Spinal cord repair with acidic fibroblast growth factor as a treatment for a patient with chronic paraplegia
Spinal cord repair with acidic fibroblast growth factor as a treatment for a patient with chronic paraplegia
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DOI：
10.1097/01.brs.0000131217.61390.2c
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发表时间：
2004-07-15
期刊：
影响因子：
3
通讯作者：
Shih, YH
中科院分区：
文献类型：
--
作者：
Cheng, H;Liao, KK;Shih, YH
研究设计.我们介绍了一名4年前因刺伤而导致脊髓完全间隙的慢性截瘫患者的病例，该患者在采用创新手术策略后康复。目的。目的：证实用含酸性成纤维细胞生长因子的纤维蛋白胶进行腓肠神经移植手术修复慢性脊髓损伤患者的临床结果。脊髓损伤通常会导致永久性残疾，并且一直没有有效的手术技术来获得满意的运动功能恢复，特别是在慢性患者中。以往的研究表明，酸性成纤维细胞生长因子可促进脊髓损伤大鼠轴突再生，减少神经元死亡。用4根腓肠神经移植物桥接T11水平的脊髓间隙，将特定的通路从白色重定向到灰质。移植区用含酸性成纤维细胞生长因子的纤维蛋白胶固定。手术前，截瘫被确定为ASIA-C，左右腿运动评分分别为12和0，针刺评分为77，左侧肢体轻触评分为77。术后2年半，他的功能状态从坐轮椅改善为能够使用步行者独立行走。在这个阶段，截瘫为ASIA-D，左右腿运动评分分别为15和12，针刺为86分，左侧肢体轻触为86分。这个病例证明了慢性截瘫患者在神经移植和生长因子修复手术后获得了显著的运动恢复。
Study Design. We present a case of a patient with chronic paraplegia with a complete spinal cord gap resulting from a stabbing injury 4 years ago recovering after an innovative surgical strategy.Objectives. To demonstrate the clinical outcome of surgical repair with sural nerve graft with fibrin glue containing acidic fibroblast growth factor in a patient with chronic spinal cord injury.Summary of Background Data. Spinal cord injury usually causes permanent disability, and there had been not effective surgical technique to obtain satisfactory functional motor recovery, particularly in chronic patients. Previous studies have revealed that acidic fibroblast growth factor could promote axonal regeneration and reduce neuronal death in adult rats with spinal cord injury.Methods. The spinal cord gap at T11 level was bridged with 4 sural nerve grafts that redirected specific pathways from white to gray matter. The grafted area was stabilized with fibrin glue containing acidic fibroblast growth factor.Results. Before the operation, the paraplegia was identified as ASIA-C, with a motor score for the right and left legs of 12 and 0, respectively, a pinprick score of 77, and 77 on a light touch of left side limbs. His functional status improved from being wheelchair-bound to being able to ambulate independently with a walker 2-and-a-half years after surgery. At this stage, paraplegia was ASIA-D, with motor scores for the right and left legs of 15 and 12, respectively, 86 for a pinprick, and 86 for a light touch of left side limbs.Conclusions. This case demonstrated significant motor recovery attained in a patient with chronic paraplegia following a repair surgery with nerve graft and growth factor.