Abstract
Background: Spinal cord injury (SCI) causes a primary injury at the lesion site and triggers a secondary injury and prolonged inflammation. There has been no definitive treatment till now. Promoting angiogenesis is one of the most important strategies for functional recovery after SCI. The omentum, abundant in blood and lymph vessels, possesses the potent ability of tissue regeneration. Methods: The present work examines the efficacy of autologous omentum, either as a flap (with vascular connection intact) or graft (severed vascular connection), on spinal nerve regeneration. After contusive SCI in rats, a thin sheath of omentum was grafted to the injured spinal cord. Results: Omental graft improved behavior scores significantly from the 3rd to 6th week after injury (6th week, 5.5 ± 0.5 vs. 8.6 ± 1.3, p < 0.05). Furthermore, the reduction in cavity and the preservation of class III β-tubulin-positive nerve fibers in the injury area was noted. Next, the free omental flap was transposed to a completely transected SCI in rats through a pre-implanted tunnel. The flap remained vascularized and survived well several weeks after the operation. At 16 weeks post-treatment, SCI rats with omentum flap treatment displayed the preservation of significantly more nerve fibers (p < 0.05) and a reduced injured cavity, though locomotor scores were similar. Conclusions: Taken together, the findings of this study indicate that treatment with an omental graft or transposition of an omental flap on an injured spinal cord has a positive effect on nerve protection and tissue preservation in SCI rats. The current data highlight the importance of omentum in clinical applications.
Highlights
Traumatic spinal cord injury (SCI) is one of the most devastating diseases and results in severe motor and sensory dysfunction below the level of injury
It causes primary injury to both neuronal axons and myelin sheaths, which is followed by secondary injury and reactive gliosis, which leads to further neurological damage [1,2,3]
The secondary injury after Spinal cord injury (SCI) involves the release of cytotoxic factors, tissue edema, decreased blood flow, and accelerated apoptosis [4,5]
Summary
Traumatic spinal cord injury (SCI) is one of the most devastating diseases and results in severe motor and sensory dysfunction below the level of injury. The prolonged inflammatory reaction and limited regenerative ability both restrict the restoration of function. The current strategies for restoration can be divided into neuroprotection and neuroregeneration according to the different time-points, there is no definitive discrimination. Neuroprotection aims to reduce the inflammatory response, which could induce neurons or supportive cells to undergo apoptosis or necrosis. Neuroregeneration aims to reduce the inhibitory effect of extracellular materials and to promote the regrowth of neurons or axons. Because of the limited regenerative capability and the presence of inhibitory materials at the injury site, effective treatments for SCI are not currently available. Spinal cord injury (SCI) causes a primary injury at the lesion site and triggers a secondary injury and prolonged inflammation. The omentum, abundant in blood and lymph vessels, possesses the potent ability of tissue regeneration
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