Spinal cord contusion

Abstract

Spinal cord injury is a major cause of disability with devastating neurological outcomes and limited therapeutic opportunities, even though there are thousands of publications on spinal cord injury annually. There are two major types of spinal cord injury, transaction of the spinal cord and spinal cord contusion. Both can theoretically be treated, but there is no well documented treatment in human being. As for spinal cord contusion, we have developed an operation with fabulous result.

Keywords: astrocyte; macrophage; neurosurgery; oligodendrocyte; spinal cord contusion.

Figure 1

Our locomotion grading system. The larger the Roman numeral the better the walking ability. Grade I refers to patients that cannot stand even with support, thus not shown in the figure.

Figure 2

Summary of the results. The roman numeral refer to the grade of the locomotion, DAI stands for days after injury before the patient was operated. By the end of the treatment, the patients had at least recovered to Grade IV (black boxes). The patient can stand firmly on a wheeled body support, but need support of the knee joint of the weight-bearing leg when walking. The best results occurred between DAI 4–14 days (the optimal operation time window), which included 13 cases, among which 9 cases (70%) can walk with a pair of crutches or even without any support.

Figure 3

Examples of three grades IV, VII, and X of the patients. (A) Grade IV, walking with help to fix the weight bearing leg. (B) Walking with a pair of cruches. (C) Free walking. The wires attached on his legs were for electromyelography.

Figure 4

Sagittal section of spinal cord contusion (hematoxylin staining). Red arrows, obstructed blood vessels. From right to left, reddish bleeding site of injury; pale ischemic zone with most of the neurons disappeared; an ischemic zone in which the morphology of most of the neurons remains largely normal. Bar = 100 μm.