Clinical significance of MRI and electrophysiology for the evaluation of hyperbaric oxygen in the treatment of acute spinal cord injury

Abstract

Objective To investigate the therapeutic effect of hyperbaric oxygen(HBO)in early treatment of acute spinal cord injury(ASCI), and to observe the clinical significance of magnetic resonance imaging(MRI)and electrophysiology in the evaluation of the effect of early HBO on ASCI. Methods Forty cases of acute incomplete spinal cord injury treated in our hospital from August 2013 to 2014 October were divided into the HBO group(n=26)and the control group(n=14). The patients of both groups received routine drug treatment. The patients in the HBO group were additionally treated with HBO 48 hours after injury. ASIA(American Spinal Cord Injury Association)and Frankel scores were evaluated the moment after injury, 15 and 30 days after injury. MRI scanning and conventional nerve conduction testing were performed for the determination of tibial and peroneal nerve motive and sensory conduction, and for the analyses of distal latency, action potential amplitude, as well as conduction velocity. Results The efficacy of the HBO group(86.2%)in the treatment of ASCI was obviously better than that of the control group(63.6%)(P<0.05). As for the therapeutic effects on motor and neural functions, the patients of the HBO group showed significant improvement in ASIA and Frankel scores, 15 and 30 days after HBO treatment. MRI images indicated that there were changes in the scope of foci. Following treatment of HBO, grade III injury by GM-WM scales in the HBO group was decreased significantly, while there was only 1 case in the control group that was relieved from grade III injury. Fifteen days after HBO, the peak value of somatosensory evoked potential(SEP)and motor evoked potential(MEP)of tibial and peroneal nerves elevated, and the latency was shortened. Sensory nerve conduction velocity(SCV)and motor nerve conduction velocity(MCV)significantly increased. Conclusions Adjunctive HBO therapy was a safe and effective treatment method for ASCI. Early and adequate treatment courses could improve its treatment efficacy. MRI and electrophysiology were of clinical significance in the evaluation of HBO efficacy in the treatment of ASCI. Key words: Hyperbaric oxygen; Acute spinal cord injury; Magnetic resonance imaging; Neurological function