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Spinal Cord Contusion Based on Precise Vertebral Stabilization and Tissue Displacement Measured by Combined Assessment to Discriminate Small Functional Differences

机译:基于精确椎体稳定度和组织移位的脊髓挫伤合并评估,以区别微小的功能差异

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摘要

Contusive spinal cord injury (SCI) is the most common type of spinal injury seen clinically. Several rat contusion SCI models have been described, and all have strengths and weaknesses with respect to sensitivity, reproducibility, and clinical relevance. We developed the Louisville Injury System Apparatus (LISA), which contains a novel spine-stabilizing device that enables precise and stable spine fixation, and is based on tissue displacement to determine the severity of injury. Injuries graded from mild to moderately severe were produced using 0.2-, 0.4-, 0.6-, 0.8-, 1.0-, and 1.2-mm spinal cord displacement in rats. Basso, Beattie, and Bresnahan (BBB) and Louisville Swim Score (LSS) could not significantly distinguish between 0.2-mm lesion severities, except those of 0.6- and 0.8-mm BBB scores, but could between 0.4-mm injury differences or if the data were grouped (0.2–0.4, 0.6–0.8, and 1.0–1.2). Transcranial magnetic motor evoked potential (tcMMEP) response amplitudes were decreased 10-fold at 0.2-mm displacement, barely detected at 0.4-mm displacement, and absent with greater displacement injuries. In contrast, somatosensory evoked potentials (SSEPs) were recorded at 0.2- and 0.4-mm displacements with normal amplitudes and latencies but were detected at lower amplitudes at 0.6-mm displacement and absent with more severe injuries. Analyzing combined BBB, tcMMEP, and SSEP results enabled statistically significant discrimination between 0.2-, 0.4-, 0.6-, and 0.8-mm displacement injuries but not the more severe injuries. Present data document that the LISA produces reliable and reproducible SCI whose parameters of injury can be adjusted to more accurately reflect clinical SCI. Moreover, multiple outcome measures are necessary to accurately detect small differences in functional deficits and/or recovery. This is of crucial importance when trying to detect functional improvement after therapeutic intervention to treat SCI.
机译:挫伤性脊髓损伤(SCI)是临床上最常见的脊髓损伤类型。已经描述了几种大鼠挫伤SCI模型,并且在敏感性,可重复性和临床相关性方面各有优缺点。我们开发了路易斯维尔损伤系统设备(LISA),其中包含一种新颖的脊柱稳定装置,能够精确,稳定地固定脊柱,并基于组织移位来确定损伤的严重程度。在大鼠中使用0.2毫米,0.4毫米,0.6毫米,0.8毫米,1.0毫米和1.2毫米的脊髓移位产生了从轻度到中度重度的损伤。 Basso,Beattie和Bresnahan(BBB)和Louisville Swim Score(LSS)不能显着地区分0.2 mm病灶严重程度,0.6和0.8 mm BBB得分除外,但可以在0.4 mm损伤之间或如果将数据分组(0.2-0.4、0.6-0.8和1.0-1.2)。经颅磁电机诱发电位(tcMMEP)响应幅度在0.2毫米位移时降低了10倍,在0.4毫米位移时几乎未检测到,并且没有更大的位移损伤。相比之下,体感诱发电位(SSEP)在0.2和0.4 mm位移处以正常幅度和潜伏期记录,但在0.6 mm位移处以较低幅度被检测到,而在更严重的情况下不存在。通过分析BBB,tcMMEP和SSEP的综合结果,可以在统计学上明显地区分0.2毫米,0.4毫米,0.6毫米和0.8毫米位移伤害,但不能区分更严重的伤害。目前的数据表明,LISA可产生可靠且可重复的SCI,其损伤参数可进行调整以更准确地反映临床SCI。此外,需要多种结果测量来准确检测功能缺陷和/或恢复的微小差异。当试图在治疗干预后检测SCI的功能改善时,这一点至关重要。

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