula espinal en el centro, craneal y caudal del sitio de lesión fueron teñidas con hematoxilina y eosina, ácido ósmico e inmunohistoquímica de la proteína ácida fibrilar glial (GFAP). Las secciones de CSCI revelaron áreas de hemorragias, necrosis y cavitación limitadas por astrocitosis reactiva, con una regulación positiva de la expresión de GFAP. Evidencia de remielinización y mitigación de características histopatológicas, astrocitosis reactiva en secciones de CSCI fue más pronunciada en la región craneal que en la caudal. El trasplante de NESC mejoró los cambios patológicos, promoviendo la remielinización.

Neuroprotective effects of Ganoderma lucidum on spinal cord injury / Efectos neuroprotectores de Ganoderma lucidum en la lesión de la médula espinal 1

SUMMARY: Traumatic injury to the spinal cord results in the delayed dysfunction and neuronal death. Impaired mitochondrial function, generation of reactive oxygen species (ROS), and lipid peroxidation occur soon after traumatic spinal cord injury (SCI), while the activation of compensatory molecules that neutralize ROS occurs at later time points. The aim of the current study was to investigate the putative neuroprotective effect of Ganoderma lucidum in a rat model of SCI. In order to induce SCI, a standard weight-drop method that induced a moderately severe injury (100 g/cm force) at T10, was used. Injured animals were given either 20 mL/kg Ganoderma lucidum or saline 30 min post injury per day by gastric gavage. At seven days postinjury, rats were decapitated. Spinal cord samples were taken for histological examination or determination of malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO) activity. SCI caused a significant decrease in spinal cord GSH content, which was accompanied with significant increases in MDA levels, MPO activity. On the other hand, Ganoderma lucidum treatment reversed all these biochemical parameters as well as SCI-induced histopathological alterations. Furthermore, impairment of the neurological functions due to SCI was improved by meloxicam treatment. The present study suggests that Ganoderma Lucidum, reduces SCI-induced oxidative stress and exerts neuroprotection by inhibiting lipid peroxidation, GSH depletion.

RESUMEN: La lesión traumática de la médula espinal provoca disfunción retrasada y muerte neuronal. La función mitocondrial deteriorada, la generación de especies reactivas de oxígeno (ERO) y la peroxidación lipídica ocurren poco después de una lesión traumática de la médula espinal (LTE), mientras que la activación de moléculas compensatorias que neutralizan ERO ocurre posteriormente. El objetivo del presente estudio fue investigar el efecto neuroprotector de Ganoderma lucidum en un modelo de LTE en ratas. Con el fin de inducir LTE, se utilizó un método estándar de pérdida de peso que indujo una lesión moderadamente grave (100 g / cm de fuerza) a T10. A los animales lesionados se les administró 20 ml / kg de Ganoderma lucidum o solución salina, por sonda gástrica, 30 minutos después de la lesión. A los siete días después de la lesión, las ratas fueron eutanasiadas por decapitación. Se tomaron muestras de médula espinal para el examen histológico y para la determinación de los niveles de malondialdehído (MDA) y glutatión (GSH), y la actividad de mieloperoxidasa (MPO). LTE causó una disminución significativa en el contenido de GSH de la médula espinal, además de aumentos significativos en los niveles de MDA y la actividad de MPO. Por otro lado, el tratamiento con Ganoderma lucidum invirtió todos estos parámetros bioquímicos así como las alteraciones histopatológicas inducidas por LTE. El deterioro de las funciones neurológicas debidas a LTE mejoró con el tratamiento con meloxicam. El presente estudio sugiere que Ganoderma lucidum, reduce el estrés oxidativo inducido por LTE y ejerce la neuroprotección mediante la inhibición de la peroxidación de los lípidos y agotamiento del GSH.

