• Bin Zhang, Ran Yan, Jun Lu, Zhenzhen Ma, Xuhui Zhang, Leiben Li, Jie Gao, Lei Xia, Ke Zhang, Feifei Zhang, Yang Liu, and Jiangang Shi.
• Department of Orthopedic Surgery, Spine Center, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
• World Neurosurg. 2019 Oct 1; 130: e1051-e1060.

ObjectiveTo identify the potent metabolic biomarkers of cauda equina injury (CEI).MethodsA total of 50 Sprague-Dawley rats were used to establish the CEI model in this study. The serum was collected at 12 hours, 1 day, 2 days, and 7 days after surgery. Ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry was performed to analyze metabolic changes in the serum of the CEI rats from different groups. The differences between the metabolic profiles of the rats in 5 groups were analyzed using partial least squares discriminant analysis (PLS-DA).ResultsMetabolic profiling revealed significant differences between the sham operated and other groups. A total of 57 potential CEI metabolite biomarkers were identified between the sham operated group and the model groups at the different time points. Principal component analysis and PLS-DA analyses revealed clear segregation between CEI versus sham operation group. These potential biomarkers appear in 15 metabolic pathways.ConclusionsUsing metabolomic analysis, we were able to identify the novel serum biomarkers of CEI that may be relevant to the diagnosis and prognosis of CEI. In addition, our pathway analysis provides important insights into the etiology of CEI and a basis for clinical diagnosis, locating biomarkers in the early stages of the pathological process.Copyright © 2019 Elsevier Inc. All rights reserved.

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