Abstract
Objective:To examine the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen therapy in treating thoracolumbar vertebral fracture-induced acute spinal cord injury (ASCI).Methods:From June 2015 to May 2018, 80 patients with thoracolumbar fractures and ASCI who were treated at Baoding First Central Hospital were selected. All patients underwent posterior laminectomy and screw fixation, and they were randomly divided into two groups using a random number table method. The control group received conventional postoperative treatment, while the experimental group was treated with riluzole combined with mannitol and hyperbaric oxygen on the basis of conventional treatment. The recovery of nerve function which included motor function and sensory function, and the changes of serum IL-6, CRP, BDNF, BFGF and other factors before treatment and four weeks after treatment of the two groups of patients were observed and evaluated.Results:After treatment, the motor function scores and sensory function scores of the two groups of patients were improved compared with those before treatment (p<0.05). Compared with the control group, the experimental group improved significantly, and the difference was statistically significant (p<0.05). The levels of IL-6, BDNF and NFGF in the experimental group were significantly lower than those in the control group (p<0.05).Conclusions:For patients with thoracolumbar fractures and ASCI undergoing laminar decompression and fixation, the comprehensive treatment plan of riluzole combined with mannitol and hyperbaric oxygen has certain advantages. Compared with the conventional therapy, it may significantly improve the movement and sensory functions of patients, relieve the inflammatory response of spinal cord, and promote recovery from the injury.
Highlights
Having become a common emergency in the emergency service of spine surgery department,[1] acute spinal cord injury (ASCI) is highly possible to incur a paraplegia and a bad prognosis as well.[2]
Two groups didn’t differ greatly in scores of sensory and movement functions (p>0.05). Both groups gained a significant improvement in the scores of sensory and movement functions 4 weeks after the treatment (p
The experimental group had significantly improved BDNF and BFGF when compared with the control group after the treatment as applied (p
Summary
Having become a common emergency in the emergency service of spine surgery department,[1] acute spinal cord injury (ASCI) is highly possible to incur a paraplegia and a bad prognosis as well.[2] According to the prevailing therapy, the patients of thoracolumbar vertebral fracture complicating ASCI should undergo operation as early as possible to eliminate the spinal cord nerve compression and accelerate neural functional recovery of the spinal cord. Other treatment methods such as hormone therapy are often needed. We have made some progress in applying an integrated therapeutic regime of combining Riluzole with mannitol and hyperbaric oxygen therapy to the ASCI patients having received posterior laminectomy and screw fixation operation
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