Unal Bunyami, Kaplan Suleyman, Odaci Ersan, Aslan Huseyin, Aksak Selina, Unal Deniz, Altunkaynak B Zuhal, Gundogdu Cemal, Gokyar Ahmet
Ataturk University, Faculty of Medicine, Department of Histology and Embryology, Erzurum, Turkey.
Ondokuz Mayis University, Faculty of Medicine, Department of Histology and Embryology, Samsun, Turkey.
Eurasian J Med. 2009 Dec;41(3):169-74.
Spinal cord injury is a common trauma among severe accidents in which the spinal cord has been severed; intravenous methylprednisolone and hypothermia are widely used in the treatment of traumatic spinal cord injuries. However, no common consensus has been reached on therapeutic approaches to prevent and reduce disability caused by spinal cord injuries. In this study, the efficacy of methylprednisolone and hypothermia treatments after experimental spinal cord injury made by dynamic weight-drop model in rabbits was investigated.
This experiment consists of three groups: injured, methylprednisolone-treated and hypothermia-treated groups. The methylprednisolone-treated group received intravenous methylprednisolone (30 mg/kg/day) immediately after spinal cord injury for three days. In the hypothermia-treated group, cold isotonic saline (5°C) was infused via a cannula into the epidural space at a rate of 10 ml/min. The temperature of the tissue was allowed to reach 25ºC, and then isotonic saline solution was given at a rate of 5 ml/min for 3 hours. Saline was given to the injured group following spinal cord injury. After 1 week of experimental injury, mid-thoracic level tissue was removed from the spinal cord for histopathological evaluation and subsequent stereological analysis.
The volume of spinal cord segment, not only parenchyma of grey and white matter but also cavity, was estimated by the Cavalieri principle. Significant differences were seen between the injured group and methylprednisolone /hypothermia-treated groups in terms of the total volume cavity of spinal cord segment; cavity volume in the grey matter and cavity volume in the white matter. No significant differences were seen between methylprednisolone and hypothermia-treated groups in terms of the total volume cavity of spinal cord segment; cavity volume in the grey matter and cavity volume in the white matter.
These results suggested that both methylprednisolone and hypothermia treatment are neuroprotective in preventing spinal cord tissue from tissue damage after experimental injury.
脊髓损伤是严重事故中常见的创伤，脊髓被切断；静脉注射甲基强的松龙和低温疗法广泛应用于创伤性脊髓损伤的治疗。然而，对于预防和减少脊髓损伤所致残疾的治疗方法尚未达成共识。本研究探讨了甲基强的松龙和低温疗法对兔动态重物坠落模型所致实验性脊髓损伤后的疗效。
本实验分为三组：损伤组、甲基强的松龙治疗组和低温治疗组。甲基强的松龙治疗组在脊髓损伤后立即静脉注射甲基强的松龙（30mg/kg/天），持续三天。在低温治疗组中，冷的等渗盐水（5°C）通过套管以10ml/min的速度注入硬膜外腔。使组织温度达到25ºC，然后以5ml/min的速度给予等渗盐水溶液3小时。脊髓损伤后给损伤组注射生理盐水。实验损伤1周后，从脊髓中取出胸段中部组织进行组织病理学评估和随后的体视学分析。
采用卡瓦列里原理估计脊髓节段的体积，包括灰质和白质实质以及空洞的体积。在脊髓节段的总空洞体积、灰质空洞体积和白质空洞体积方面，损伤组与甲基强的松龙/低温治疗组之间存在显著差异。在脊髓节段的总空洞体积、灰质空洞体积和白质空洞体积方面，甲基强的松龙治疗组与低温治疗组之间无显著差异。
这些结果表明，甲基强的松龙和低温疗法在预防实验性损伤后脊髓组织损伤方面均具有神经保护作用。
