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Despite the frequent use of orthopedic braces or spine stabilizers in diseases such as kyphosis, lordosis, and scoliosis, as well as in the case of injuries and rehabilitation after surgeries, there is no clear evidence of their proper stabilization of the spine while carrying out daily activities. This study sought to assess the spine’s mobility while wearing three different orthopedic braces while performing basic tasks. Ten healthy subjects were enrolled. Three Inertial Measurement Units (IMUs) were attached superficially along the spine at approximate levels: cervical (C7), between thoracic (T8) and lumbar (L3), and sacrum. The angle between sensors was monitored to provide data on the sagittal profile. In addition, the displacement of the spine’s longitudinal axis was measured (rotation). There are three types of orthopedic braces: the semi-rigid Hohmann corset, the Jewett brace, and the Thoracolumbar Fixed Spinal Orthosis (TLSO). Four tasks were monitored: standing, sitting, walking, and picking up an item from the floor with one hand. All braces provided a similar level of stability in both the sagittal plane and rotational axis while lifting an object. On the other hand, while walking and sitting, the TLSO was the only orthosis providing a statistically significant rigidity in the sagittal plane. When performing a more voluntary task, the measured rigidity of softer braces was significantly increased when compared with more involuntary tasks. A certain degree of motion restriction with spinal orthoses may come from the feedback pressure, which stimulates paraspinal muscles to contract and thus increases the overall rigidity of the trunk.

The olfactory bulb (OB) is a unique structure in the central nervous system that retains the ability to create new neuronal connections. Glial cells isolated from the OB have been recently considered as a novel and promising tool to establish an effective therapy for central nervous system injuries. Due to the hindered access to autologous tissue for cell isolation, an allogeneic source of tissues obtained postmortem has been proposed. In this study, we focused on the morphological and molecular characteristics of human OB-derived glial cells isolated postmortem, at different time points after a donor's death. We evaluated the proliferative activity of the isolated cells, and investigated the ultrastructure of the mitochondria, the accumulation of intracellular reactive oxygen species, and the activity of superoxide dismutase. The data obtained clearly indicate that the duration of ischemia is crucial for the viability/senescence rate of OB-derived glial cells. The OB can be isolated during autopsy and still stand as a source of viable glial cells, but ischemia duration is a major factor limiting its potential usefulness in therapies.

Numerous studies in animals have shown the unique property of olfactory ensheathing cells to stimulate regeneration of lesioned axons in the spinal cord. In a Phase I clinical trial, we assessed the safety and feasibility of transplantation of autologous mucosal olfactory ensheathing cells and olfactory nerve fibroblasts in patients with complete spinal cord injury. Six patients with chronic thoracic paraplegia (American Spinal Injury Association class A-ASIA A) were enrolled for the study. Three patients were operated, and three served as a control group. The trial protocol consisted of pre- and postoperative neurorehabilitation, olfactory mucosal biopsy, culture of olfactory ensheathing cells, and intraspinal cell grafting. Patient's clinical state was evaluated by clinical, neurophysiological, and radiological tests. There were no adverse findings related to olfactory mucosa biopsy or transplantation of olfactory ensheathing cells at 1 year after surgery. There was no evidence of neurological deterioration, neuropathic pain, neuroinfection, or tumorigenesis. In one cell-grafted patient, an asymptomatic syringomyelia was observed. Neurological improvement was observed only in transplant recipients. The first two operated patients improved from ASIA A to ASIA C and ASIA B. Diffusion tensor imaging showed restitution of continuity of some white matter tracts throughout the focus of spinal cord injury in these patients. The third operated patient, although remaining ASIA A, showed improved motor and sensory function of the first spinal cords segments below the level of injury. Neurophysiological examinations showed improvement in spinal cord transmission and activity of lower extremity muscles in surgically treated patients but not in patients receiving only neurorehabilitation. Observations at 1 year indicate that the obtaining, culture, and intraspinal transplantation of autologous olfactory ensheathing cells were safe and feasible. The significance of the neurological improvement in the transplant recipients and the extent to which the cell transplants contributed to it will require larger numbers of patients.

