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. 2009 Dec;41(3):169-74.

Neuroprotective effects of methylprednisolone and hypothermia after experimental spinal cord injury: a histopathological and stereological study

Bunyami Unal  1 , Suleyman Kaplan  2 , Ersan Odaci  3 , Huseyin Aslan  4 , Selina Aksak  1 , Deniz Unal  1 , B Zuhal Altunkaynak  2 , Cemal Gundogdu  5 , Ahmet Gokyar  6
Affiliations

Neuroprotective effects of methylprednisolone and hypothermia after experimental spinal cord injury: a histopathological and stereological study

Bunyami Unal et al. Eurasian J Med. 2009 Dec.

Abstract
in English, Turkish

Objective: Spinal cord injury is a common trauma among severe accidents in which the spinal cord has been severed; intravenous methylprednisolone and hypothermia are widely used in the treatment of traumatic spinal cord injuries. However, no common consensus has been reached on therapeutic approaches to prevent and reduce disability caused by spinal cord injuries. In this study, the efficacy of methylprednisolone and hypothermia treatments after experimental spinal cord injury made by dynamic weight-drop model in rabbits was investigated.

Materials and methods: This experiment consists of three groups: injured, methylprednisolone-treated and hypothermia-treated groups. The methylprednisolone-treated group received intravenous methylprednisolone (30 mg/kg/day) immediately after spinal cord injury for three days. In the hypothermia-treated group, cold isotonic saline (5°C) was infused via a cannula into the epidural space at a rate of 10 ml/min. The temperature of the tissue was allowed to reach 25ºC, and then isotonic saline solution was given at a rate of 5 ml/min for 3 hours. Saline was given to the injured group following spinal cord injury. After 1 week of experimental injury, mid-thoracic level tissue was removed from the spinal cord for histopathological evaluation and subsequent stereological analysis.

Results: The volume of spinal cord segment, not only parenchyma of grey and white matter but also cavity, was estimated by the Cavalieri principle. Significant differences were seen between the injured group and methylprednisolone /hypothermia-treated groups in terms of the total volume cavity of spinal cord segment; cavity volume in the grey matter and cavity volume in the white matter. No significant differences were seen between methylprednisolone and hypothermia-treated groups in terms of the total volume cavity of spinal cord segment; cavity volume in the grey matter and cavity volume in the white matter.

Conclusions: These results suggested that both methylprednisolone and hypothermia treatment are neuroprotective in preventing spinal cord tissue from tissue damage after experimental injury.

Amaç: Omurilik zedelenmesi, omuriliğin hasar gördüğü kazalar arasında yaygın bir travmadır. Damar içi metilprednizolon ve hipotermi, travmatik omurilik zedelenmesi tedavisinde yaygın olarak kullanılır. Ancak; omurilik zedelenmelerinin sebep olduğu özürlülüğü azaltan ve önleyen terapötik yaklaşımların üzerinde ortak bir uzlaşıya varılamamıştır. Bu çalışmada; tavşanlarda dinamik ağırlığı azaltma yöntemiyle yapılan deneysel omurilik zedelenmesinden sonra metilprednizolon ve hipotermi tedavilerinin etkinliği araştırılmıştır.

Gereç ve yöntem: Bu deney; yaralı grup, metilprednizolon ile tedavi edilmiş grup ve hipotermi ile tedavi edilmiş grup olmak üzere 3 gruptan oluşmuştur. Metilprednizolon ile tedavi edilmiş gruba, omurilik zedelenmesinden hemen sonra, üç gün boyunca damar içi metilprednizolon (30 mg/kg/gün) verilmiştir. Hipotermi ile tedavi edilmiş grup da, soğuk izotonik tuz çözeltisi (5°C), 10 ml/dk ’lik bir oranda kanula yoluyla epidural bölgeye enjekte edilmiştir. Doku ısısının 25°C ulaşmasına müsade edildi ve daha sonra izotonik tuz solüsyonu, üç saat boyunca 5 ml/dk ‘lik bir oranda verildi. Tuz çözeltisi, omurilik zedelenmesi olan yaralı gruba verildi. Deneysel zedelenmeden bir hafta sonra, omurilikten, histopatalojik değerlendirme ve sonrasındaki stereolojik analizler için orta torakal seviyedeki doku alındı.