Transplantation of rat-derived microglial cells promotes functional recovery in a rat model of spinal cord injury

This study evaluated the effect of microglia transplantation on neurological functional recovery in rats subjected to traumatic spinal cord injury (SCI). The rat model of SCI was established using a weight drop device. Forty SCI rats were randomly divided into the microglia group and the saline group. Then, rat-derived microglial cells or normal saline was injected into the injured site 7 days after surgery. The Basso-Beattie-Bresnahan (BBB) score, inclined plate test, and motor-evoked potentials (MEPs) were applied to assess the recovery of motor function. Hematoxylin and eosin (H&E) staining was used to assess the therapeutic effect. Microglia transplantation significantly improved BBB scores and functional scores at 2, 3, 4, 6, and 8 weeks after surgery compared to saline injection (P<0.05). Meanwhile, a prolonged MEP latency and decreased MEP amplitude were observed at 4 and 8 weeks in the microglia group (P<0.05). Histological analysis showed less damage and better prognosis in SCI rats of the microglia group. BrdU+ cell tracing experiments showed that microglia were recruited to the injured area of the spinal cord at 7 and 14 days after transplantation. The intensity of immunofluorescence was increased in CD68+ and OX42+ microglia at 2 days, 1 week, and 2 weeks, and then decreased at 3 and 4 weeks after transplantation in the microglia group. The transplantation of activated microglia played a key role in promoting the recovery of spinal cord function in a rat model of SCI.

Standardization of a spinal cord lesion model and neurologic evaluation using mice

OBJECTIVE: To standardize a spinal cord lesion mouse model. METHODS: Thirty BALB/c mice were divided into five groups: four experimental groups and one control group (sham). The experimental groups were subjected to spinal cord lesion by a weight drop from different heights after laminectomy whereas the sham group only underwent laminectomy. Mice were observed for six weeks, and functional behavior scales were applied. The mice were then euthanized, and histological investigations were performed to confirm and score spinal cord lesion. The findings were evaluated to prove whether the method of administering spinal cord lesion was effective and different among the groups. Additionally, we correlated the results of the functional scales with the results from the histology evaluations to identify which scale is more reliable. RESULTS: One mouse presented autophagia, and six mice died during the experiment. Because four of the mice that died were in Group 5, Group 5 was excluded from the study. All the functional scales assessed proved to be significantly different from each other, and mice presented functional evolution during the experiment. Spinal cord lesion was confirmed by histology, and the results showed a high correlation between the Basso, Beattie, Bresnahan Locomotor Rating Scale and the Basso Mouse Scale. The mouse function scale showed a moderate to high correlation with the histological findings, and the horizontal ladder test had a high correlation with neurologic degeneration but no correlation with the other histological parameters evaluated. CONCLUSION: This spinal cord lesion mouse model proved to be effective and reliable with exception of lesions caused by a 10-g drop from 50 mm, which resulted in unacceptable mortality. The Basso, Beattie, Bresnahan Locomotor Rating Scale and Basso Mouse Scale are the most reliable functional assessments, and but the horizontal ladder test is not recommended.

Granulocyte colony-stimulating factor combined with Methylprednisolone improves functional outcomes in rats with experimental acute spinal cord injury

OBJECTIVES: To evaluate the effects of combined treatment with granulocyte colony-stimulating factor (G-CSF) and methylprednisolone in rats subjected to experimental spinal cord injury. METHODS: Forty Wistar rats received a moderate spinal cord injury and were divided into four groups: control (no treatment); G-CSF (G-CSF at the time of injury and daily over the next five days); methylprednisolone (methylprednisolone for 24 h); and G-CSF/Methylprednisolone (methylprednisolone for 24 h and G-CSF at the time of injury and daily over the next five days). Functional evaluation was performed using the Basso, Beattie and Bresnahan score on days 2, 7, 14, 21, 28, 35 and 42 following injury. Motor-evoked potentials were evaluated. Histological examination of the spinal cord lesion was performed immediately after euthanasia on day 42. RESULTS: Eight animals were excluded (2 from each group) due to infection, a normal Basso, Beattie and Bresnahan score at their first evaluation, or autophagy, and 32 were evaluated. The combination of methylprednisolone and G-CSF promoted greater functional improvement than methylprednisolone or G-CSF alone (p<0.001). This combination also exhibited a synergistic effect, with improvements in hyperemia and cellular infiltration at the injury site (p<0.001). The groups displayed no neurophysiological differences (latency p=0.85; amplitude p=0.75). CONCLUSION: Methylprednisolone plus G-CSF promotes functional and histological improvements superior to those achieved by either of these drugs alone when treating spinal cord contusion injuries in rats. Combining the two drugs did have a synergistic effect.