Bilateral chronic subdural haemorrhage accompanying meningioma is a very rare clinical condition. We present a case of a 69-year-old female patient with large meningioma completely obliterating the posterior third part of the superior sagittal sinus with accompanying bilateral chronic subdural haematomas. Three anatomical zones of venous collateral circulation were revealed by the preoperative digital subtraction angiography. The tumour and haematomas were removed completely with no major complications. The most likely pathomechanism of the development of bilateral chronic subdural haematomas was venous hypertension caused by an occlusion of major cerebral venous trunks. As a result of a minor thrombotic incident or insignificant head injury, the distended veins of collateral circulation that were volumetrically burdened could have been damaged. Patients with large tumours occluding the superior sagittal sinus, who did not qualify for or refused surgery, should be carefully monitored clinically and neuroradiologically because of possibly increased risk of an intracranial haemorrhage.

Neurological disorders and injuries such as ischemic or haemorrhagic strokes or traumatic brain injuries result in the damage of cerebral parenchyma structures and in consequence, the loss of neurological functions. The current clinical strategies for the treatment of the brain nervous tissue disruptions are limited. The aforementioned methods can reduce the tissue degeneration or mitigate the subsequent symptoms, but do not alter the fact that many of the affected people are incapable of returning to the condition before the accident and they need long-lasting rehabilitation. Regenerative strategies based on the cell therapies and the use of polymeric scaffolds seem to be very promising for many patients. Polymer scaffolds may provide an opportunity to enhance the probability of cell therapy success by creating an artificial extracellular matrix which further facilitates cell survival, proliferation, differentiation, and promotes integrity of transplanted as well as endogenous cells. This paper presents selected forms of the polymeric scaffolds, which have been tested for the restoration processes within brain tissue and their potential clinical applications of scaffolds in both the treatment of posttraumatic neuronal loss and the neurodegenerative disorders.

Traumatic spinal cord injuries are very serious burden for the organism of affected human population, and are more critical because mostly touching the young cluster of population. Physical, emotional and economic problems caused by traumatic spinal cord injuries as a general rule significantly limit the individual patient functionality and are burden for the society. The spinal cord has considerable lack of ability for spontaneous and functional regeneration, hence the spinal cord injury cause a solemn and frequently permanent disabilities. The pathophysiology of spinal cord injury is the results of sequential two phenomena, primary physical and biochemical secondary mechanisms of injury. After physical injury, the spinal cord undergoes a sequential progression in biochemical pathologic deviations increasing after injury, that are mutually deteriorating and cause further damage in the spinal cord. Consequently series of pathological processes lead to haemorrhage, oedema, neuronal necrosis, axonal fragmentation, demyelination of the remaining axons, and formation of ultimately cyst. Furthermore spinal cord injuries can immediately result in neural cells death and cause disruption of the blood supply to the site of the injury. The most important difference between peripheral and central nervous system is the fact that in the spinal cord the neuronal cell bodies are damaged, while in the peripheral nervous system only axons are injured. In the surroundings of the spinal cord, one of the major factors hampering regeneration is the glial scar expansion. The spreading of densely packed astrocytes on the site of injuries effectively inhibit axon growth through the nerve grow blocking. Glial scar, which consists mainly of overactive astrocytes and fibroblasts, as well as the presence of growth-inhibitor molecules such as chondroitin sulphate proteoglycans (derived from the breakdown of damaged nerve cells) form a physicochemical barrier for effective regenerating axons. The recent scientific progress in medicine, biology and biomaterials engineering, and predominantly in the fields of neurosurgery, cell culture and tissue engineering, creates the opportunity for the development of new therapies, which support healing of the effects of traumatic spinal cord injuries and prevent further neurodegenerative processes. The most promising effects so far have been obtained using well-designed polymer scaffold as structural support for axon regeneration combined with drug delivery system or therapeutic cell line and neurotrophic factors. This review article focuses on the application of selected biomaterials for the regeneration of traumatic spinal cord injuries. First, the basic anatomical structure of the spinal cord has been described. Then the injury and neurodegenerative mechanisms within the peripheral and central nervous system have been compared. The pathophysiology of the spinal cord damage has been referred to the current strategy of biomaterials engineering in experimental therapies supporting neuroregeneration processes. In the summary, the promising interdisciplinary therapeutic strategies aimed at the regeneration of the spinal cord have been highlighted.