A novel mouse model of central cord syndrome

Patients with potential spinal stenosis are susceptible to central cord syndrome induced by blunt trauma.Suitable animal models are helpful for studying the pathogenesis and treatment of such injuries.In this study,we established a mouse model of acute blunt traumatic spinal cord injury by compressing the C6 spinal cord with 5 and 10 g/mm~2 compression weights to simulate cervical central cord syndrome.Behavioral testing confirmed that this model exhibited the characteristics of central cord syndrome because motor function in the front paws was impaired,whereas basic motor and sensory functions of the lower extremities were retained.Hematoxylin-eosin staining showed that the diseased region of the spinal cord in this mouse model was restricted to the gray matter of the central cord,whereas the white matter was rarely affected.Magnetic resonance imaging showed a hypointense signal in the lesion after mild and severe injury.In addition,immunofluorescence staining showed that the degree of nerve tract injury in the spinal cord white matter was mild,and that there was a chronic inflammation reaction.These findings suggest that this mouse model of central cord syndrome can be used as a model for preclinical research,and that gray matter is most vulnerable to injury in central cord syndrome,leading to impaired motor function.

Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation

This study was aimed to explore the anterior cervical surgery methods to treat central cord syndrome without radiographic spinal fracture-dislocation(CCSWORFD),retrospectively analyze the cases of CCSWORFD,and evaluate the curative effect of anterior cervical surgery methods for CCSWORFD.Twenty four cases of CCSWORFD(19 males and 5 females),all suffering from cervical hyperextension injury,between 45–68(average 59)years old,were operated on by anterior cervical surgery methods.Among these,18 cases had been followed up for 6–24(average 15)months;18 cases,who had anterior decompression and platefixation with titanium mesh bone grafting or iliac bone grafting achieved reliable effects based on the Japanese Orthopedics Association(JOA)evaluation(improved scores of cases with titanium mesh bone grafting,t=2.800,P<0.05;improved scores of cases with iliac bone grafting,t=3.270,P<0.05)and reliable reconstruction of cervical spine.The two groups obtained the same curative effect(t=0.470,P>0.05).Most of these cases had degeneration of cervical vertebra.The decompression which relieves the oppression to the spinal cord can help lessen edema of the spinal cord,and earlyfixation for stability of cervical vertebra is better for the recovery of spinal cord injury.Anterior operation with titanium mesh bone grafting or iliac bone grafting are both reliable curative methods for CCSWORFD,and titanium mesh bone grafting can avoid the trauma of the supplying graft.Mesh bone grafting can also shorten hospital stay.

Outcome of Early Surgical Decompression in Traumatic Incomplete Spinal Cord Injury

Objectives: Central cord syndrome has been reported to occur with particular frequency among older persons with cervical spondylosis who sustain hyperextension neck injury. This study aims to determine the efficacy of early surgical decompression (within 24 hours) of traumatic central cord syndrome patients in comparison with conservative management for central cord syndrome to determine a line of management to these cases. Methods: 60 patients suffering from acute traumatic central cord syndrome with various neurological deficits were divided into 2 groups, group A (conservatively managed) and group B (surgically managed). Patients in group B were operated upon within 24 hr. of trauma by posterior decompression. Clinical assessment of each patient on admission, discharge and 3 months follow-ups was done using the ASIA Impairment Scale, FIM, Ashworth scale, bladder function, and neuropathic pain symptoms. Results: Data collected from both groups showed, group A (the conservative group) consisted of 22 male (73.3%) and 8 female subjects (26.6%) with a mean age of 57.5 years while in group B (surgical group) the sample consisted of 20 male (66.6%) and 10 female subjects (33.3%) with a mean age of 58.6 years. There was an improvement in our study—according to ASIA and FIM scales—in 8 patients of 30 (26.6%) in the conservative group. In the surgical group, improvement in 16 patients (53.3%). Conclusions: Early surgical decompression with laminectomy and duroplasty can be considered a reliable modality in the management of traumatic CCS and can effectively reduce the secondary injury of the spinal cord and consequent deterioration with less hospital stay.