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Objective:Spinal cord edema contributes to the pathophysiological mechanisms underlying spinal cord injury (SCI) and is associated with functional recovery after SCI. Early myelotomy may be a promising surgical intervention for reducing SCI-induced edema. However, it remains unclear whether myelotomy can reduce SCI-induced edema. In addition, aquaporin-4 (AQP4) and aquaporin-9 (AQP9) have important roles in the regulation of water homeostasis. Here, we aimed to determine the effects of myelotomy on AQP4 and AQP9 expression and spinal cord edema in a rat model of moderate SCI.Methods:Rats were randomly assigned to three groups: the sham control group (n=22) receiving laminectomy alone; the contusion group (n=44) receiving laminectomy plus contusion; and the myelotomy group (n=44) receiving laminectomy plus contusion followed by myelotomy at 24 h. Functional recovery was estimated by the open-field and inclined plane tests. Spinal cord edema was determined by measuring the water content. The expression of AQP4 and AQP9 was determined by western blot.Results:Compared with the contusion group, myelotomy significantly improved the Basso, Beattie and Bresnahan scores in the open-field test and resulted in a higher mean angle value in the incline plane test. Myelotomy significantly reduced SCI-induced edema at 4 and 6 days after SCI, which was accompanied by downregulation of AQP4 and AQP9 expression.Conclusion:Myelotomy improves locomotor function, reduces edema in rats with SCI and is associated with decreased expression of AQP4 and AQP9. [ABSTRACT FROM AUTHOR]

Study design:Lithium has attracted much attention as a neuroregenerative agent for spinal cord injury in animal models. We hypothesized that the lithium can be beneficial to patients with spinal cord injury. The safety and pharmacokinetics of lithium has been studied in our earlier phase I clinical trial, indicating its safety. This is a phase II clinical trial to evaluate its efficacy on chronic spinal cord injury patients.Objectives:The aim of this study was to investigate the efficacy of lithium on chronic spinal cord injury patients.Setting:A major spinal cord injury rehabilitation center in Beijing, China.Methods:Randomized, double-blind, placebo-controlled 6-week parallel treatment arms with lithium carbonate and with placebo. A total of 40 chronic spinal cord injury subjects were recruited. Oral lithium carbonate was titrated or placebo was simulated to maintain the serum lithium level of 0.6-1.2 mmol l−1 for 6 weeks, followed by a 6-month follow-up. The functional outcomes and the neurological classifications, as well as the safety parameters, adverse events and pharmacokinetic data were carefully collected and monitored.Results:No significant changes in the functional outcomes and the neurological classifications were found. The only significant differences were in the pain assessments using visual analog scale comparing the lithium and the placebo group. No severe adverse event was documented in the study.Conclusion:The lithium treatment did not change the neurological outcomes of patients with chronic spinal cord injury. It is worth to investigate whether lithium is effective in the treatment of neuropathic pain in chronic spinal cord injury.Sponsorship:China Spinal Cord Injury Network Company Limited. [ABSTRACT FROM AUTHOR]

Study design:The purpose of this study was to explore the changes in pelvic floor muscle tension at different times after suprasacral spinal cord injury (SS) and sacral cord injury (SC), and learn more about pelvic floor dysfunction (PFD) after spinal cord injury (SCI).Method:A total of 70 healthy female Sprague–Dawley (SD) rats, weighing between 250 and 280 g, were randomly divided into seven groups with 10 rats in each group, which included five SS groups (3 days and 2, 4, 8 and 12 weeks after injury), one SC group (4 weeks after injury) and one normal group. Muscle tension, including muscle compliance, and contraction activity elicited using electrostimulation under two initial lengths were measured at different time points.Results:(1) Muscle compliance decreased within 4 weeks in the SS group (P>0.05), began to increase at 8 weeks (P<0.05) and reached the peak at 12 weeks, which were all lower than the normal level; (2) contraction activity under both initial lengths tended to decrease within 4 weeks, peak at 8 weeks (P<0.05) and decline again at 12 weeks , which were all lower than that of the normal group as well; and (3) the SC group showed similar compliance with the normal group (P>0.05) and less contraction activity when compared with other SS groups (P<0.05).Conclusion:Measurement for the compliance and contraction activity of pubococcygeus indicates the changes from decreasing to increasing after suprasacral cord injury, and similar compliance combined with rather low contraction activity compared with the normal group after sacral cord injury, both of which are in accordance with PFD after spinal cord injury. [ABSTRACT FROM AUTHOR]