Dural closure, cord approximation, and clot removal: Enhancement of tissue sparing in a novel laceration spinal cord injury model

Yi Ping Zhang, Christopher Iannotti, Lisa B.E. Shields, Yingchun Han, Darlene A. Burke, Xiao Ming Xu, Christopher B. Shields

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Object. Laceration-induced spinal cord injury (SCI) results in the invasion of a connective tissue scar, progressive damage to the spinal cord due to complex secondary injury mechanisms, and axonal dieback of descending motor pathways. The authors propose that preparation of the spinal cord for repair strategies should include hematoma removal and dural closure, resulting in apposition of the severed ends of the spinal cord. Such procedures may reduce the size of the postinjury spinal cord cyst as well as limit scar formation. Methods. Using a novel device, the Vibraknife, the authors created a dorsal hemisection of the spinal cord at C-6 in the adult rat. In Group 1 (eight rats), the dura mater was repaired with apposition of the two stumps of the spinal cord to reduce the lesion gap. In Group 2 (10 rats), the dura was not closed and the two cord stumps were not approximated. All rats were killed at 4 weeks postinjury, and the spinal cords from each group were removed and examined using histological, stereological, and immunohistochemical methods. In Group 1 rats a significant reduction of the total lesion volume and connective tissue scar was observed compared with those in Group 2 (Student t-test, p < 0.05). Approximation of the stumps did not promote the regeneration of corticospinal tract fibers or sensory axons through the lesion site. Conclusions. Apposition of the severed ends of the spinal cord by dural closure reduces the lesion gap, cystic cavitation, and connective tissue scar formation. These outcomes may collectively reduce secondary tissue damage at the injury site and shorten the length of the lesion gap, which will facilitate transplantation-mediated axonal regeneration after laceration-induced SCI.

Original languageEnglish (US)
Pages (from-to)343-352
Number of pages10
JournalJournal of neurosurgery
Volume100
Issue number4 SUPPL.
DOIs
StatePublished - Apr 2004

Keywords

  • Connective tissue scar
  • Cystic cavitation
  • Dorsal hemisection
  • Inflammation
  • Spinal cord injury
  • Vibraknife

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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