Resumo
Intervertebral disc extrusion (IVDE) is the most common cause of spinal cord compression in dogs, whose prognosis is variable and depends on several factors, with deep pain perception (DPP) being the main parameter used. Investigations of new prognostic factors are studied to assist in the estimation of functional recovery. Thus, this study aimed to evaluate whether spinal hyperesthesia (SH) at the compression site can be used as a prognostic factor for the functional recovery of dogs with acute IVDE (Hansen type I), without DPP being subjected to thoracolumbar hemilaminectomy. Decompression surgery was performed on the same day or the day after admission. The duration of the loss of DPP until surgery performance ranged from 1 to 60 days, with a median of 4.5 days for the group of dogs with SH and 5.5 days for those without SH. Among the 68 dogs included in this retrospective study, 73.5% (50/68) showed SH, and 26.5% (18/68) were not identified. Recovery was satisfactory in 60% (30/50) of dogs with SH and in 27.7% (5/18) of dogs without SH, demonstrating that paraplegic dogs without DPP but with SH were 3.9 times more likely to recover when compared to dogs in the same condition, but with no SH. No studies have evaluated SH by palpation of the spine as a prognostic factor, which reinforces the relevance of the present study. The results of this study imply that SH in paraplegic dogs affected by thoracolumbar IVDE, without the presence of DPP, can be used as a possible prognostic indicator of functional recovery.
A extrusão do disco intervertebral (EDIV) é a causa mais comum de lesão compressiva na medula espinhal de cães, cujo prognóstico é variável e depende de diversos fatores, sendo a percepção de dor profunda (PDP) o principal parâmetro utilizado. Pesquisas de novos fatores prognósticos são estudados com intuito de auxiliar na estimativa mais precisa de recuperação funcional. Com isso, o objetivo do estudo foi avaliar se a hiperestesia espinhal (HE) no local da compressão, pode ser utilizada como um fator prognóstico para recuperação funcional de cães com extrusão aguda do disco intervertebral (Hansen tipo I), sem a presença de PDP submetidos a hemilaminectomia toracolombar. A cirurgia descompressiva ocorreu no mesmo dia ou no dia seguinte ao atendimento. A duração da perda de dor profunda até a realização da cirurgia variou de 1 a 60 dias, com uma mediana de 4,5 dias para o grupo de cães com e 5,5 dias para aqueles sem hiperestesia espinhal. Dos 68 cães incluídos nesse estudo retrospectivo, 73,5% (50/68) apresentavam HE e, em 26,5% (18/68) a dor não foi identificada. A recuperação foi satisfatória nos cães com HE em 60% (30/50) e, sem HE, em 27,7% (5/18) dos casos, demonstrando que os cães paraplégicos sem PDP, mas com presença de hiperestesia espinhal tem 3,9 vezes mais chances de recuperação quando comparado com cães na mesma condição, mas sem HE. Não foram encontrados trabalhos que avaliaram a HE mediante a palpação da coluna vertebral como um fator prognóstico, o que reforça a relevância do presente estudo. Os resultados do presente trabalho sugerem que a HE em cães paraplégicos acometidos por EDIV toracolombar sem presença de PDP pode ser utilizada como um possível indicador prognóstico de recuperação funcional.
Assuntos
Animais , Cães , Paraplegia/veterinária , Traumatismos da Medula Espinal/veterinária , Medição da Dor/veterinária , Percepção da Dor , Hiperestesia/veterinária , Degeneração do Disco Intervertebral/veterináriaResumo
The interlocking nail represents an excellent option as a surgical approach to treat fractures in long bones in veterinary medicine. However, failures were reported mainly due to a slack present in the interface of the rod with the screws. The present study tested and mechanically compare axial compression loads of two novel models of stable angle interlocking nails with threaded holes. Among the two models, one was uniplanar and the other was multiplanar with orthogonally arranged distal holes. Twenty-one specimens made of polylactic acid were used for the implantation of interlocking nail´s rods, divided into three groups: conventional interlocking nail (G1), novel interlocking nail with a stable angle with holes arranged in a single plane (G2), and novel interlocking nail with a stable angle in two planes, with the penultimate hole at 90 degrees from the others (G3). Biomechanical tests were performed using axial, cyclic, and destructive compression load for comparison between them. All the specimens showed plastic deformation in the screws after destructive tests, in both proximal and distal sides, being highly intense in G1. G2 and G3 of the stable angle rods supported higher loads than G1 in all tests performed (P<0.05). The novel stems did not differ statistically from each other (P>0.05). The initial hypothesis that the novel models would provide increased stability was confirmed; however, no differences were demonstrated between them. The screw locking system on the rods allowed high resistance values in the tests performed, proving to be effective and potentially applicable in real clinical situations.
A haste intramedular bloqueada representa excelente opção para abordagem cirúrgica de fraturas em ossos longos na medicina veterinária. Todavia, falhas decorrentes principalmente de "folga" presente na interface da haste com os parafusos foram relatadas. O presente estudo teve como objetivo testar e comparar mecanicamente, por cargas de compressão axial, dois novos modelos de haste intramedular bloqueada de ângulo estável com orifícios roscados, sendo uma delas uniplanar e outra multiplanar com orifícios distais dispostos ortogonalmente. Vinte e um corpos de prova confeccionados em ácido polilático (PLA) foram utilizados para implantação das hastes intramedulares bloqueadas, divididos em três grupos: Haste bloqueada convencional (G1); haste bloqueada nova de ângulo estável com orifícios dispostos em único plano (G2); haste bloqueada nova de ângulo estável em dois planos, com o penúltimo orifício em 90 graus dos demais (G3). Utilizou-se ensaios biomecânicos por carga de compressão axial, cíclicos e destrutivos, para comparação entre eles. Todos mostraram deformação plástica nos parafusos após testes destrutivos, tanto proximais como distais, sendo mais intensa no grupo 1. Os grupos 2 e 3 das hastes de ângulo estável suportaram cargas superiores em relação ao G1 em todos os testes realizados (P<0.05). As hastes novas não diferiram estatisticamente entre si (P>0,05). A hipótese inicial de que os novos modelos proporcionariam maior estabilidade foi confirmada, entretanto não foi demonstrada diferenças entre eles. O sistema de bloqueio roscado dos parafusos nas hastes permitiu valores elevados de resistência nos testes realizados, mostrando-se efetivo e, potencialmente aplicável em situações clínicas reais.
