Urgent surgical decompression compared to methylprednisolone for the treatment of acute spinal cord injury: a randomized prospective study in beagle dogs
Authors
Rabinowitz, Richard S.Eck, Jason C.
Harper, C. Michel Jr.
Larson, Dirk R.
Jimenez, Miguel A.
Parisi, Joseph E.
Friedman, Jonathan A.
Yaszemski, Michael J.
Currier, Bradford L.
UMass Chan Affiliations
Department of Orthopedics and Physical RehabilitationDocument Type
Journal ArticlePublication Date
2008-10-02Keywords
Acute DiseaseAnimals
Combined Modality Therapy
*Decompression, Surgical
*Disease Models, Animal
Dogs
Male
Methylprednisolone
Prospective Studies
Spinal Cord Injuries
Time Factors
Treatment Outcome
Orthopedics
Rehabilitation and Therapy
Metadata
Show full item recordAbstract
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.Source
Spine (Phila Pa 1976). 2008 Oct 1;33(21):2260-8. Link to article on publisher's siteDOI
10.1097/BRS.0b013e31818786dbPermanent Link to this Item
http://hdl.handle.net/20.500.14038/43038PubMed ID
18827690Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/BRS.0b013e31818786db