Dynamic changes in intramedullary pressure 72 hours after spinal cord injury

Neural Regen Res, 2019 · DOI: 10.4103/1673-5374.249237 · Published: May 1, 2019

Spinal Cord Injury Orthopedics Telehealth & Digital Health

Simple Explanation

This study explores how pressure inside the spinal cord changes in the 72 hours after an injury. Researchers used a wireless monitoring system to track these pressure changes in rabbits. The study found that intramedullary pressure changes dynamically and can be divided into three phases after spinal cord injury: a sharp increase, a steady increase, and a decrease. These phases are linked to bleeding, swelling, and damage to the blood-spinal cord barrier. The results suggest that reducing pressure inside the spinal cord early after injury may help protect the nerves. The study also highlights the potential of using continuous monitoring to guide treatment decisions in spinal cord injury.

Study Duration

72 hours

Participants

62 healthy female Japanese white rabbits

Evidence Level

Not specified

Key Findings

1
Intramedullary pressure changes dynamically in three stages after spinal cord injury: steep rise (1-7 hours), steady rise (8-38 hours), and descending (39-72 hours).
2
Severe spinal cord hemorrhage is the primary cause of the rapid increase in intramedullary pressure early after spinal cord injury.
3
Edema and blood-spinal cord barrier disruption are important factors influencing intramedullary pressure in the later stages (II and III) of spinal cord injury.

Research Summary

This study investigated the dynamic changes of intramedullary pressure (IMP) in the 72 hours following spinal cord injury (SCI) in rabbits using telemetry systems to understand the pathological mechanisms involved. The study identified three distinct stages of IMP changes: a steep rise in the first 7 hours, a steady rise from 8-38 hours, and a descending phase from 39-72 hours post-SCI. The research suggests that severe hemorrhage is the main cause of the initial IMP increase, while edema and blood-spinal cord barrier disruption play significant roles in the later stages.

Practical Implications

Optimal Timing for Decompression

Early spinal cord decompression (within 7 hours post-SCI) may be more effective in protecting surviving nerve tissue.

Clinical Monitoring

Monitoring IMP has important significance in clinical settings for ensuring adequate blood perfusion of the spinal cord and guiding the timing and effect of surgical decompression after SCI.

Therapeutic Targets

Treatments aimed at reducing hemorrhage, edema, and blood-spinal cord barrier disruption could be beneficial in managing IMP and improving outcomes after SCI.

Study Limitations

1
Direct insertion of a pressure probe into the spinal cord may cause slight injury.
2
IMP changes were measured only in the injury epicenter.
3
IMP was monitored here for only for 72 hours

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