Spinal Cord Nerve Function Research Articles

Transplantation of MiR-28-5p-Modified BMSCs Promotes Functional Recovery After Spinal Cord Injury

Traumatic spinal cord injury (TSCI) is a prevalent central nervous system condition that imposes a significant burden on both families and society, affecting more than 2 million people worldwide. Recently, there has been increasing interest in bone marrow mesenchymal stem cell (BMSC) transplantation as a promising treatment for spinal cord injury (SCI) due to their accessibility and low immunogenicity. However, the mere transplantation of BMSCs has limited capacity to directly participate in the repair of host spinal cord nerve function. MiR-28-5p, identified as a key differentially expressed miRNA in spinal cord ischemia–reperfusion injury, exhibits differential expression and regulation in various neurological diseases. Nevertheless, its involvement in this process and its specific regulatory mechanisms in SCI remain unclear. Therefore, this study aimed to investigate the potential mechanisms through which miR-28-5p promotes the neuronal differentiation of BMSCs both in vivo and in vitro. Our results indicate that miR-28-5p may directly target Notch1, thereby facilitating the neuronal differentiation of BMSCs in vitro. Furthermore, the transplantation of lentivirus-mediated miR-28-5p-overexpressed BMSCs into SCI rats effectively improved footprint tests and Basso, Beattie, and Bresnahan (BBB) scores, ameliorated histological morphology (hematoxylin–eosin [HE] and Nissl staining), promoted axonal regeneration (MAP2 and growth-associated protein 43 [GAP43]), and facilitated axonal remyelination (myelin basic protein [MBP]). These findings may suggest that miR-28-5p-modified BMSCs could serve as a therapeutic target to enhance the behavioral and neurological recovery of SCI rats.

Polymethylmethacrylate-augmented screw fixation in treatment of senile thoracolumbar tuberculosis combined with severe osteoporosis

To explore the safety and effectiveness of polymethylmethacrylate-augmented screw fixation (PASF) in the treatment of elderly thoracolumbar tuberculosis combined with severe osteoporosis. The clinical data of 20 elderly patients with thoracolumbar tuberculosis and severe osteoporosis who underwent PASF after anterior or posterior debridement and bone grafting and met the selection criteria between December 2012 and December 2014 were retrospectively analyzed. There were 8 males and 12 females with an average age of 68.5 years (range, 65-72 years). T value of bone mineral density was -4.2 to -3.6, with an average of -3.9. There were 12 cases of thoracic tuberculosis, 3 cases of thoracolumbar tuberculosis, and 5 cases of lumbar tuberculosis. The diseased segments involved T 3-L 4, including 11 cases of single-segment disease, 6 cases of double-segment disease, and 3 cases of multi-segment disease. The disease duration was 3-9 months, with an average of 6 months. The preoperative spinal nerve function of the patients was evaluated by the American Spinal Injury Association (ASIA) grading. There were 2 cases of grade A, 5 cases of grade B, 6 cases of grade C, 4 cases of grade D, and 3 cases of grade E. Postoperative imaging examination was used to evaluate the bone graft fusion and paravertebral abscess absorption, and to measure the Cobb angle of the segment to evaluate the improvement of kyphosis. The levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were tested. The visual analogue scale (VAS) score, Oswestry disability index (ODI), and ASIA grading were used to evaluate the effectivreness before operation, at 1 month after operation, and at last follow-up. The clinical cure of tuberculosis was also evaluated. All operation successfully completed. The operation time was 154-250 minutes, with an average of 202 minutes; the intraoperative blood loss was 368-656 mL, with an average of 512 mL. All 20 patients were followed up 18-42 months, with an average of 26.8 months. The postoperative pain and symptoms of tuberculosis in all patients relieved, and the paravertebral abscess was absorbed, reaching the cure standard for spinal tuberculosis. All bone grafts fusion achieved within 1 year after operation. Only 1 case had asymptomatic bone cement leakage into the paravertebral veins, and the remaining patients had no serious complications such as bone cement leakage in the spinal canal, pulmonary embolism, and neurovascular injury. At last follow-up, spinal cord nerve function significantly improved when compared with preoperative one. Among them, ASIA grading were 7 cases of grade C, 8 cases of grade D, and 5 cases of grade E, showing significant difference when compared with preoperative one ( Z=2.139, P=0.000). VAS score, ODI score, segmental Cobb angle, ESR, and CRP at 1 month after operation and at last follow-up were significantly improved when compared with preoperative ones ( P<0.05); there was no significant difference between 1 month after operation and last follow-up ( P>0.05). During the follow-up, no complications such as failure of internal fixation, proximal junctional kyphosis, or tuberculosis recurrence occurred. For elderly patients with thoracolumbar tuberculosis and severe osteoporosis, PASF treatment is safe and effective.

