Urgent surgical decompression compared to methylprednisolone for the treatment of acute spinal cord injury: A randomized prospective study in beagle dogs

Richard S. Rabinowitz, Jason C. Eck, C. Michel Harper, Dirk R. Larson, Miguel A. Jimenez, Joseph E Parisi, Jonathan A. Friedman, Michael J Yaszemski, Bradford L. Currier

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Study Design. Experimental dog model of acute spinal cord injury. Objective. To compare the relative value of methylprednisolone, surgical decompression, or both for the treatment of traumatic spinal cord injury. Summary of Background Data. Acute spinal cord injury results from both primary damage to the spinal cord at the time of the initial injury as well as a deleterious secondary cascade of events, which leads to further damage. Surgical decompression is known to improve clinical outcomes, but the timing of surgical decompression remains controversial. Methods. A nylon tie was used to constrict the spinal cord in 18 adult male beagle dogs. The animals were then prospectively randomized to 3 groups: 1) surgical decompression at 6 hours and intravenous methylprednisolone; 2) surgical decompression at 6 hours and intravenous saline; and 3) intravenous methylprednisolone without surgical decompression. Each animal was evaluated by somatosensory-evoked potentials, daily neurologic assessment, and histologic examination at 2 weeks following injury. Results. Immediately following spinal cord constriction, all animals were paraplegic, incontinent, and the somatosensory-evoked potentials were abolished. Surgical decompression 6 hours after injury, with or without methylprednisolone, led to significantly better neurologic function at 2 weeks than methylprednisolone alone. Conclusion. In the setting of acute and persistent spinal cord compression in beagle dogs, surgical decompression 6 hours after injury, with or without methylprednisolone, is more effective for improving neurologic recovery than methylprednisolone alone.

Original languageEnglish (US)
Pages (from-to)2260-2268
Number of pages9
JournalSpine
Volume33
Issue number21
DOIs
StatePublished - Oct 1 2008

Fingerprint

Surgical Decompression
Methylprednisolone
Spinal Cord Injuries
Prospective Studies
Dogs
Nervous System
Spinal Cord
Somatosensory Evoked Potentials
Wounds and Injuries
Spinal Cord Compression
Nylons
Constriction
Theoretical Models

Keywords

  • Decompression
  • Methylprednisolone
  • Outcomes
  • Spinal cord injury
  • Trauma

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Rabinowitz, R. S., Eck, J. C., Harper, C. M., Larson, D. R., Jimenez, M. A., Parisi, J. E., ... Currier, B. L. (2008). Urgent surgical decompression compared to methylprednisolone for the treatment of acute spinal cord injury: A randomized prospective study in beagle dogs. Spine, 33(21), 2260-2268. https://doi.org/10.1097/BRS.0b013e31818786db

Urgent surgical decompression compared to methylprednisolone for the treatment of acute spinal cord injury : A randomized prospective study in beagle dogs. / Rabinowitz, Richard S.; Eck, Jason C.; Harper, C. Michel; Larson, Dirk R.; Jimenez, Miguel A.; Parisi, Joseph E; Friedman, Jonathan A.; Yaszemski, Michael J; Currier, Bradford L.

In: Spine, Vol. 33, No. 21, 01.10.2008, p. 2260-2268.

Research output: Contribution to journalArticle

Rabinowitz, RS, Eck, JC, Harper, CM, Larson, DR, Jimenez, MA, Parisi, JE, Friedman, JA, Yaszemski, MJ & Currier, BL 2008, 'Urgent surgical decompression compared to methylprednisolone for the treatment of acute spinal cord injury: A randomized prospective study in beagle dogs', Spine, vol. 33, no. 21, pp. 2260-2268. https://doi.org/10.1097/BRS.0b013e31818786db
Rabinowitz, Richard S. ; Eck, Jason C. ; Harper, C. Michel ; Larson, Dirk R. ; Jimenez, Miguel A. ; Parisi, Joseph E ; Friedman, Jonathan A. ; Yaszemski, Michael J ; Currier, Bradford L. / Urgent surgical decompression compared to methylprednisolone for the treatment of acute spinal cord injury : A randomized prospective study in beagle dogs. In: Spine. 2008 ; Vol. 33, No. 21. pp. 2260-2268.
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