Assuntos
Traumatismos da Medula Espinal/veterinária , Fixação Intramedular de Fraturas/veterinária , Testes Mecânicos/instrumentaçãoResumo
This retrospective study described the therapeutic modalities used for the rehabilitation of cats with neurological and orthopedic diseases and provided data regarding the number of sessions, frequency, and treatment duration; the study also evaluated the modality acceptance by this species. Twenty cats were selected, 11 with neurological diseases and nine with orthopedic conditions. Acute spinal cord trauma and femoral fracture were the most frequently observed neurological (72.7%) and orthopedic (44.4%) conditions, respectively. Manual therapies comprised of passive stretching (PS), passive range of motion (PROM), and bicycle movement (BM) exercises were included in all the protocols.Therapeutic modality acceptance was positive for physical agents, thermotherapy, and hydrotherapy (100%);in manual therapies, it was positive in 40% and partially positive in 60% of cats; in kinesiotherapy, it was positive for all the assisted active exercises and negative for the active exercises. The number of physical therapy sessions significantly influenced the positive acceptance of PS (P < 0.05). The PS, PROM, and BM exercises were the most commonly used modalities; the number of physiotherapy sessions and duration of treatment were higher in cats with neurological diseases, and acceptance was positive in most therapeutic modalities.
RESUMO: O objetivo deste estudo retrospectivo foi descrever as modalidades terapêuticas utilizadas na reabilitação de gatos com doenças neurológicas e ortopédicas em um centro de reabilitação, fornecer dados referentes ao número de sessões, a frequência, a duração do tratamento e avaliar a aceitação das modalidades pela espécie. Foram selecionados 20 gatos, sendo, 11 com doenças neurológicas e nove com afecções ortopédicas. O trauma agudo de medula espinhal e a fratura de fêmur foram as doenças neurológicas (72,7%) e ortopédicas (44,4%) mais observadas, respectivamente. As terapias manuais compostas pelos exercícios de alongamento passivo (AP), movimentação passiva articular (MPA) e movimento em bicicleta (MB) foram incluídas em 100% dos protocolos. A aceitação das modalidades terapêuticas foi positiva para os agentes físicos, termoterapia e hidroterapia (100%); nas terapias manuais, foi positiva em 40% e parcialmente positiva em 60% dos gatos e, na cinesioterapia, foi positiva para os exercícios ativos assistidos em 100% e negativa para os exercícios ativos. O número de sessões de fisioterapia influenciou significativamente na aceitação positiva do alongamento passivo (P < 0,05). O AP, a MPA, o MB foram as modalidades mais utilizadas; o número de sessões de fisioterapia e a duração do tratamento foram maiores nos gatos com doenças neurológicas e a aceitação foi positiva na maioria das modalidades terapêuticas.
Assuntos
Animais , Gatos , Traumatismos da Medula Espinal/reabilitação , Gatos/lesões , Modalidades de Fisioterapia/veterinária , Fraturas do Fêmur/reabilitaçãoResumo
ABSTRACT Purpose To probe the mechanism of mild hypothermia combined with rutin in the treatment of spinal cord injury (SCI). Methods Thirty rats were randomized into the following groups: control, sham, model, mild hypothermia (MH), and mild hypothermia plus rutin (MH+Rutin). We used modified Allen's method to injure the spinal cord (T10) in rats, and then treated it with MH or/and rutin immediately. BBB scores were performed on all rats. We used HE staining for observing the injured spinal cord tissue; ELISA for assaying TNF-α, IL-1β, IL-8, Myeloperoxidase (MPO), and Malondialdehyde (MDA) contents; Dihydroethidium (DHE) for measuring the reactive oxygen species (ROS) content; flow cytometry for detecting apoptosis; and both RT-qPCR and Western blot for determining the expression levels of TGF-β/Smad pathway related proteins (TGF-β, Smad2, and Smad3). Results In comparison with model group, the BBB score of MH increased to a certain extent and MH+Rutin group increased more than MH group (p < 0.05). After treatment with MH and MH+Rutin, the inflammatory infiltration diminished. MH and MH+Rutin tellingly dwindled TNF-β, MDA and ROS contents (p < 0.01), and minified spinal cord cell apoptosis. MH and MH+Rutin could patently diminished TGF-β1, Smad2, and Smad3 expression (p < 0.01). Conclusions MH+Rutin can suppress the activation of TGF-β/Smad pathway, hence repressing the cellular inflammatory response after SCI.