Comparison among bone marrow mesenchymal stem and mononuclear cells to promote functional recovery after spinal cord injury in rabbits

Abstract Purpose: To investigate the efficacy of allogeneic mesenchymal stem-cells and autologous mononuclear cells to promote sensorimotor recovery and tissue rescue. Methods: Female rabbits were submitted to the epidural balloon inflation method and the intravenous cells administrations were made after 8 hours or seven days after injury induction. Sensorimotor evaluation of the hindlimbs was performed, and the euthanasia was made thirty days after the treatment. Spinal cords were stained with hematoxylin and eosin. Results: Both therapies given 8 hours after the injury promoted the sensorimotor recovery after a week. Only the group treated after a week with mononuclear cells showed no significant recovery at post-injury day 14. In the days 21 and 28, all treatments promoted significant recovery. Histopathological analysis showed no difference among the experimental groups. Our results showed that both bone marrow-derived cell types promoted significant sensorimotor recovery after injury, and the treatment made at least a week after injury is efficient. Conclusion: The possibilities of therapy with bone marrow-derived cells are large, increasing the therapeutic arsenal for the treatment of spinal cord injury.

Desenvolvimento e validação de um questionário de qualidade de vida em indivíduos com lesão da medula espinal / Development and validation of a quality of life questionnaire for individuals with spinal cord injury

Objetivo: Criar e testar as propriedades psicométricas de um instrumento específico para quantificação da qualidade de vida de indivíduos com lesão da medula espinal. Método: A partir dos métodos de consenso existentes, foi escolhida a técnica Delphi para criação do questionário e o SF-36 como método critério. Resultados: A consistência interna foi α=0,827. A confiabilidade intra e interavaliadores se mostram alta pelo coeficiente de correlação intraclasse e teste de bland e altman pela diferença da média. Pode-se observar correlações fortes entre o QVLM e SF-36 nos domínios capacidade funcional e aspectos físicos e correlação moderada nos domínios estado de saúde e aspectos emocionais. Houve diferença significante entre as quatro aplicações do QVLM demonstrando que o questionário é sensível à mudança. Conclusão: O QVLM foi criado com metodologia adequada e a avaliação das propriedades psicométricas traduzem em um instrumento válido, confiável, consistente e sensível a mudanças

Objective: Create and test the psychometric proprieties of the specific instrument for the quantification of the quality of life in subjects with spinal cord injuries. Methods: From the existing consensus methods was chosen the Delphi technique for the creation of the questionnaire and the SF-36 for criteria method. Results: The internal consistence was α=0,827. The intra and inter evaluators confidence shows itself high by the intra class correlation coefficient and the Brand and Altman test by the difference of average. Can be observed strong correlations between the QVLM and SF-36 in the functional capacity and physical aspects domains and moderate correlation in the health state and emotional aspects domains. There was a significant difference between the four applications of QVLM, demonstrating that the questionnaire is sensible to change. Conclusion: The QVLM was created with a suitable methodology and the evaluation of the psychometrics proprieties turn out to be on a valid, reliable, consisting and sensible to changes instrument

Effects of ganglioside G(M1) and erythropoietin on spinal cord lesions in rats: functional and histological evaluations

OBJECTIVE: To evaluate the functional and histological effects of ganglioside G(M1) and erythropoietin after experimental spinal cord contusion injury. METHODS: Fifty male Wistar rats underwent experimental spinal cord lesioning using an NYU-Impactor device and were randomly divided into the following groups, which received treatment intraperitoneally. The G(M1) group received ganglioside G(M1) (30 mg/kg); the erythropoietin group received erythropoietin (1000 IU/kg); the combined group received both drugs; and the saline group received saline (0.9%) as a control. A fifth group was the laminectomy group, in which the animals were subjected to laminectomy alone, without spinal lesioning or treatment. The animals were evaluated according to the Basso, Beattie and Bresnahan (BBB) scale, motor evoked potential recordings and, after euthanasia, histological analysis of spinal cord tissue. RESULTS: The erythropoietin group had higher BBB scores than the G(M1) group. The combined group had the highest BBB scores, and the saline group had the lowest BBB scores. No significant difference in latency was observed between the three groups that underwent spinal cord lesioning and intervention. However, the combined group showed a significantly higher signal amplitude than the other treatment groups or the saline group (p<0.01). Histological tissue analysis showed no significant difference between the groups. Axonal index was significantly enhanced in the combined group than any other intervention (p<0.01). CONCLUSION: G(M1) and erythropoietin exert therapeutic effects on axonal regeneration and electrophysiological and motor functions in rats subjected to experimental spinal cord lesioning and administering these two substances in combination potentiates their effects.