The effects of walking training onset on motor evoked potentials after acute spinal cord injury

AimThe purposes of this study were to explore the optimal time for starting walking training in the first month after spinal cord injury (SCI) in rats and to discuss the relationship between changes in motor function and transcranial electrical motor evoked potentials (tceMEPs). MethodsFour groups of rats with SCI (BSWTT-3, 7, 14, 12) performed body-weight-supported treadmill training (BWSTT) for three weeks beginning at 3, 7, 14, and 21 days after SCI, respectively. The Basso, Beattie, and Bresnahan (BBB) score and tceMEPs were assessed weekly. Weekly repeated measures and multiple comparisons between groups were performed to identify differences in motor function and tceMEPs. Correlation analysis was performed to clarify the relationship between BBB scores and tceMEPs over time. ResultsAlthough there was no significant difference between the BWSTT-14 group and the other three BWSTT groups at the end of the experiment in terms of BBB scores and the latency of tceMEPs, the BWSTT-14 group obtained the best trends in improvement of BBB scores and the latencies and amplitudes of tceMEPs over time. The BBB scores of rats with SCI were strongly negatively correlated with tceMEPs latency. The BBB scores of rats with SCI, except for the rats in the BWSTT-3 group, were strongly positively correlated with the tceMEPs amplitude. ConclusionsThe preliminary conclusion was that based on a rat model, 14 days after SCI was the optimal time for starting BWSTT. tceMEPs were an objective indicator of spinal cord nerve function, which was strongly correlated with motor function recovery. However, one limitation of this study was that the rats in the Sham group did not undergo BWSTT, which made the training itself a confounding factor for the results.

Baicalin effects on rats with spinal cord injury by anti‐inflammatory and regulating the serum metabolic disorder

Baicalin had neuroprotective effects on inhibiting neuronal cell apoptosis induced by spinal cord ischemic injury. This study aimed to explore the protective effects of Baicalin on rats with spinal cord injury (SCI) and its mechanism of action. The recovery of spinal cord nerve function in rats was evaluated by the Basso, Beattie, and Bresnahan (BBB) score and the combine behavioral score (CBS). The expressions of cytokines tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), and IL-6 were detected by the enzyme-linked immunosorbent assay method. Expressions of inflammation-related proteins were detected by Western blot. Multivariate statistical analysis was performed for serum metabolites. The BBB and CBS score results showed that Baicalin had a certain improvement on rats with SCI. SCI symptoms were significantly improved in low-dose and high-dose groups. The levels of TNF-α, IL-1β, and IL-6 in the SCI group were significantly increased. The expressions of NF-κB p65, NF-κB p50, p-IκBα, and IKKα in the SCI group showed the opposite trend compared with the low-dose and high-dose groups. Compared with the sham group, glutamine, levels of 3-OH-butyrate, N-acetylaspartate, and glutathione were significantly reduced, and the levels of glutamate and betaine were significantly increased in the SCI group. When Baicalin was administered, the contents of glutamine synthase (GS) and glutaminase (GLS) were significantly reduced, indicating that Baicalin had the effect of improving GS and GLS. Baicalin has protective effects on improving SCI and lower extremity motor function, has a significant anti-inflammatory effect, and regulates the serum metabolic disorder caused by SCI in rats.

Posterior lumbar interbody fusion and internal fixation for complete thoracolumbar fracture and dislocation

Objective To investigate the clinical features, safety and clinical efficacy of the posterior decompression and interbody fusion with internal fixation for complete thoracolumbar fracture and dislocation. Methods The clinical data of 23 patients with complete thoracolumbar fracture and dislocation treated by posterior decompression and interbody fusion with pedicle screw fixation from August 2011 to October 2014 were retrospectively analyzed. There were 18 males and 15 females, aging from 20 to 50 years old with an average age of 38.2±0.3 years. There were 8 cases of T10,11 vertebral dislocation, 8 of T11,12 vertebral dislocation, 3 of T12L1 vertebral dislocation, and 4 of L1,2 vertebral dislocation. All the patients had different degrees of multiple rib fractures and pneumothorax complications. Preoperative spinal cord nerve function was evaluated according to the American Spinal Injury Association of spinal cord function (ASIA). There were 10 cases of ASIA grade A and 13 cases of grade B. Operation time, intraoperative blood loss, clinical outcome, imaging X-ray and CT examination, segmental kyphosis angle and bone graft fusion were recorded. Results All the patients were followed up for 13 to 26 months, average 20.2±4.3 months. The operation time ranged from 150 to 260 min with the average time of 180.3±14.8 min; intraoperative blood loss was 800-1 500 ml with the average of 950.2±98.1 ml. Preoperative sagittal Cobb angle was -13.5°±6.3° (range, -20.1° to 2.3°); postoperative sagittal Cobb angle was 1.43°±6.4° (range, -7.6° to 3.5°); at the latest follow-up, sagittal Cobb angle was 1.6°±6.3° (range, -8.1° to 10.3°); the dislocation reduced from preoperative 100% to postoperative 0-15% (10%±6%) . After operation, the ASIA grade of 2 cases improved from A to B, and 5 cases improved from B to C. All of the patients had bone fusion after operation, no false joint or nonunion occurred, no loosening or breakage of internal fixation occurred. Conclusion There are high risks and difficulty of surgery for those who with thoracolumbar fracture dislocation and severe injuries of spine and spinal cord combined with multiple injuries. Proper treatment of preoperative complications is the premise of good curative effect; reliable fusion and long segment internal fixation is the key of operation. Single posterior decompression and reduction with interbody fusion and internal fixation is less invasive and could achieve satisfactory clinical efficacy. Key words: Thoracic vertebrae; Lumbar vertebrae; Spinal fractures; Dislocations; Spinal fusion

