Shuai Ren1,2,3, Ze-Han Liu1,2,3, Qiong Wu4, Kuang Fu4, Jun Wu5, Li-Ting Hou6, Ming Li1,2,3, Xin Zhao1,2,3, Qing Miao1,2,3, Yun-Long Zhao1,2,3, Sheng-Yu Wang1,2,3, Yan Xue1,2,3, Zhen Xue1,2,3, Ya-Shan Guo1,2,3, Sergio Canavero7, Xiao-Ping Ren1,2,3,8. 1. Hand and Microsurgery Center, the second Affiliated Hospital of Harbin Medical University, Harbin, China. 2. State-Province Key Laboratories of Biomedicine-Pharmaceutics, Harbin Medical University, Harbin, China. 3. Heilongjiang Medical Science Institute, Harbin Medical University, Harbin, China. 4. Department of MRI Diagnosis, the second Affiliated Hospital of Harbin Medical University, Harbin, China. 5. Department of Neurology, the second Affiliated Hospital of Harbin Medical University, Harbin, China. 6. Department of Anesthesia, the second Affiliated Hospital of Harbin Medical University, Harbin, China. 7. HEAVEN/GEMINI International Collaborative Group, Turin, Italy. 8. Department of Molecular Pharmacology & Therapeutics, Stritch School of Medicine, Loyola University Chicago, Chicago, IL, USA.
Abstract
AIMS: Despite more than a century of research, spinal paralysis remains untreatable via biological means. A new understanding of spinal cord physiology and the introduction of membrane fusogens have provided new hope that a biological cure may soon become available. However, proof is needed from adequately powered animal studies. METHODS AND RESULTS: Two groups of rats (n=9, study group, n=6 controls) were submitted to complete transection of the dorsal cord at T10. The animals were randomized to receive either saline or polyethylene glycol (PEG) in situ. After 4 weeks, the treated group had recovered ambulation vs none in the control group (BBB scores; P=.0145). One control died. All animals were studied with somatosensory-evoked potentials (SSEP) and diffusion tensor imaging (DTI). SSEP recovered postoperatively only in PEG-treated rats. At study end, DTI showed disappearance of the transection gap in the treated animals vs an enduring gap in controls (fractional anisotropy/FA at level: P=.0008). CONCLUSIONS: We show for the first time in an adequately powered study that the paralysis attendant to a complete transection of the spinal cord can be reversed. This opens the path to a severance-reapposition cure of spinal paralysis, in which the injured segment is excised and the two stumps approximated after vertebrectomy/diskectomies.
AIMS: Despite more than a century of research, spinal paralysis remains untreatable via biological means. A new understanding of spinal cord physiology and the introduction of membrane fusogens have provided new hope that a biological cure may soon become available. However, proof is needed from adequately powered animal studies. METHODS AND RESULTS: Two groups of rats (n=9, study group, n=6 controls) were submitted to complete transection of the dorsal cord at T10. The animals were randomized to receive either saline or polyethylene glycol (PEG) in situ. After 4 weeks, the treated group had recovered ambulation vs none in the control group (BBB scores; P=.0145). One control died. All animals were studied with somatosensory-evoked potentials (SSEP) and diffusion tensor imaging (DTI). SSEP recovered postoperatively only in PEG-treated rats. At study end, DTI showed disappearance of the transection gap in the treated animals vs an enduring gap in controls (fractional anisotropy/FA at level: P=.0008). CONCLUSIONS: We show for the first time in an adequately powered study that the paralysis attendant to a complete transection of the spinal cord can be reversed. This opens the path to a severance-reapposition cure of spinal paralysis, in which the injured segment is excised and the two stumps approximated after vertebrectomy/diskectomies.
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