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Duraplasty in Traumatic Thoracic Spinal Cord Injury: Impact on Spinal Cord Hemodynamics, Tissue Metabolism, Histology, and Behavioral Recovery Using a Porcine Model

脊髓 脊髓损伤 医学 蛛网膜下腔 薄壁组织 硬脑膜 麻醉 绳索 胸椎 外科 腰椎 解剖 病理 腰椎 脑脊液 精神科
作者
Femke Streijger,Kyoung‐Tae Kim,Kitty So,Neda Manouchehri,Katelyn Shortt,Elena B. Okon,Charlotte Morrison,Allan Fong,Rishab Gupta,Aysha Allard Brown,Seth Tigchelaar,Jenny Sun,Ella Liu,Martin S. Keung,Christopher Daly,Peter A. Cripton,Mypinder S. Sekhon,Donald Griesdale,Brian K. Kwon
出处
期刊:Journal of Neurotrauma [Mary Ann Liebert]
卷期号:38 (21): 2937-2955 被引量:10
标识
DOI:10.1089/neu.2021.0084
摘要

After acute traumatic spinal cord injury (SCI), the spinal cord can swell to fill the subarachnoid space and become compressed by the surrounding dura. In a porcine model of SCI, we performed a duraplasty to expand the subarachnoid space around the injured spinal cord and evaluated how this influenced acute intraparenchymal hemodynamic and metabolic responses, in addition to histological and behavioral recovery. Female Yucatan pigs underwent a T10 SCI, with or without duraplasty. Using microsensors implanted into the spinal cord parenchyma, changes in blood flow (ΔSCBF), oxygenation (ΔPO2), and spinal cord pressure (ΔSCP) during and after SCI were monitored, alongside metabolic responses. Behavioral recovery was tested weekly using the Porcine Injury Behavior Scale (PTIBS). Thereafter, spinal cords were harvested for tissue sparing analyses. In both duraplasty and non-animals, the ΔSCP increased ∼5 mm Hg in the first 6 h post-injury. After this, the SCP appeared to be slightly reduced in the duraplasty animals, although the group differences were not statistically significant after controlling for injury severity in terms of impact force. During the first seven days post-SCI, the ΔSCBF or ΔPO2 values were not different between the duraplasty and control animals. Over 12 weeks, there was no improvement in hindlimb locomotion as assessed by PTIBS scores and no reduction in tissue damage at the injury site in the duraplasty animals. In our porcine model of SCI, duraplasty did not provide any clear evidence of long-term behavioral or tissue sparing benefit after SCI.
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