Transpedicular screw fixation plus percutaneous vertebroplasty for treatment of severe thoracolumbar osteoporotic vertebral compression fractures

Objective To investigate the curative effect of transpedicular screw fixation plus percutaneous vertebroplasty (PVP) for treatment of severe thoracolumbar osteoporotic vertebral compression fractures (OVCF). Methods Twenty-one patients with severe OVCF presenting to our hospital from July 2012 to May 2015 were analyzed retrospectively. There were nine male and twelve female patients, aged 50-78 years (mean, 68.8 years). The level of injury was T11 in four patients, T12 in six, L1 in five, L2 in three, L3 in two and L4 in one. Time between injury and surgery was 2-16 d (mean, 7.5 d). All patients underwent pedicle screw fixation at the injured level combined with PVP. Visual analogue scale (VAS) was used for evaluation of lower back pain after operation, Oswestry disability index(ODI) for lower back function, lateral thoracolumbar film for Cobb angle and anterior vertebral height compression ratio, and American Spinal Injury Association (ASIA) score for spinal cord nerve function. Postoperative complications were recorded. Results All patients were followed up for 12-21 months [(15.7±2.9)months]. Postoperative studies showed significant differences in VAS[ (2.9±1.1)scores], ODI [(30.8±7.5)% ], Cobb angle [ (21.5±7.3)°] and anterior vertebral height compression ratio [(44.3±13.9)%] compared to the preoperative measures (P 0.05). According to the ASIA score, eight patients with neural function injury had one to two level recovery at the final follow-up. Asymptomatic cement leakage occurred in seven patients after operation. There was no internal fixation breakage at the final follow-up. Conclusions Transpedicular screw fixation plus PVP can not only restore the height and strength of the injured vertebrae and correct kyphotic deformity, but also relieve low back pain and improve function of the spine. Therefore, the technique is a safe, reliable and effective surgical treatment for severe thoracolumbar OVCF. Key words: Osteoporotic fractures; Vertebroplasty; Pedicle screw fixation

Changes in spinal cord nerve function due to differences in motor imagery method: a comparison of the composite image and single image

Changes in spinal cord nerve function due to differences in motor imagery method: a comparison of the composite image and single image

Human umbilical cord blood-derived mesenchymal stem cell transplantation for the treatment of spinal cord injury.

The aim of the present study was to investigate the effects of human umbilical cord blood-derived mesenchymal stem cell (HUCB-MSC) transplantation on the functional restoration of spinal cord injury (SCI). A total of 46 adult Wistar rats were randomly divided into three groups: Injury (n=15), control (n=15) and transplantation (n=16). A SCI model was established using the modified Allen’s method (vulnerating energy, 25 g/cm). The rats in the control and transplantation groups were injected at the site of the injury with physiological saline and HUCB-MSC suspension, respectively. At week one, two and four following treatment, the behavior of the rats was evaluated using the Basso, Beattie, Bresnahan locomotor rating scale. In addition, immunohistochemistry (IHC) was performed on samples from the rats that had been sacrificed four weeks subsequent to the treatment. Recovery of the spinal cord nerve function was identified to be significantly different at week two and four following treatment (P<0.05), and IHC identified that at week four following treatment novel nerve cells were being produced. Thus, transplantation of HUCB-MSCs promoted the recovery of the damaged function of spinal cord nerves in rats with SCI.

Prevention and nursing on perioperative complications of sacral tumor resection and reconstruction

Objective To investigate the measures of prevention and care on perioperative complications of sacral tumor resection and reconstruction. Methods Enhanced the awareness of the common complications before surgery and strengthen measures of prevention and care including psychological care, intraoperative bleeding prevention, bowel sphincter function training and skin preparation. The postoperative care including closely monitoring the vital signs, observing the spinal cord nerve function, strengthen nursing care containing the posture care, wound and drainage tube care, early stage rehabilitation guidance and limb functional training were carried out. Results During the perioperative period, without complications occurred. Conclusions Emphasis the prevention and care on complications and carrying out the proper treatment and nursing measures are essential to successful surgeries and the recovery of patients. Key words: Sacral reconstruction; Complication; Prevention; Perioperative; Nursing