Dural repair reduces connective tissue scar invasion and cystic cavity formation after acute spinal cord laceration injury in adult rats
Dural repair reduces connective tissue scar invasion and cystic cavity formation after acute spinal cord laceration injury in adult rats
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DOI：
10.1089/neu.2006.23.853
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发表时间：
2006-06-01
影响因子：
4.2
通讯作者：
Shields, Christopher B.
中科院分区：
文献类型：
--
作者：
Iannotti, Christopher;Zhang, Y. Ping;Shields, Christopher B.
本研究检查了在大鼠模型中急性颈部撕裂脊髓损伤（SCI）后硬脑膜成形术是否可以（1）改善损伤附近的脑脊液（CSF）循环;（2）最大限度地减少结缔组织瘢痕形成;（3）减少创伤后炎症和囊性空洞。在横向硬脑膜/蛛网膜切口和C5-6脊髓背侧半切术后，将5 mm（2）尸体硬脑膜同种异体移植物放置在病变上，并用纤维蛋白胶固定（n = 12）。对照组动物接受相同的硬脑膜/蛛网膜切口和颈椎背侧半切术，未进行硬脑膜修复（n = 12）。在损伤后1、5和10周，获得平片脊髓造影以表征CSF循环，并使用体视学方法比较两组之间的组织保留程度。进行免疫组织化学研究以评估炎症（艾德-1）、结缔组织瘢痕形成（层粘连蛋白和IV型胶原）和反应性星形胶质细胞增生（GFAP）的程度。我们的研究结果表明，硬脑膜同种异体移植物可以改善邻近损伤部位的脑脊液流量，这可能是由于减少了损伤部位的脑膜纤维化/瘢痕形成。体视学分析表明，硬脑膜成形术导致在每个时间点病灶体积显著减小（P < 0.01），与创伤后囊性空洞几乎完全衰减相关（p < 0.001）。免疫荧光研究表明，硬膜成形术减少了艾德-1阳性巨噬细胞/小胶质细胞浸润到病变部位和周围，这可能是硬膜成形术后继发性损伤明显减少的原因。我们的结论是，急性脊髓撕裂后硬脑膜成形术可能（1）通过限制脑膜纤维化改善CSF流量;（2）减少结缔组织瘢痕形成;（3）减弱巨噬细胞积聚和进行性继发性损伤。
This study examined whether duraplasty after acute cervical laceration spinal cord injury (SCI) in a rat model could (1) improve cerebrospinal fluid (CSF) circulation adjacent to the injury; (2) minimize connective tissue scarring; and (3) reduce post-traumatic inflammation and cystic cavitation. Following a transverse dural/arachnoid incision and C5-6 dorsal spinal hemisection, a 5-mm(2) cadaveric dura mater allograft was placed over the lesion and fixed with fibrin glue (n = 12). Control animals received an identical dural/arachnoid incision and cervical dorsal hemisection without dural repair (n = 12). At 1, 5, and 10 weeks post-injury, plain film myelograms were obtained to characterize CSF circulation, and stereological methods were used to compare the extent of tissue sparing between the two groups. Immunohistochemical studies were performed to assess the degree of inflammation (ED-1), connective tissue scarring (laminin and type IV collagen), and reactive astrogliosis (GFAP). Our results indicate that dural allograft can improve CSF flow adjacent to the site of injury, which may be due to reduced meningeal fibrosis/scarring at the lesion site. Stereological analysis demonstrated that duraplasty resulted in a significant reduction in lesion volume at each time-point (P < 0.01) associated with a nearly complete attenuation of post-traumatic cystic cavitation (p < 0.001). Immunofluorescence studies demonstrated that duraplasty reduced the infiltration of ED-1-positive macrophages/microglia into and surrounding the lesion site, which may be responsible for the marked reduction in secondary injury following duraplasty. We conclude that duraplasty following acute spinal cord laceration may (1) improve CSF flow by limiting meningeal fibrosis; (2) reduce connective tissue scar formation; and (3) attenuate macrophage accumulation and progressive secondary injury.