Evaluation of the Long-Term Effects of Surgical Management of Spinal Cord Perfusion Strategies Using a Porcine Spinal Cord Injury Model
Abstract
The care and management of traumatic spinal cord injury (SCI) has changed very little over the last 20 years, and the morbidity from these injuries remains unacceptably high. The current goal of care for a person with SCI is to reduce the compression to the injured spinal cord and artificially elevating the blood pressure in the hope that this aids spinal cord perfusion. The specifics of spinal cord perfusion in the acute post-injury period are poorly characterized, and the clinician s understanding of spinal cord perfusion is based on assumptions drawn from the traumatic brain injury literature. However, there is no evidence that spinal cord perfusion after injury is the same as brain perfusion after traumatic brain injury. Thus, the goal of this research is to use an animal model (pigs) that has many anatomical similarities to the human patients to directly test physiological assumptions that currently guide clinical management. The outcome of this study will be highly informative as to the best practice in critical care intervention after SCI. This research will be most applicable to patients who receive a new injury, as it will provide information to the surgeons and other physicians treating the acute SCI as to the best practice for surgical management. In addition, this information will also be important to patients with chronic SCI in the instance that those patients may need subsequent surgical management (i.e., for syringomyelia, spine stabilization, etc.). The potential clinical application of this research is to provide scientific/medical evidence that will inform spinal cord surgeons as to the best acute care and management methods for improving outcome after SCI. This is a highly translational project which starts with a clinical question (bedside) that is being addressed in a highly clinically relevant large animal model of SCI (bench) to subsequently inform best practice in the both the intensive care unit and operating room (bedside). Thus, we anticipate that upon the conclusion of this research, the benefits of this knowledge will be rapidly conferred to patients in the form of best practice guidelines for the surgical management of SCI. Indeed, our team of neurosurgeons at the University of Alabama at Birmingham consists of multiple key authors who write the Guidelines for the Surgical Management of Cervical SCI. This research will likely advance the field of SCI by providing a detailed understanding of relationship between blood, intraparenchymal, and intrathecal pressure on spinal cord perfusion and outcomes. This will enable physicians to use evidence in the decisions related to providing the best care available for newly injured patients and persons living with chronic SCI who require surgical management of the spine.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610655
Entities
People
- Candace Floyd
Organizations
- United States Army
- University of Alabama at Birmingham