Creation of an intramedullary cavity by hemorrhagic necrosis removal 24 h after spinal cord contusion in rats for eventual intralesional implantation of restorative materials

PLoS ONE, 2017 · DOI: https://doi.org/10.1371/journal.pone.0176105 · Published: April 17, 2017

Spinal Cord Injury Surgery Research Methodology & Design

Simple Explanation

This study investigates a surgical method to remove hemorrhagic necrosis after spinal cord injury in rats. Hemorrhagic necrosis is considered harmful because it can worsen the initial injury and interfere with nerve regeneration. The goal was to create a cavity in the injured spinal cord by removing the necrotic tissue. This cavity could then be used for future implantation of therapeutic materials to promote healing. A small surgical approach to debridement (SSAD) was found to effectively remove the necrosis without causing further damage to the spinal cord. The resulting cavity was suitable for injecting hydrogel, suggesting it could house therapeutic implants.

Study Duration

8 weeks

Participants

166 adult female Long-Evans rats

Evidence Level

Not specified

Key Findings

1
Small surgical approach to debridement (SSAD) effectively removed hemorrhagic necrosis after acute cord contusion in rats.
2
SSAD created intramedullary spaces (10-15 μL) suitable for future intralesional placement of pro-reparative cells or regenerative biomaterials without further damaging the injured spinal cord.
3
SSAD resulted in modest improvement of myelination in rats subjected to both moderate and severe injuries.

Research Summary

The study aimed to develop a safe surgical method for removing intramedullary hemorrhagic necrosis (IHN) after spinal cord contusion in rats to create a cavity for future therapeutic implants. A small surgical approach to debridement (SSAD) was found to be effective in removing IHN without causing significant additional damage to the spinal cord, as opposed to more extensive myelotomies. The resulting cavity created by SSAD was suitable for filling with hydrogel, suggesting its potential for housing therapeutic cells or biomaterials for cord regeneration, with a modest improvement in myelination.

Practical Implications

Therapeutic Implantation

The created cavity provides a space for implanting cells or biomaterials to promote spinal cord regeneration.

Clinical Relevance

The use of a contusion model mimics common human spinal cord injuries, making the findings more applicable to clinical settings.

Timing of Intervention

The study supports early intervention (24 hours post-injury) to maximize the benefits of therapeutic implants.

Study Limitations

1
Independent variables across debridement procedures could have contributed to differences among groups.
2
The injured cord after SSAD was characterized mainly by histology
3
More in depth animal studies are warranted for a better understanding of how SSAD might modify key areas within the microenvironment of the injury, including molecular events.

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