Assuntos
Animais , Ratos , Traumatismos da Medula Espinal/terapia , Hipotermia , Rutina/uso terapêutico , Medula Espinal , Fator de Crescimento Transformador beta , Ratos Sprague-DawleyResumo
As lesões decorrentes de atropelamento são as principais causas de fraturas e luxações vertebrais, ocasionando graus variáveis de injúrias vertebrais e medulares. O presente trabalho tem como objetivo relatar a ocorrência de lesão traumática em coluna vertebral de cão sem raça definida, com quatro anos de idade, resultando em luxação T11-12, com exposição de T11 e secção medular, estando o paciente paraplégico, com sinais de lesão em neurônio motor superior e ausência de nocicepção profunda em membros pélvicos. O tratamento de escolha foi a vertebrectomia de T11, associada ao alinhamento de T10-12 com introdução de pinos e fixação com polimetilmetacrilato (PMMA) associado à ceftriaxona. Em decorrência de lesão na pleura parietal no trans-cirúrgico, optou-se pela toracostomia para introdução de tubo torácico, o qual permaneceu no paciente por quatro dias. No pós-operatório, o paciente apresentou recuperação satisfatória, sendo recomendado aos tutores a confecção de cadeira de rodas a fim de facilitar sua locomoção. A técnica mostrou-se satisfatória para minimizar as infecções passíveis de ocorrência em fraturas expostas, bem como melhorar a qualidade de vida do paciente, evitando-se dores crônicas.
Injuries resulting from being run over are the leading causes of vertebral fractures and dislocations, causing varying vertebral and spinal injuries. The present study aims to report the occurrence of traumatic injury to the spine of a mixed breed dog, aged four years, resulting in a T11-12 dislocation, with T11 exposure and spinal section, with the patient showing paraplegia, signs of an upper motor neuron lesion and absence of deep nociception in pelvic limbs. The treatment of choice was T11 vertebrectomy, associated with the alignment of T10-12 with the introduction of pins and fixation with polymethylmethacrylate (PMMA) associated with ceftriaxone. Due to a lesion in the parietal pleura during the surgery, thoracostomy was chosen to introduce a chest tube, which remained in the patient for four days. In the postoperative period, the patient presented a satisfactory recovery, and it was recommended that tutors make a wheelchair to facilitate their mobility. The technique proved to be satisfactory for minimizing infections that could occur in open fractures and improving the patient's quality of life, avoiding chronic pain.
Assuntos
Animais , Traumatismos da Medula Espinal/veterinária , Cirurgia Veterinária , Fraturas da Coluna Vertebral/veterinária , Paraplegia/veterinária , Toracostomia/veterinária , Fratura-Luxação/veterináriaResumo
ABSTRACT Purpose To investigate the effect of ferulic acid (FA) on spinal cord injury (SCI)-induced motor dysfunction and to explore the possible pharmacological mechanisms. Methods Adult male Wistar rats were used in our study. SCI was achieved by clipping the spinal cord T9 of the rat by a vascular clip for 2 minutes. The motor function of the rat was evaluated by Basso, Beattie, and Bresnahan scoring method (BBB) and inclined plane test. Hematoxylin and eosin (HE) staining, NISSL staining, and transmission electron microscopic examination were used to evaluate alterations at the histological level. Polymerase chain reaction (PCR), Western blots, and enzyme-linked immunosorbent assays (ELISA) were employed in biochemical analysis. Results The BBB score and inclined plane test score significantly decreased after SCI surgery, whereas chronic FA treatment (dose of 90 mg/kg, i.g.) for 28 days improved SCI-induced motor dysfunction. HE staining showed that SCI surgery induced internal spinal cord edema, but the structural changes of the spinal cord could be reversed by FA treatment. NISSL staining and transmission electron microscopic examination confirmed the improvement of the effect of FA on the injury site. In the biochemical analysis, it could be found that FA inhibitedSCI-induced mRNA and protein overexpression of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α), as well as iNOS and COX-2 via the modulation of NF-κB level in the spinal cord of SCI rat. Moreover, the SCI-induced decrease of Bcl-2/Bax ratio was also reversed by FA treatment. However, the effect of FA on the expression of Beclin-1 was not statistically significant. Conclusions FA showed a therapeutic effect on SCI, which may be associated with the regulation of neuroinflammation and apoptosis.
Assuntos
Animais , Masculino , Ratos , Traumatismos da Medula Espinal/tratamento farmacológico , Medula Espinal , Ratos Wistar , Ratos Sprague-Dawley , Apoptose , Ácidos Cumáricos , Recuperação de Função FisiológicaResumo
Background: Acute spinal traumas can lead to irreversible damage associated with vascular and inflammatory changes in neural tissue. Since spine and spinal cord traumas have an unfavorable prognosis in small animals, and reports of the use of Steinmann pins and polymethylmethacrylate repair of lumbar vertebra fracture-luxation in puppies are rare in the literature, the present paper aimed to report the surgical treatment of transversal fracture through the body of the fourth lumbar vertebra, with dorsocranial displacement of the caudal fragment by using Steinmann pins and polymethylmethacrylate in a 7-month-old Labrador Retriever male dog. Case: A 7-month-old intact male Labrador Retriever dog, weighing 24.0 kg was attended at School Veterinary Hospital with a history of hit by car and paraplegia of the hind limbs. On neurological examination was observed no proprioception and no deep pain sensitivity on the both pelvic limbs. The lumbar spinal palpation showed intense pain, and the motor function and patellar reflexes were reduced. The values of haematological and biochemical analysis remained within the reference values for the species. Radiographs revealed a transversal fracture through the body of the fourth lumbar vertebra, with dorsocranial displacement of the caudal fragment, and was decided to perform a surgical treatment by open reduction and internal fixation of the fracture. The dog was positioned in ventral recumbency for surgery, and a dorsal midline incision was made from the second lumbar vertebra to the sixth lumbar vertebra. Two crossed 1.5 mm Kirschner wires were placed through the caudal articular facets of the fourth lumbar vertebra to provide initial stability...
