• Richard S Rabinowitz, Jason C Eck, C Michel Harper, Dirk R Larson, Miguel A Jimenez, Joseph E Parisi, Jonathan A Friedman, Michael J Yaszemski, and Bradford L Currier.
• Barrington Orthopaedic Associates, Hoffman Estates, IL, USA.
• Spine. 2008 Oct 1;33(21):2260-8.

Study DesignExperimental dog model of acute spinal cord injury.ObjectiveTo compare the relative value of methylprednisolone, surgical decompression, or both for the treatment of traumatic spinal cord injury.Summary Of Background DataAcute spinal cord injury results from both primary damage to the spinal cord at the time of the initial injury as well as a deleterious secondary cascade of events, which leads to further damage. Surgical decompression is known to improve clinical outcomes, but the timing of surgical decompression remains controversial.MethodsA nylon tie was used to constrict the spinal cord in 18 adult male beagle dogs. The animals were then prospectively randomized to 3 groups: 1) surgical decompression at 6 hours and intravenous methylprednisolone; 2) surgical decompression at 6 hours and intravenous saline; and 3) intravenous methylprednisolone without surgical decompression. Each animal was evaluated by somatosensory-evoked potentials, daily neurologic assessment, and histologic examination at 2 weeks following injury.ResultsImmediately following spinal cord constriction, all animals were paraplegic, incontinent, and the somatosensory-evoked potentials were abolished. Surgical decompression 6 hours after injury, with or without methylprednisolone, led to significantly better neurologic function at 2 weeks than methylprednisolone alone.ConclusionIn the setting of acute and persistent spinal cord compression in beagle dogs, surgical decompression 6 hours after injury, with or without methylprednisolone, is more effective for improving neurologic recovery than methylprednisolone alone.

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