Spinal cord injury without radiographic abnormalities [SCIWORA] in a preschool child: a case report

A 3, 1/2 year old boy presented at the Soldiers' Family Rehabilitation Unit, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi with 2, 1/2 years' history of weakness and numbness in legs and loss of control over bowel and bladder following run over by a vehicle. At presentation, the child was unable to stand without support with power of 2/5 in iliopsoas, 3/5 in extensor hallucis longus and 0/5 in ankle plantar flexors on both sides. The power in quadriceps was0/5 on right and 2/5 on left side. The knee and ankle jerks were absent bilaterally. Sensations to both light touch and pin prick were impaired below T9 level on both sides. Perianal sensations were intact but voluntary anal contraction was absent. He was categorized as a case of Spinal Cord Injury T9 as classified by American Spinal Injury Association [ASIA] with impairment Scale C. X-Rays and Magnetic Resonance Imaging Scans were normal. These investigations aided by relevant clinical features qualified him as a case of Spinal Cord Injury without Radiographic Abnormalities

Time-related effects of general functional training in spinal cord-injured rats

OBJECTIVES: This prospective, randomized, experimental study with rats aimed to investigate the influence of general treatment strategies on the motor recovery of Wistar rats with moderate contusive spinal cord injury. METHODS: A total of 51 Wistar rats were randomized into five groups: control, maze, ramp, runway, and sham (laminectomy only). The rats underwent spinal cord injury at the T9-T10 levels using the NYU-Impactor. Each group was trained for 12 minutes twice a week for two weeks before and five weeks after the spinal cord injury, except for the control group. Functional motor recovery was assessed with the Basso, Beattie, and Bresnahan Scale on the first postoperative day and then once a week for five weeks. The animals were euthanized, and the spinal cords were collected for histological analysis. RESULTS: Ramp and maze groups showed an earlier and greater functional improvement effect than the control and runway groups. However, over time, unexpectedly, all of the groups showed similar effects as the control group, with spontaneous recovery. There were no histological differences in the injured area between the trained and control groups. CONCLUSION: Short-term benefits can be associated with a specific training regime; however, the same training was ineffective at maintaining superior long-term recovery. These results might support new considerations before hospital discharge of patients with spinal cord injuries.

Inflammation & apoptosis in spinal cord injury.

Spinal cord injury (SCI) consists of a two-steps process involving a primary mechanical injury followed by an inflammatory process and apoptosis. Secondary insult is characterized by further destruction of neuronal and glial cells, and leads to expansion of the damage, so that the paralysis can extend to higher segments. With the identification of mechanisms that either promote or prevent neuronal inflammation and apoptosis come new approaches for preventing and treating neurodegenerative disorders. From a clinical perspective, this article discusses novel targets for the development of therapeutic agents that have the potential to protect the spinal cord from irreversible damage and promote functional recovery.

Incidental demyelinating inflammatory lesions in asymptomatic patients: a Brazilian cohort with radiologically isolated syndrome and a critical review of current literature / Desmielinização inflamatória incidental em indivíduos assintomáticos: uma coorte brasileira com síndrome radiológica isolada e uma revisão crítica da literatura atual

Despite the definition of specific diagnostic criteria to identify radiologically isolated syndrome (RIS) suggestive of multiple sclerosis, its natural history remains incompletely understood. We retrospectively analyzed a Brazilian cohort of 12 patients to clarify their features and to emphasize the role of imaging predictors in clinical conversion. We demonstrated that, although some individuals did not exhibit progression over a lengthy follow-up period (16.7 percent), most patients will progress clinically or radiologically in the initial years of the follow-up (83.3 percent). Infratentorial and spinal cord involvement, as well as the total number of lesions, were more relevant predictors of progression than gadolinium enhancement. Further studies remain necessary to define the risk of conversion in males and to clarify the cognitive abilities of RIS patients. This study may provide an improved understanding of the natural course and evolution of incidental magnetic resonance imaging lesions, and further assists with the management of RIS in clinical practice.