Assuntos
Masculino , Animais , Cães , Luxações Articulares/veterinária , Pinos Ortopédicos/veterinária , Polimetil Metacrilato , Vértebras Lombares/cirurgia , Vértebras Lombares/lesões , Traumatismos da Medula Espinal/cirurgia , Traumatismos da Medula Espinal/veterináriaResumo
O objetivo deste estudo foi avaliar o efeito da ω-conotoxina MVIIC e das células-tronco mesenquimais (CTM) de forma isolada e sua associação nos ratos submetidos ao trauma medular agudo (TMA). Trinta Rattus novergicus, linhagem Wistar, três meses de idade, foram distribuídos igualmente em cinco grupos experimentais: controle negativo (CN), controle positivo (CP), ω-conotoxina MVIIC (MVIIC), células-tronco mesenquimais da medula óssea (CTM-MO) e associação (MVIIC + CTM-MO). O grupo CN foi submetido à laminectomia sem trauma medular, e os grupos CP, MVIIC, CTM-MO e MVIIC + CTM-MO foram submetidos ao trauma medular contusivo. O grupo CP recebeu, uma hora após o TMA, 10µL de PBS estéril, e os grupos MVIIC e MVIIC + CTM-MO receberam 10µL de PBS contendo 20pmol da ω-conotoxina MVIIC, todos por via intratecal. Os grupos CTM-MO e MVIIC + CTM-MO receberam, 24 horas após, 1x106 de CTM via intravenosa. Avaliou-se a recuperação da função locomotora até o sétimo dia pós-trauma. Os animais tratados com MVIIC + CTM-MO obtiveram recuperação motora após o trauma medular agudo (P<0,05). Conclui-se que essa associação apresentou efeito neuroprotetor com melhora na função locomotora em ratos Wistar.(AU)
The objective of this study was to evaluate the effect of isolated ω-conotoxin MVIIC and mesenchymal stem cells (MSCs) and its association in rats submitted to acute spinal cord injury (SCI). Thirty Rattus norvegicus, Wistar strain, three-month-old rats were randomly distributed in five experimental groups with six animals: negative control (CN), positive control (CP), ω-conotoxin MVIIC (MVIIC), bone marrow mesenchymal stem cells (CTM-MO) and the association (MVIIC + CTM-MO). The CN group underwent laminectomy without spinal cord trauma, and groups CP, MVIIC, CTM-MO and MVIIC + CTM-MO were submitted to contusive spinal cord trauma. The CP group received 10µl of PBS one hour after SCI, and groups MVIIC and MVIIC + CTM-MO received 10µl of PBS containing 20pmol of ω-conotoxin MVIIC, both intrathecally. Groups CTM-MO and MVIIC + CTM-MO received 1x106 of MSCs intravenously 24 hours later. The recovery of locomotor function was evaluated up to seven days post-injury. The animals treated with MVIIC + CTM-MO obtained motor recovery after SCI (P<0.05). It is concluded that this association showed neuroprotective effect with improvements in locomotor function in Wistar rats.(AU)
Assuntos
Animais , Ratos , Traumatismos da Medula Espinal/reabilitação , Bloqueadores dos Canais de Cálcio , ômega-Conotoxinas/uso terapêutico , Células-Tronco Mesenquimais , Terapia Baseada em Transplante de Células e Tecidos/veterinária , Neuroproteção , Ratos WistarResumo
Traumatic events such as a motor vehicle accident or falling from heights are very common in veterinary medicine and often lead to vertebral fracture-luxation with concomitant spinal cord injuries, mostly in the thoracolumbar spine. The purpose of this cadaveric biomechanical study was to determine the feasibility of the three-column concept in canine thoracolumbar segments with induced fractures. Eighteen Functional Spinal Units (FSU) of the thoracolumbar segments (T12-L2) were collected from 18 medium-sized adult dog cadavers and were subjected to flexion-extension and lateral bending tests so that range of motion (ROM) was recorded with a goniometer. Fractures were induced by compressive loads applied by a universal testing machine (EMIC®). After this, specimens were screened using computed tomography (CT) and the fractures were graded as affecting one, two or three columns, and divided into groups A, B, and C, respectively. Post-fracture range of motion (ROM) was compared with the previous results. Groups B and C (with fractures in two or three columns) had instability in the two axes evaluated (P<0.05). The outcomes of this study support the applicability of the three-column theory to thoracolumbar spines of dogs, as the FSUs that suffered fractures in two or more columns showed axial instability.(AU)
Eventos traumáticos, como acidentes automobilísticos ou quedas, são muito comuns na medicina veterinária e, frequentemente, levam a fraturas ou luxações vertebrais, associadas a lesões medulares concomitantes, mais frequentemente na coluna toracolombar. O propósito deste estudo biomecânico em cadáveres foi determinar a viabilidade da teoria dos três compartimentos em fraturas induzidas em segmentos toracolombares de cães. Dezoito unidades espinhais funcionais (UEF) de segmentos toracolombares (T12-L2) foram coletadas de 18 cadáveres de cães adultos de médio porte e submetidas a testes de flexão-extensão e curvamento lateral, de modo que a amplitude de movimento (ADM) foi registrada com um goniômetro. Fraturas foram induzidas por meio de cargas compressivas aplicadas por uma máquina universal de ensaios (EMIC®). As amostras foram submetidas à tomografia computadorizada (TC), e as fraturas foram classificadas como afetando um, dois ou três compartimentos e divididas nos grupos A, B e C, respectivamente. A ADM pós-fratura foi comparada com os resultados prévios. Os grupos B e C (com fraturas em dois ou três compartimentos) apresentaram instabilidade nos dois eixos avaliados (P<0,05). Os resultados deste estudo corroboram a aplicabilidade da teoria dos três compartimentos para segmentos de coluna toracolombar em cães, uma vez que as UEF que sofreram as fraturas em dois ou mais compartimentos apresentaram instabilidade axial.(AU)
