Spinal Cord Injury: A Systematic Review of Current Treatment Options

Cadotte, David W.; Fehlings, Michael G.

doi:10.1007/s11999-010-1674-0

Cited by 117 publications

(77 citation statements)

References 58 publications

(119 reference statements)

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“…Most of the clinical trials for SCI are directed to limiting secondary injury to prevent neurological function loss and to provide the anatomical substrate for further reparation. 89 In this line of evidence, PROG treatment holds promise for success. In fact, multipotential drugs such as PROG, which have pleiotrophic sites of action and modulate multiple injury mechanisms, could be the focus of future clinical trials in spinal cord trauma.…”

Section: Resultsmentioning

confidence: 99%

Progesterone Reduces Secondary Damage, Preserves White Matter, and Improves Locomotor Outcome after Spinal Cord Contusion

Garcı́a-Ovejero

GonzálezSusana²,

Paniagua-TorijaBeatriz³

et al. 2014

Journal of Neurotrauma

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Progesterone is an anti-inflammatory and promyelinating agent after spinal cord injury, but its effectiveness on functional recovery is still controversial. In the current study, we tested the effects of chronic progesterone administration on tissue preservation and functional recovery in a clinically relevant model of spinal cord lesion (thoracic contusion). Using magnetic resonance imaging, we observed that progesterone reduced both volume and rostrocaudal extension of the lesion at 60 days post-injury. In addition, progesterone increased the number of total mature oligodendrocytes, myelin basic protein immunoreactivity, and the number of axonal profiles at the epicenter of the lesion. Further, progesterone treatment significantly improved motor outcome as assessed using the Basso-Bresnahan-Beattie scale for locomotion and CatWalk gait analysis. These data suggest that progesterone could be considered a promising therapeutical candidate for spinal cord injury.

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Section: Resultsmentioning

confidence: 99%

Progesterone Reduces Secondary Damage, Preserves White Matter, and Improves Locomotor Outcome after Spinal Cord Contusion

Garcı́a-Ovejero

GonzálezSusana²,

Paniagua-TorijaBeatriz³

et al. 2014

Journal of Neurotrauma

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“…Immediately after SCI, a cascade of molecular and cellular events known as the secondary injury contributes to worsen the primary lesions [1].…”

Section: Introductionmentioning

confidence: 99%

Effect of norepinephrine on spinal cord blood flow and parenchymal hemorrhage size in acute-phase experimental spinal cord injury

Soubeyrand

Dubory

Laemmel³

et al. 2013

Eur Spine J

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Purpose In the acute phase of spinal cord injury (SCI), ischemia and parenchymal hemorrhage are believed to worsen the primary lesions induced by mechanical trauma. To minimize ischemia, keeping the mean arterial blood pressure above 85 mmHg for at least 1 week is recommended, and norepinephrine is frequently administered to achieve this goal. However, no experimental study has assessed the effect of norepinephrine on spinal cord blood flow (SCBF) and parenchymal hemorrhage size. We have assessed the effect of norepinephrine on SCBF and parenchymal hemorrhage size within the first hour after experimental SCI. Methods A total of 38 animals were included in four groups according to whether SCI was induced and norepinephrine injected. SCI was induced at level Th10 by dropping a 10-g weight from a height of 10 cm. Each experiment lasted 60 min. Norepinephrine was started 15 min after the trauma. SCBF was measured in the ischemic penumbra zone surrounding the trauma epicenter using contrast-enhanced ultrasonography. Hemorrhage size was measured repeatedly on parasagittal B-mode ultrasonography slices.Results SCI was associated with significant decreases in SCBF (P = 0.0002). Norepinephrine infusion did not significantly modify SCBF. Parenchymal hemorrhage size was significantly greater in the animals given norepinephrine (P = 0.0002). Conclusion In the rat, after a severe SCI at the Th10 level, injection of norepinephrine 15 min after SCI does not modify SCBF and increases the size of the parenchymal hemorrhage.Keywords Spinal cord injury Á Spinal cord blood flow Á Norepinephrine Á Contrast-enhanced ultrasonography A. Dubory and E. Laemmel have equally contributed to this work. E. Vicaut and J. Duranteau have equally contributed to this work.

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“…Patients surviving SCI are often left with debilitating paraplegia that significantly affects their daily activities and quality of life 1 . Experimental SCI models have been an indispensable tool in the scientific investigation to understand the pathophysiology of SCI and associated neural repair processes.…”

Section: Introductionmentioning

confidence: 99%

Photothrombosis-induced Focal Ischemia as a Model of Spinal Cord Injury in Mice

Choudhury

Zhang

et al. 2015

JoVE

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Spinal cord injury (SCI) is a devastating clinical condition causing permanent changes in sensorimotor and autonomic functions of the spinal cord (SC) below the site of injury. The secondary ischemia that develops following the initial mechanical insult is a serious complication of the SCI and severely impairs the function and viability of surviving neuronal and non-neuronal cells in the SC. In addition, ischemia is also responsible for the growth of lesion during chronic phase of injury and interferes with the cellular repair and healing processes. Thus there is a need to develop a spinal cord ischemia model for studying the mechanisms of ischemia-induced pathology. Focal ischemia induced by photothrombosis (PT) is a minimally invasive and very well established procedure used to investigate the pathology of ischemia-induced cell death in the brain. Here, we describe the use of PT to induce an ischemic lesion in the spinal cord of mice. Following retro-orbital sinus injection of Rose Bengal, the posterior spinal vein and other capillaries on the dorsal surface of SC were irradiated with a green light resulting in the formation of a thrombus and thus ischemia in the affected region. Results from histology and immunochemistry studies show that PT-induced ischemia caused spinal cord infarction, loss of neurons and reactive gliosis. Using this technique a highly reproducible and relatively easy model of SCI in mice can be achieved that would serve the purpose of scientific investigations into the mechanisms of ischemia induced cell death as well as the efficacy of neuroprotective drugs. This model will also allow exploration of the pathological changes that occur following SCI in live mice like axonal degeneration and regeneration, neuronal and astrocytic Ca 2+ signaling using two-photon microscopy. Video LinkThe video component of this article can be found at

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Spinal Cord Injury: A Systematic Review of Current Treatment Options

Cited by 117 publications

References 58 publications

Progesterone Reduces Secondary Damage, Preserves White Matter, and Improves Locomotor Outcome after Spinal Cord Contusion

Progesterone Reduces Secondary Damage, Preserves White Matter, and Improves Locomotor Outcome after Spinal Cord Contusion

Effect of norepinephrine on spinal cord blood flow and parenchymal hemorrhage size in acute-phase experimental spinal cord injury

Photothrombosis-induced Focal Ischemia as a Model of Spinal Cord Injury in Mice

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