Bulgular: Sadece gri ve ak cevherin parankimasının değil aynı zamanda kavitenin de bulunduğu omurilik segmentinin hacmi, Cavalieri Prensibi ile hesaplanmıştır. Beyaz cevherin kavite hacmi, gri cevherin kavite hacmi ve omurilik segmentinin total kavite hacmi yönünden, metilprednizolon/hipotermi ile tedavi edilmiş gruplar ve yaralı grup arasında anlamlı farklılıklar görüldü. Beyaz cevherin kavite hacmi, gri cevherin kavite hacmi ve omurilik segmentinin total kavite hacmi yönünden, metilprednizolon ve hipotermi ile tedavi edilmiş gruplar arasında anlamlı farklılıklar görülmedi.

Sonuç: Sonuçlar, hem metilprednizolon hem de hipotermi tedavilerinin, deneysel zedelenmeden sonra omurilik dokusunun, hasarlı dokulardan korunmasında nöroprotektif olduğunu ileri sürmüştür.

Keywords: Cavalieri principle; Experimental spinal cord injury; Hypothermia; Methylprednisolone; Stereology.

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Figures

Fig. 1
Fig. 1
Total volume of spinal cord segment (parenchyma + cavities) in Inj, HT and MP groups (Mean ± SEM). No significant difference was seen among groups. Inj, injured; HT, hypothermia; MP, methylprednisolone.
Fig. 2
Fig. 2
Volume of cavities in SC segment of Inj, HT and MP groups (Mean ± SEM). (*) Inj vs HT (*) p<0.001; (+), Inj vs MP (+) p<0.001. Inj, injured; HT, hypothermia; MP, methylprednisolone.
Fig. 3
Fig. 3
Total volume of cavities + parenchyma in grey matter of groups. (*) Inj vs HT (*) p<0.001; (+), Inj vs MP (+) p<0.001. Inj, injured; HT, hypothermia; MP, methylprednisolone.
Fig. 4
Fig. 4
Total volume of cavities in grey matter of the groups. (*) Inj vs HT, (*) p<0.001; (+), Inj vs MP, (+) p<0.001. Inj, injured; HT, hypothermia; MP, methylprednisolone.
Fig. 5
Fig. 5
Total volume of cavities in white matter of groups. (*) Inj vs HT, (*) p<0.001; (+), Inj vs MP, (+) p<0.001. Inj, injured; HT, hypothermia; MP, methylprednisolone.
Fig. 6
Fig. 6
Total volume of cavity + parenchyma in the white matter of Inj, HT and MP groups. Inj, injured; HT, hypothermia; MP, methylprednisolone.
Fig. 7
Fig. 7
A, B and C show representative transverse sections of spinal cord from Inj, MP and HT groups, respectively. Multiple and large cavitations within the lesion area in the Inj group are seen (A). As seen in the micrographs (B and C), the cavity volume in both white and grey matter is significantly reduced by MP and HT treatments, respectively. Inset in (A) show cavities in the tissue. Inj, injured; CA, cavity; WM, white matter; GM, grey matter; MP, methylprednisolone; HT, hypothermia. Haematoxylin and eosin staining.
Fig. 8
Fig. 8
The micrographs of transverse sections of the spinal cord with a superimposed point-counting grid. This point-counting test grid was used for the estimation of volume of cavities in the white matter (A and D), volume of the grey matter (B and E) and the volume of white matter (C and F) respectively. Haematoxylin and eosin staining.
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References

    1. Delattre JY, Arbit E, Thaler HT, Rosenblum MK, Posner JB. A dose-response study of dexamethasone in a model of spinal cord compression caused by epidural tumor. J Neurosurg. 1989;70:920–5. - PubMed
    1. Merola A, O’Brien MF, Castro BA, et al. Histologic characterization of acute spinal cord injury treated with intravenous methylprednisolone. J Orthop Trauma. 2002;16:155–61. - PubMed
    1. Fukaya C, Katayama Y, Kasai M, Kurihara J, Maejima S, Yamamoto T. Evaluation of time-dependent spread of tissue damage in experimental spinal cord injury by killed-end evoked potential: effect of high-dose methylprednisolone. J Neurosur. 2003;98:56–62. - PubMed
    1. Inamasu J, Ichikizaki K. Mild hypothermia in neurologic emergency: an update. Ann Emerg Med. 2002;40:220–30. - PubMed
    1. Tetik O, Islamoglu F, Goncu T, Cekirdekci A, Buket S. Reduction of spinal cord injury with pentobarbital and hypothermia in a rabbit Model. Eur J Vasc Endovasc Surg. 2002;24:540–4. - PubMed

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