Assuntos
Animais , Cães , Traumatismos da Medula Espinal/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Cadáver , Fraturas Ósseas/diagnóstico por imagem , Fenômenos Biomecânicos , Acidentes por Quedas , Acidentes de Trânsito , Tomografia Computadorizada por Raios X/veterináriaResumo
Background: Acute spinal cord injury, a common cause of neurological dysfunction in humans and animals, impairsmotor, sensory and autonomic functions and may result in permanent disability. Nandrolone decanoate (ND) is a steroidwidely studied for its predominantly anabolic effect and low androgenic potential. Several researchers have described thepositive interference of ND in neurological tissue, such as increased synthesis and release of neurotrophic substances, butto date no studies have evaluated the action of this steroid in acute spinal cord injury. The aim of this study was thereforeto evaluate the effect of ND in rats subjected to acute spinal cord injury.Materials, Methods & Results: Thirty-two young adult Wistar rats (Rattus norvegicus), weighing between 240 and 260 g,were divided into three groups. The first group (GNAN) (n=13) was subjected to acute spinal cord injury and treated withND; the control group (GCON) (n=13) was subjected to spinal cord injury without treatment; and the third group (GLAM)(n=6) underwent laminectomy without prior spinal cord injury, in order to control changes caused by the procedure. A 20g metal device was released from a height of 25 cm to produce the spinal cord injury. After exposing the spinal canal, a2-mm diameter metal rod was placed directly in contact with the spinal cord, and when the weight was released, the rodwas struck, causing the spinal cord injury. An intramuscular injection of 2 mg/kg of ND was administered the immediatepostoperative period. The animals were assessed to ascertain the recovery of their motor function on five occasions, namelyat 24 h, 48 h, 72 h, 7 and 14 days after undergoing spinal cord injury. This assessment was performed using the Basso,Beattie and Bresnahan (BBB) model. The animals were euthanized 14 days post-op and fragments of the spinal cord andurinary...
Assuntos
Animais , Ratos , Decanoato de Nandrolona/análise , Decanoato de Nandrolona/uso terapêutico , Traumatismos da Medula Espinal/tratamento farmacológico , Traumatismos da Medula Espinal/veterinária , Esteroides , Fármacos Neuroprotetores/uso terapêutico , Ratos WistarResumo
Doenças na medula espinhal causam dor, dificuldade ambulatorial e incontinência urinária, interferindo de forma significativa na qualidade de vida dos animais. A localização clínica das lesões neurológicas bem como a característica do curso das doenças, é de extrema importância na elaboração dos possíveis diagnósticos diferenciais. Para se definir o diagnóstico e tratamento, são necessários exames complementares. Atualmente, destacam-se os exames de imagem avançados como tomografia computadorizada (TC) e a ressonância magnética (RM) como possibilidades complementares. Estes exames, entretanto, são pouco disponíveis no Brasil e em outros países em desenvolvimento, ou estão restritos aos grandes centros urbanos. Desta maneira, técnicas que exijam menor tecnologia e estão mais disponíveis, como mielografia, ainda têm papel fundamental no diagnóstico e planejamento cirúrgico de afecções medulares em locais nos quais a TC e RM são inacessíveis. Para a realização da mielografia, o paciente deve ser submetido à anestesia geral e a punção deve ser feita em condições estéreis em cisterna magna ou em região lombar. O fluir do liquor, caso o animal movimente a cauda ou membros, são indícios de que o bisel da agulha está no espaço subaracnóideo e o contraste deve ser administrado. Existem quatro tipos de padrão mielográfico (normal, extradural, intradural-extramedular e intramedular) e cada padrão pode estar relacionado a diferentes tipos de afecção. A administração do contraste no espaço subaracnóideo pode causar inúmeros efeitos adversos, sendo o mais estudado a ocorrência de convulsões após mielografia.
Spinal cord diseases can cause pain and urinary incontinence. All these clinical signs can interfere in a significant way in life quality of ill patients. The clinical localization of the neurological lesions as well as the characteristic of the diseases course are of extreme importance in the elaboration of the possible differential diagnoses. In order to define the diagnosis and treatment, additional tests are necessary. Advanced imaging exams such as computed tomography (CT) and magnetic resonance imaging (MRI) stand out as complementary possibilities. These image modalities aren ́t easily accessible in Brazil and other developing countries and are restricted to big cities. Considering this, more traditional image techniques such as myelography are still useful in spinal cord diseases diagnosis and treatment in places where CT and or MRI are inaccessible. Myelography requires general anesthesia and the spinal tap area must be clipped and surgically prepared. The spinal tap can be done in subarachnoid lumbar space or cisterna magna. Liquor fluence, twitching the tail or limbs are signs that the needle is in the subarachnoid space and myelography contrast can be administrated. There are four myelography patterns: normal, extradural, intradural-extramedullary and intramedullary) and these patterners can occur in different diseases etiologies. Subdural contrast administration can cause many side effects, the most studied is myelography induced seizures.
