Department of Orthopaedic Surgery, St Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Spine (Phila Pa 1976). 2011 Mar 15;36(6):434-40. doi: 10.1097/BRS.0b013e3181d3cf82.
This study investigated the outcome of combined therapy with irradiation and methylprednisolone (MP) after a traumatic spinal cord injury (SCI).
To evaluate the neurologic outcomes as well as the antiapoptotic and anti-inflammatory effects on traumatic SCI in rats after combined therapy.
Although irradiation carries the risk of secondary SCI, it has been effective for the regeneration of the axons of nerve cells by reducing gliosis. Thus, to minimize apoptosis and irradiation risks after SCI, this study investigated the effects of steroid injections before irradiation.
Thirty-two rats were used for the experimental procedure. After a traumatic SCI, they were divided into 4 groups of 8 rats each: (1) a control group that only had rats with a SCI (Group 1); (2) a group that received MP at 30 minutes, 6 hours and 24 hours, and then received irradiation 2 days after the SCI (Group 2); (3) a group that received MP at 30 minutes, and irradiation 2 days after the SCI (Group 3); and (4) a group that received irradiation 2 days after the traumatic SCI (Group 4).
The degree of recovery using the inclined plane climbing test was greatest in Group 2, followed by Group 3, Group 4, and Group 1. The cavitation lesions, Terminal Deoxynucleotidyl Transferase dUTP Nick End Labeling -positive apoptosis, glial fibrillary acidic protein-positive astrocyte count, and CC-1-positive oligodendrocyte count significantly decreased in the irradiated groups (Groups 2, 3, 4) compared to the control group (Group 1). In particular, they decreased considerably more in the group that received MP 3 times (Group 2) compared to the group that received MP only once (Group 3).
These results suggest that the combined therapy was effective and might provide synergistic effects for neurologic recovery after a traumatic SCI.
本研究调查了外伤性脊髓损伤（SCI）后联合放疗和甲基强的松龙（MP）治疗的结果。
评估联合治疗对大鼠外伤性 SCI 后神经功能的影响，以及对细胞凋亡和炎症的影响。
尽管放疗会增加继发性 SCI 的风险，但它通过减少神经胶质增生，对神经细胞轴突的再生有效。因此，为了最大限度地减少 SCI 后凋亡和放疗的风险，本研究在放疗前进行了类固醇注射的效果研究。
32 只大鼠用于实验。外伤性 SCI 后，将它们分为 4 组，每组 8 只大鼠：（1）仅发生 SCI 的对照组（第 1 组）；（2）在 30 分钟、6 小时和 24 小时给予 MP，然后在 SCI 后 2 天接受放疗的组（第 2 组）；（3）在 30 分钟给予 MP，并在 SCI 后 2 天接受放疗的组（第 3 组）；（4）在外伤性 SCI 后 2 天接受放疗的组（第 4 组）。
使用斜板攀爬试验评估的恢复程度，第 2 组最大，其次是第 3 组、第 4 组和第 1 组。与对照组（第 1 组）相比，照射组（第 2 组、第 3 组、第 4 组）的空洞病变、末端脱氧核苷酸转移酶 dUTP 缺口末端标记阳性凋亡、胶质纤维酸性蛋白阳性星形胶质细胞计数和 CC-1 阳性少突胶质细胞计数显著减少。特别是与仅接受一次 MP 的组（第 3 组）相比，接受 3 次 MP 的组（第 2 组）减少得更多。
这些结果表明联合治疗是有效的，可能对外伤性 SCI 后神经功能恢复有协同作用。
