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Radiation therapy combined with microsurgery shows promise for curing injured spinal cord

could grow across the lesion site, restoring the connection between the brain and the spinal cord, with resulting restoration of control of the brain over muscle function.

In the current research, the scientists made a severe crush injury, similar to a human contusion/fracture injury, in spinal cord of adult rats just below the waist. In crush injuries, tissue decay is exacerbated by the secondary damage caused by massive swelling as fluids build up from the injured blood vessels. When the researchers administered radiation alone, there was no detectable beneficial effect on the bodys repair of the crushed cord. However, the researchers recalled findings from nearly a century ago by Alfred R. Allen showing that incision at the damage site along the midline of the cord (myelotomy) could drain the accumulated fluids and reduce tissue damage.

Kalderon and her colleagues at Sloan-Kettering then made longitudinal micro-incisions down the center of the injured cord within the first 24 hours after injury to release the fluid buildup. There was significant reduction in the size of lesion site, confirming Allens work. They then combined the radiation treatment with the microsurgery. When a midline incision was performed at one hour after injury, followed by localized radiation therapy given for ten days starting on day ten after injury, there was nearly a two-fold improvement in the bodys ability to heal the injured cord compared with untreated rats. This suggests that fluid accumulation and swelling must first be prevented if the radiation therapy is to be effective in promoting wound repair.

The researchers were able to show the improvements in wound healing both by post-mortem examination of the tissue three months after injury, as well as MRI on the living rats. This indicates that the success of these therapies on humans could also be evaluated using MRI technology.

The researchers also tested a third level of treatment
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Contact: Nurit Kalderon
kalderon@spinalcordcure.org
212-564-9498
Public Library of Science
24-Jul-2007


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