Assuntos
Animais , Cães , Compressão da Medula Espinal/diagnóstico por imagem , Compressão da Medula Espinal/veterinária , Mielografia/efeitos adversos , Mielografia/veterinária , Traumatismos da Medula Espinal/diagnóstico por imagem , Técnicas de Diagnóstico Neurológico/veterináriaResumo
Abstract Purpose: To evaluate the influence tramadol on functional recovery of acute spinal cord injury in rats. Methods: Ten rats were divided into two groups (n = 5). All animals were submitted by a laminectomy and spinal cord injury at eighth thoracic vertebra. In control group, the rats didn't receive any analgesic. In tramadol group, the rats received tramadol 4mg/Kg at 12/12h until 5 days by subcutaneous. Animals were following by fourteen days. Was evaluated the Basso, Beattie, Bresnahan scale (locomotor evaluation) and Rat Grimace Scale (pain evaluation) at four periods. Results: There no difference between the groups in locomotor evaluation in all periods evaluated (p>0.05) and in both groups there was a partial recover of function. The tramadol group show a lower pain levels at the first, third and seventh postoperatively days when comparing to the control group. Conclusion: The tramadol as an analgesic agent don't influence on functional recovery of acute spinal cord injury in rats
Assuntos
Animais , Masculino , Traumatismos da Medula Espinal/tratamento farmacológico , Tramadol/uso terapêutico , Recuperação de Função Fisiológica/efeitos dos fármacos , Analgésicos Opioides/uso terapêutico , Traumatismos da Medula Espinal/reabilitação , Fatores de Tempo , Tramadol/farmacologia , Medição da Dor , Distribuição Aleatória , Doença Aguda , Reprodutibilidade dos Testes , Resultado do Tratamento , Ratos Wistar , Dor Crônica/prevenção & controle , Analgésicos Opioides/farmacologia , LaminectomiaResumo
Abstract Purpose: To investigate the effects of aquaporin 4 (AQP4) and inward rectifier potassium channel 4.1 (Kir4.1) on medullospinal edema after treatment with methylprednisolone (MP) to suppress acute spinal cord injury (ASCI) in rats. Methods: Sprague Dawley rats were randomly divided into control, sham, ASCI, and MP-treated ASCI groups. After the induction of ASCI, we injected 30 mg/kg MP via the tail vein at various time points. The Tarlov scoring method was applied to evaluate neurological symptoms, and the wet-dry weights method was applied to measure the water content of the spinal cord. Results: The motor function score of the ASCI group was significantly lower than that of the sham group, and the spinal water content was significantly increased. In addition, the levels of AQP4 and Kir4.1 were significantly increased, as was their degree of coexpression. Compared with that in the ASCI group, the motor function score and the water content were significantly increased in the MP group; in addition, the expression and coexpression of AQP4 and Kir4.1 were significantly reduced. Conclusion: Methylprednisolone inhibited medullospinal edema in rats with acute spinal cord injury, possibly by reducing the coexpression of aquaporin 4 and Kir4.1 in medullospinal tissues.
Assuntos
Animais , Masculino , Ratos , Doenças da Medula Espinal/tratamento farmacológico , Traumatismos da Medula Espinal/tratamento farmacológico , Metilprednisolona/farmacologia , Canais de Potássio Corretores do Fluxo de Internalização/metabolismo , Edema/tratamento farmacológico , Aquaporina 4/metabolismo , Glucocorticoides/farmacologia , Medula Espinal/citologia , Medula Espinal/efeitos dos fármacos , Doenças da Medula Espinal/metabolismo , Traumatismos da Medula Espinal/induzido quimicamente , Metilprednisolona/uso terapêutico , Distribuição Aleatória , Doença Aguda , Imunofluorescência , Ratos Sprague-Dawley , Canais de Potássio Corretores do Fluxo de Internalização/uso terapêutico , Modelos Animais de Doenças , Edema/metabolismo , Aquaporina 4/uso terapêutico , Glucocorticoides/uso terapêuticoResumo
A utilização de células-tronco na reparação de lesões tem sido extensivamente investigada. Neste estudo, examinamos os efeitos terapêuticos de dois transplantes (12x106 céls/transplante) de células-tronco mesenquimais alogênicas derivadas do tecido adiposo (CTDAs) em 11 cães com lesões crônicas traumáticas toracolombares da medula espinhal. As CTDAs foram foram cultivadas in vitro, a proliferação e a viabilidade foram avaliadas. As suspensões foram expandidas e administradas no espaço intradural com intervalo de uma semana entre transplantes. Os cães foram submetidos à avaliações clínicas, laboratoriais, radiográficas, tomográficas, sensitivas, motoras e cistométricas. A maioria dos animais não tinha raça definida (63,63%), mesma proporção para o acometimento de fêmeas e foi observada predominância de fratura com subluxação vertebral (81,81%). Na comparação dos cães pré e pós-transplante não foram observadas alterações hematológicas e três animais (27,27%) apresentaram cistite bacteriana. Em relação a sensibilidade, motricidade e cistometria, também não houve alterações significativas dos índices antes e pós transplantes, sendo observado a ausência nociceptiva na maioria dos animais (72,73%), paraplegia e incontinência urinária na mesma proporção. Neste estudo concluiu-se que o protocolo utilizado de transplante de CTDAs, demonstrou ser um tratamento seguro para cães com lesão medular crônica, com melhora discreta da funcionalidade vesical, porém sem melhora clínica significativa.(AU)
The use of stem cells in injury repair has been extensively investigated. In this study, we examined the therapeutic effects of two transplants (12x106 cells/transplantation) of allogenic adipose-derived stem cells (ASCs) in 11 dogs with chronic spinal cord injury. ASC were cultured in vitro, proliferation and cell viability were evaluated. Cell suspensions were prepared and administered in the intradural space, with a one-week interval between transplants. The animals were submitted to clinical, laboratory, radiographic, tomographic, sensory, motor and cystometric evaluations. Most of the animals were not a breed defined (63.63%), the same proportion for females affected, predominance of vertebral subluxation fracture was observed (81.81%). Before and after the transplants no hematological changes were observed, three animals (27.27%) presented bacterial cystitis, and in relation to motor, cystometry and sensitivity, no improvement was observed; the rates were maintained before and after transplants, predominance of nociceptive absence in most animals (72.73%), and paraplegia and urinary incontinence in the same proportion. In this study it was concluded that the use of ADSCs for the treatment of dogs with chronic spinal cord injury is safe, with a slight improvement in bladder function, but without significantly clinical improvement.(AU)
Assuntos
Animais , Cães , Compressão da Medula Espinal/cirurgia , Compressão da Medula Espinal/veterinária , Traumatismos da Medula Espinal/cirurgia , Traumatismos da Medula Espinal/veterinária , Transplante de Células-Tronco Mesenquimais/veterinária , Cães/lesõesResumo
Abstract Purpose: To investigate the efficacy of allogeneic mesenchymal stem-cells and autologous mononuclear cells to promote sensorimotor recovery and tissue rescue. Methods: Female rabbits were submitted to the epidural balloon inflation method and the intravenous cells administrations were made after 8 hours or seven days after injury induction. Sensorimotor evaluation of the hindlimbs was performed, and the euthanasia was made thirty days after the treatment. Spinal cords were stained with hematoxylin and eosin. Results: Both therapies given 8 hours after the injury promoted the sensorimotor recovery after a week. Only the group treated after a week with mononuclear cells showed no significant recovery at post-injury day 14. In the days 21 and 28, all treatments promoted significant recovery. Histopathological analysis showed no difference among the experimental groups. Our results showed that both bone marrow-derived cell types promoted significant sensorimotor recovery after injury, and the treatment made at least a week after injury is efficient. Conclusion: The possibilities of therapy with bone marrow-derived cells are large, increasing the therapeutic arsenal for the treatment of spinal cord injury.