Apesar da definição dos critérios diagnósticos específicos para identificar a síndrome radiológica isolada (SRI) sugestiva de esclerose múltipla, sua história natural ainda não foi completamente entendida. Analisamos retrospectivamente uma coorte brasileira de 12 pacientes visando a esclarecer suas características e enfatizar o papel da imagem em predizer conversão clínica. Embora alguns indivíduos não apresentem progressão em longo período de acompanhamento (16,7 por cento), a maioria dos pacientes com SRI progrediu clínica ou radiologicamente nos primeiros anos do seguimento (83,3 por cento). O comprometimento infratentorial e da medula espinhal, bem como o número total de lesões, foram mais relevantes em predizer a progressão que a presença de impregnação pelo gadolínio. Estudos futuros são necessários para definir o risco de conversão em homens e para esclarecer a repercussão cognitiva da SRI. Este estudo pode ampliar o entendimento da história natural e da evolução das lesões incidentais à imagem de ressonância magnética contribuindo para a adequada condução clínica da SRI.

Experiencia en tratamiento quirúrgico de cinco casos de siringomielia / Experience in surgical treatment of five cases of syringomyelia

Siringomielia, cavidades quísticas dentro del cordón espinal. Con incidencia baja de 8.4 por 100000 por año, Presentamos nuestra experiencia en tratamiento quirúrgico de 5 casos de siringomielia. Se presenta serie clínica, sin distinción de edad ni sexo, con diagnostico de siringomielia y que cumplan con los criterios quirúrgicos establecidos por el grupo. Estudiamos 5 pacientes, la totalidad de los casos presentaron síndrome disociativo medular por siringomielia, 4 casos sexo femenino, promedio de edad de 40,8 años, rango de seguimiento de 6 años a 6 meses, 5 casos procedentes del estado Mérida, 100% diagnostico por resonancia, 3 caso localización cervical, 1 caso la etiología es hemangioma capilar, a los 5 se les realizo derivación siringosubaracnoidea con mejoría clínica y en el postoperatorio tardío un 20% presento recidiva, manejada conservadoramente.

Syringomyelia, cystic cavities within the spinal cord. With low incidence of 8.4 per 100000 per year, present our experience in surgical treatment of 5 cases of syringomyelia. We present clinical series, regardless of age, sex diagnosed with syringomyelia and meet surgical criteria established by the grupo. We studied 5 patients, all cases had spinal cord syndrome and syringomyelia dissociative 4 cases female, mean age of 40.8 years, range 6-year follow-up to 6 months, 5 cases from the state of Merida, 100% resonance diagnosis, 3 cases cervical lesion, 1 case of capillary hemangioma etiology, to 5 were conducted with clinical improvement siringosubaracnoidea bypass and postoperative period by 20% for 1 case of recurrent, conservatively managed.

Forensic identification of cervical spinal cord injury without fracture or dislocation in 25 cases / 法医学杂志

OBJECTIVE@#To explore forensic identification of causality between injury and the consequence in cases of cervical spinal cord injury without fracture or dislocation.@*METHODS@#Twenty-five cases of cervical spinal cord injury without fracture or dislocation were collected. The age, mode of injury, imaging reports, cervical vertebral degeneration, clinical manifestations, diagnosis, treatment and injury consequences were summarized. The causality between injury and its consequence were classified as direct cause, main cause, same cause, minor cause and no cause.@*RESULTS@#Age, mode of injury, cervical vertebral degeneration and spinal stenosis were important factors in the analysis of causality. In the injured younger than 8-year-old trauma was generally the direct cause to the damage. While in other injured, it was needed to analyze the various factors comprehensively.@*CONCLUSION@#Comprehensive analysis of age, mode of injury, cervical vertebral degeneration, spinal stenosis and other factors would contribute to accurate identification of the causality between the injury and the consequences in cases of cervical spinal cord injury without fracture or dislocation.

