Combination of mouse nerve growth factor and mecobalamin for treatment of incomplete spinal cord injury without high-dose methylprednisolone therapy

Abstract

Objective To evaluate the clinical efficacy of mouse nerve growth factor (mNGF) plus mecobalamin in the treatment of incomplete spinal cord injury (ISCI) without high-dose methylprednisolone therapy. Methods From October 2007 to September 2010,72 ISCI patients (Frankel grades B,C & D)without previous high-dose methylprednisolone therapy were treated in our department,of whom 56 were retrospectively selected for the present study and divided into 2 groups.In group A 28 patients were treated with combination of mNGF and meeobalamin; 28 patients in group B were treated with mecobalamin only.In this series,American Spinal Injury Association (ASIA) impairment scale and Activity of Daily Living (ADL) evaluation were used to observe and calculate nerve function improvement preoperation and 1 week,8 weeks,12 months postoperation. Results The mean follow-up period was 20 months (from 12 to 48 months).No mortality or incision infection was observed.Fusions of bone graft were observed 10 months postoperation on average.The ASIA and ADL scores at 1 week,8 weeks and 12 months postoperation were significant higher than those preoperation in both groups (P ＜0.05) except the ASIA score 1 week postoperation in group B.The postoperative ASIA and ADL scores in Group A were all significantly higher than those in group B ( P ＜ 0.05).The nerve function improvement at 1 week,8 weeks and 12 months postoperation in group A were 32.1％ (9/28),82.1％ (23/28) and 92.9％ (26/28) respectively,which were better than those in group B [25.0％ (7/28),50.0％ (14/28) and 71.4％ (20/28) ],with a significant difference at 8 weeks and 12 months postoperation ( P ＜ 0.05 ). Conclusion Compared with administration of sole mecobalamin,combination of mNGF and mecobalamin proves to be highly effective in promoting ISCI recovery and improving nerve functiont. Key words: Spinal cord injury; Mouse; Nerve growth factor; Mecobalamin; Nerve function