Assuntos
Animais , Feminino , Ratos , Traumatismos da Medula Espinal/cirurgia , Leucócitos Mononucleares/transplante , Transplante de Medula Óssea/métodos , Recuperação de Função Fisiológica , Transplante de Células-Tronco Mesenquimais/métodos , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/patologia , Fatores de Tempo , Transplante Autólogo , Transplante Homólogo , Tomografia Computadorizada por Raios X , Modelos Animais de Doenças , Vias NeuraisResumo
Abstract Purpose: To investigate the therapeutic potential of human immature dental pulp stem cells in the treatment of chronic spinal cord injury in dogs. Methods: Three dogs of different breeds with chronic SCI were presented as animal clinical cases. Human immature dental pulp stem cells were injected at three points into the spinal cord, and the animals were evaluated by limb function and magnetic resonance imaging (MRI) pre and post-operative. Results: There was significant improvement from the limb function evaluated by Olby Scale, though it was not supported by the imaging data provided by MRI and clinical sign and evaluation. Conclusion: Human dental pulp stem cell therapy presents promising clinical results in dogs with chronic spinal cord injuries, if used in association with physical therapy.
Assuntos
Humanos , Animais , Cães , Traumatismos da Medula Espinal/veterinária , Transplante de Células-Tronco/veterinária , Polpa Dentária/citologia , Doenças do Cão/terapia , Traumatismos da Medula Espinal/terapia , Imageamento por Ressonância Magnética , Doença Crônica , Resultado do Tratamento , Recuperação de Função Fisiológica , Transplante de Células-Tronco/métodosResumo
Fraturas e luxações vertebrais (FLV) estão dentre as principais afecções que acometem a coluna vertebral em cães, com elevado risco de danos permanentes às estruturas neurais. Objetivou-se estudar as características e implicações associadas às FLV toracolombares em 37 cães, visando auxiliar uma melhor abordagem clínica em pacientes com esta afecção. As FLV foram mais comuns em machos não castrados com acesso a rua. Dentre a etiologia, 32 cães foram acometidos por acidente automobilístico. 14 cães apresentaram lesões não neurológicas em outros sistemas orgânicos. A presença de fraturas instáveis foi a alteração radiográfica mais comum. Em 16,2% dos animais, observaram-se lesões vertebrais fora do foco principal. O tempo até o atendimento neurológico inicial variou de um a 720 dias, no qual a maioria foi encaminhada sem imobilização externa. Houve diferença estatisticamente significante quanto à recuperação neurológica ao se comparar os graus de deslocamento de 0 a 25% e de 76 a 100%.(AU)
Vertebral fractures and luxations (VFL) are one of the most common and severe neurological issues found in clinical practice, with an elevated risk of permanent damage to the spinal cord. Our objective was to study the characteristics and implications associated with thoracolumbar VFL in 37 dogs, aiming assist a better clinical approach to patients with this disease. The VFL were more common in intact males with access to the street. Regarding etiology, 32 dogs were involved in car accidents. Of the dogs included in this research, 14 had non-neurological issues in other systems. The presence of unstable fractures was the most common radiographic change. In 16.2% of the dogs, vertebral lesions were observed outside the main site. Mean time until initial neurologic exam varied between one and 720 days, and most dogs were referred without external coaptation. There was a significant difference in recovery of the dogs when comparing a degree of dislocation of 0 to 25% and 76 to 100%.(AU)
Assuntos
Animais , Cães , Paraplegia/veterinária , Traumatismos da Medula Espinal/veterinária , Traumatismos Torácicos/veterinária , Luxações Articulares/veterinária , Vértebras Lombares/lesões , Estudos EpidemiológicosResumo
Abstract Purpose: Spinal Cord injury represents, in veterinary medicine, most of the neurological attendances and may result in permanent disability, death or euthanasia. Due to inflammation resulting from trauma, it originates the glial scar, which is a cell interaction complex system. Its function is to preserve the healthy circuits, however, it creates a physical and molecular barrier that prevents cell migration and restricts the neuroregeneration ability. Methods: This review aims to present innovations in the scene of treatment of spinal cord injury, approaching cell therapy, administration of enzyme, anti-inflammatory, and other active principles capable of modulating the inflammatory response, resulting in glial scar reduction and subsequent functional improvement of animals. Results: Some innovative therapies as cell therapy, administration of enzymes, immunosuppressant or other drugs cause the modulation of inflammatory response proved to be a promising tool for the reduction of gliosis. Conclusion: Those tools promise to reduce gliosis and promote locomotor recovery in animals with spinal cord injury.
