• Rowena E A Newcombe, John W Finnie, Anna V Leonard, Jim Manavis, Peter L Reilly, Robert Vink, and Peter C Blumbergs.
• *School of Medical Sciences, University of Adelaide, Adelaide, Australia †SA Pathology, Hanson Institute Centre for Neurological Diseases and Schools of Medical and Veterinary Science, University of Adelaide, Adelaide, Australia ‡Division of Health Sciences, University of South Australia, Adelaide, Australia.
• Spine. 2015 Apr 15;40(8):E450-7.

Study DesignImmunohistochemical assessment of apoptotic markers in human cases of compressive myelopathy due to neoplastic compression.ObjectiveTo characterize the role of apoptosis in neoplastic compressive myelopathy in human postmortem tissue with extramedullary tumor involvement.Summary Of Background DataNeoplasms, whether primary or metastatic, may lead to compression of the spinal cord and development of a compressive myelopathy syndrome. Apoptotic processes of cell death are thought to contribute to cell death in chronic compressive myelopathy because of degenerative spondylosis, but this has not previously been described in neoplastic compression.MethodsSix postmortem cases of human neoplastic compressive myelopathy were assessed for apoptosis using a panel of immunohistochemical markers including Fas, B-cell lymphoma 2 (Bcl-2), caspase-3 and 9, DNA-dependent protein kinase catalytic subunit (DNA-PKcs), poly (ADP-ribose) polymerase (PARP), apoptosis-inducing factor (AIF), and terminal deoxynucleotide transferase dUTP Nick End Labeling (TUNEL).ResultsApoptosis was maximal at the site of tumor compression. Glial cells, predominantly oligodendrocytes, were immunopositive for DNA-PKcs, PARP, AIF, and TUNEL. Axons were immunopositive for caspase 3, DNA-PKcs, and AIF. Neurons were immunopositive for DNA-PKcs, PARP, AIF, and TUNEL.ConclusionThe current study demonstrates that apoptosis plays a role in human neoplastic compressive myelopathy. Necrosis dominates the severe end of the spectrum of compression. The prominent oligodendroglial involvement is suggestive that apoptosis may be important in the ongoing remodeling of white matter due to sustained compression.Level Of Evidence4.

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