Early decompression promotes motor recovery after cervical spinal cord injury in rats with chronic cervical spinal cord compression.
Early decompression promotes motor recovery after cervical spinal cord injury in rats with chronic cervical spinal cord compression.
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DOI：
10.1038/s41598-022-14723-8
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发表时间：
2022-08-24
影响因子：
4.6
通讯作者：
Ohtori, Seiji
中科院分区：
文献类型：
--
作者：
Okimatsu, Sho;Furuya, Takeo;Miura, Masataka;Shiratani, Yuki;Yunde, Atsushi;Inoue, Takaki;Maki, Satoshi;Ohtori, Seiji
近年来，无影像学异常的老年脊髓损伤患者（SCIWORA）越来越多，在大多数颈脊髓损伤中很常见。基础研究表明，脊髓损伤后早期减压对无狭窄的脊髓是有效的；没有研究报道减压对脊髓压缩性病变模型的疗效。本研究的目的是评估慢性脊髓压缩损伤大鼠急性脊髓损伤后减压手术的效果，模拟SCIWORA。将吸水聚合物片（Aquaprene DX，三洋化学工业公司）背侧插入8周龄Sprague Dawley大鼠颈4 - 5椎板下间隙，建立慢性脊柱压缩性损伤大鼠模型。在16周龄时，30只轻度脊髓病或无症状大鼠，Basso， Beattie和Bresnahan评分（BBB评分）为19或更高，进行脊髓压迫损伤。将大鼠分为三组：立即减压组（损伤后立即减压）、亚急性减压组（损伤后1周减压）和非减压组。损伤后4周进行行为学和组织学评价。20周龄时，即刻减压组和亚急性减压组大鼠BBB评分和前肢运动量表（FLS）均显著高于非减压组。即刻减压组与亚急性减压组间无显著性差异。TUNEL（转移酶介导的dUTP缺口末端标记）染色显示，与非减压组相比，减压组和非减压组的阳性细胞明显减少。LFB （Luxol fast blue）染色显示脱鞘明显增多，而GAP-43 （growth associated protein-43）染色显示非减压组阳性细胞较少。慢性压缩性损伤大鼠脊髓损伤后急性或亚急性期减压手术是有效的。立即减压组与亚急性减压组间无显著性差异。
The number of elderly patients with spinal cord injury without radiographic abnormalities (SCIWORA) has been increasing in recent years and common of most cervical spinal cord injuries. Basic research has shown the effectiveness of early decompression after spinal cord injury on the spinal cord without stenosis; no studies have reported the efficacy of decompression in models with spinal cord compressive lesions. The purpose of this study was to evaluate the effects of decompression surgery after acute spinal cord injury in rats with chronic spinal cord compressive lesions, mimicking SCIWORA. A water-absorbent polymer sheet (Aquaprene DX, Sanyo Chemical Industries) was inserted dorsally into the 4–5th cervical sublaminar space in 8-week-old Sprague Dawley rats to create a rat model with a chronic spinal compressive lesion. At the age of 16 weeks, 30 mildly myelopathic or asymptomatic rats with a Basso, Beattie, and Bresnahan score (BBB score) of 19 or higher were subjected to spinal cord compression injuries. The rats were divided into three groups: an immediate decompression group (decompress immediately after injury), a sub-acute decompression group (decompress 1 week after injury), and a non-decompression group. Behavioral and histological evaluations were performed 4 weeks after the injury. At 20 weeks of age, the BBB score and FLS (Forelimb Locomotor Scale) of both the immediate and the sub-acute decompression groups were significantly higher than those of the non-decompression group. There was no significant difference between the immediate decompression group and the sub-acute decompression group. TUNEL (transferase-mediated dUTP nick end labeling) staining showed significantly fewer positive cells in both decompression groups compared to the non-decompression group. LFB (Luxol fast blue) staining showed significantly more demyelination, and GAP-43 (growth associated protein-43) staining tended to show fewer positive cells in the non-decompression group. Decompression surgery in the acute or sub-acute phase of injury is effective after mild spinal cord injury in rats with chronic compressive lesions. There was no significant difference between the immediate decompression and sub-acute decompression groups.
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