Assuntos
Animais , Ratos , Traumatismos da Medula Espinal/terapia , Cicatriz/veterinária , Gliose/veterinária , Células-Tronco , Medicina Veterinária , Cicatriz/patologia , Recuperação de Função Fisiológica , Modelos Animais de Doenças , Gliose/etiologia , Gliose/patologiaResumo
Traumatic spinal cord injury results in severe neurological deficits, mostly irreversible. The cell therapy represents a strategy for treatment particularly with the use of stem cells with satisfactory results in several experimental models. The aim of the study was to compare the treatment of spinal cord injury (SCI) with and without mesenchymal stem cells (MSC), to investigate whether MSCs migrate and/or remain at the site of injury, and to analyze the effects of MSCs on inflammation, astrocytic reactivity and activation of endogenous stem cells. Three hours after SCI, animals received bone marrow-derived MSCs (1×107 in 1mL PBS, IV). Animals were euthanized 24 hours, 7 and 21 days post-injury. The MSC were not present in the site of the lesion and the immunofluorescent evaluation showed significant attenuation of inflammatory response with reduction in macrophages labeled with anti-CD68 antibody (ED1), decreased immunoreactivity of astrocytes (GFAP+) and greater activation of endogenous stem cells (nestin+) in the treated groups. Therefore, cell transplantation have a positive effect on recovery from traumatic spinal cord injury possibly due to the potential of MSCs to attenuate the immune response.
A lesão medular resulta em déficits neurológicos graves, a maioria irreversíveis. A terapia celular representa uma estratégia para o tratamento, especialmente com a utilização de células-tronco, com resultados satisfatórios em vários modelos experimentais. O objetivo do estudo foi comparar o tratamento de lesões da medula espinal (SCI), com e sem o uso de células-tronco mesenquimais (MSC), para investigar se as MSCs migram e/ou permanecem no local de lesão, e para analisar os efeitos de MSCs sobre a inflamação, reatividade astrocitária e ativação das células-tronco endógenas. Três horas depois da SCI, os animais receberam as MSC derivadas da medula óssea (1 × 107 em 1 mL de PBS, IV). Os animais foram sacrificados 24 horas, 7 e 21 dias pós-lesão. As MSC não estavam presentes no local da lesão e a avaliação por imunofluorescência demonstrou atenuação significativa da resposta inflamatória com redução em macrófagos marcados com anticorpo anti CD68 (ED1), diminuição da imunorreatividade de astrócitos (GFAP +) e maior ativação das células-tronco endógenas (nestin+) nos grupos tratados. Assim, o transplante de células teve efeito positivo sobre a recuperação de lesão traumática da medula espinal, possivelmente devido ao potencial das MSCs para atenuar a resposta imunológica.
Assuntos
Animais , Ratos , Células-Tronco Mesenquimais , Células-Tronco Neurais , Medula Espinal , Ratos/anatomia & histologia , Traumatismos da Medula Espinal , Neurocirurgia , Terapia Baseada em Transplante de Células e TecidosResumo
The Schiff-Sherrington phenomenon is an extensor hypertonicity of the forelimbs that occurs when there is a severe injury in the thoracolumbar segment. A 4-years-old, intact female, mixed breed dog, presented with vehicle trauma history followed by non-ambulatory paraparesis, extensor rigidity of forelimb and allodynia pain sensation. Superficial pain sensation was decreased. The treatment was based on unique dose of dexamethasone followed by oral administration of meloxicam, tramadol hydrochloride, dypirone, omeprazole and, poly vitamin complex. Low field magnetic resonance image (MRI) showed hyperintensity signal between T12 and T13 on T2-wheighting image compatible with neuronal edema. In the day after, allodynia and extensor rigidity presented spontaneously resolution. At 10th day, return to voluntary ambulation without assistance. Schiff-Sherrington posture is usually associated with poor prognosis and grade V traumatic injury of the thoracolumbar spinal cord. We report a grade III traumatic spinal cord injury confirmed with MRI as only neuronal edema causing the posture. The Schiff-Sherrington posture often resolves spontaneously in 10-14 days, but neurological signs of trauma can persist. The conservative treatment proposed was efficient, promoting forelimb recovery on the day after and total recovery of motor function in 10 days.
O fenômeno Schiff-Sherrington é a hipertonicidade extensores dos membros torácicos que ocorre quando há lesão severa do seguimento de medula espinhal toracolombar. Uma canina, fêmea, sem raça definida de 4 anos de idade foi apresentada após trauma por automóvel seguido de paraparesia não ambulatória, rigidez extensora dos membros torácicos e sensação dolorosa classificada como alodinia. A dor superficial estava diminuída. O tratamento se baseou na administração única de dexametasona seguida da prescrição de meloxicam, cloridrato de tramadol, dipirona, omeprazol e complexos vitamínicos. A ressonância magnética de baixo campo demonstrou hiperintesidade de sinal entre T12 e T13 nas sequencias ponderadas em T2, o que é compatível com edema neuronal. No dia seguinte, alodinia e a rigidez extensora apresentaram resolução espontânea. No 10º dia, houve retorno a deambulação voluntária sem assistência. A postura de Schiff-Sherington está geralmente associada a prognóstico ruim e lesões traumáticas grau V da medula espinhal toracolombar. Relata-se uma lesão medular traumática grau III confirmada por ressonância magnética somente como edema neuronal levando à posição. A postura de Schiff-Sherrington frequentemente se resolve espontaneamente em 10- 14 dias, mas sinais neurológicos podem persistir. O tratamento conservativo proposto foi eficiente, promovendo recuperação dos membros torácicos no dia seguinte e a recuperação total da função motora em 10 dias.