Anti-inflammatory effect of the epigallocatechin gallate following spinal cord trauma in rat

Spinal cord injury [SCI] stimulates an inflammatory reaction that causes substantial secondary damage inside the injured spinal tissue. The purpose of this study was to determine the anti-inflammatory effects of epigallocatechin gallate [EGCG] on traumatized spinal cord. Methods: Rats were randomly divided into four groups of 12 rats each as follow: sham-operated group, trauma group, and EGCG-treatment groups [50 mg/kg, i.p., immediately and 1 hour after SCI]. Spinal cord samples were taken 24 hours after injury and studied for determination of myeloperoxidase [MPO] activity, histopathological assessment and immunohistochemistry of tumor necrosis factor-a [TNF-alpha], interleukin-1 beta [IL-1beta], Nitrotyrosine, inducible nitric oxide synthase [iNOS], cyclooxygenase-2 [COX-2], and poly [ADP-ribose] polymerase [PARP]. The results showed that MPO activity was significantly decreased in EGCG-treatment groups. Attenuated TNF-alpha, IL-1beta, Nitrotyrosine, iNOS, COX-2, and PARP expression could be detected in the EGCG treated rats. Also, EGCG attenuated myelin degradation. On the basis of these findings, we propose that EGCG may be effective in protecting rat spinal cord from secondary damage by modulating the inflammatory reactions

Spinal cord injury-induced astrocyte migration and glial scar formation: Effects of magnetic stimulation frequency.

The effects of magnetic stimulation on spinal cord injury-induced migration of white matter astrocytes were studied using an established animal model. Ethidium bromide was injected into the dorsal spinal cord funiculus of adult Sprague-Dawley rats on the left side at T10-11. Animals then received 1.52 Tesla-pulsed magnetic stimulation for 5 min at different frequencies (0-20 Hz) for 14 consecutive days. Selected animals received the non-competitive MEK1/2 inhibitor U0126 (10 μM), prior to stimulation at 10 Hz. Lesion volumes were measured in hematoxylin/eosin-stained sections. Expression of glial fibrillary acidic protein (GFAP), microtubule associated protein-2 (MAP-2) and extra-cellular signal-regulated kinase1/2 (ERK1/2) near the epicenter of injury was examined by Western blotting with quantification using an image analysis system. Lesion volumes decreased and GFAP and p-ERK1/2 expression increased with increasing magnetic stimulation frequency (0-10 Hz). MAP-2 expression was not affected at any frequency. Pretreatment with U0126 reduced GFAP and ERK1/2 expression and increased lesion volumes in response to stimulation at 10 Hz. It is concluded that magnetic stimulation increases the migration of astrocytes to spinal cord lesions. Activation of the ERK1/2 signaling pathway is proposed to mediate astrocyte migration and glial scar formation in response to spinal cord injury.

Gravidez em mulheres com trauma medular prévio / Pregnancy on women with previous medullary injury

No Brasil, há 130 mil indivíduos com trauma da medula espinhal e, a cada cinco pessoas vítimas de lesão traumática da medula, uma é mulher. Devido ao trauma da medula espinhal ser menos incidente entre mulheres, e por estas permanecerem férteis e capazes de levar uma gravidez a termo, a literatura tem ignorado grandemente seu estudo ? fato que não elimina as muitas alterações psicofisiológicas, bem como as alterações na sexualidade e outras dificuldades durante a gestação. Apesar disso, os poucos estudos existentes indicam que, nesse caso, o parto normal pode ser vantajoso em relação à cesariana. O objetivo do trabalho foi realizar uma revisão da literatura sobre o assunto, e assim colaborar com os profissionais da área da saúde quanto à atenção à gestante com trauma da medula espinhal

In Brazil, there are 130 thousand individuals with spinal cord injury, and one out of five injured people is a woman. Due to the lower incidence of spinal cord injury among women, and to the fact that they remain fertile and able to carry a pregnancy to term, the literature has largely ignored their study ? a fact which does not exclude the many psycho-physiological changes, as well as alterations in sexuality and other difficulties during pregnancy. Nevertheless, the few existing studies indicate that the normal birth may be advantageous when compared to the cesarean. The objective of the article is to conduct a review of the literature on the subject, and thus collaborate with health care professionals on the attention to pregnant women with spinal cord injury