Abstract:
STUDY DESIGN:Experimental dog model of acute spinal cord injury. OBJECTIVE:To compare the relative value of methylprednisolone, surgical decompression, or both for the treatment of traumatic spinal cord injury. SUMMARY OF BACKGROUND DATA:Acute spinal cord injury results from both primary damage to the spinal cord at the time of the initial injury as well as a deleterious secondary cascade of events, which leads to further damage. Surgical decompression is known to improve clinical outcomes, but the timing of surgical decompression remains controversial. METHODS:A nylon tie was used to constrict the spinal cord in 18 adult male beagle dogs. The animals were then prospectively randomized to 3 groups: 1) surgical decompression at 6 hours and intravenous methylprednisolone; 2) surgical decompression at 6 hours and intravenous saline; and 3) intravenous methylprednisolone without surgical decompression. Each animal was evaluated by somatosensory-evoked potentials, daily neurologic assessment, and histologic examination at 2 weeks following injury. RESULTS:Immediately following spinal cord constriction, all animals were paraplegic, incontinent, and the somatosensory-evoked potentials were abolished. Surgical decompression 6 hours after injury, with or without methylprednisolone, led to significantly better neurologic function at 2 weeks than methylprednisolone alone. CONCLUSION:In the setting of acute and persistent spinal cord compression in beagle dogs, surgical decompression 6 hours after injury, with or without methylprednisolone, is more effective for improving neurologic recovery than methylprednisolone alone.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Rabinowitz RS,Eck JC,Harper CM Jr,Larson DR,Jimenez MA,Parisi JE,Friedman JA,Yaszemski MJ,Currier BLdoi
10.1097/BRS.0b013e31818786dbsubject
Has Abstractpub_date
2008-10-01 00:00:00pages
2260-8issue
21eissn
0362-2436issn
1528-1159pii
00007632-200810010-00003journal_volume
33pub_type
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