Evaluation of duraplasty surgical intervention on intrathecal pressure in a clinically relevant large animal model of traumatic spinal cord injury
Following traumatic spinal cord injury (SCI), secondary injury processes occur that can last for days to weeks beyond the primary trauma. Spinal cord edema (swelling) develops rapidly and can remain increased for weeks. Edema is thought to contribute to raised intrathecal pressure (ITP) which results in reduced vascular perfusion, starving the spinal cord tissue of important nutrients, contributing to increased tissue damage, and manifesting as greater functional deficits. Currently, acute surgical intervention, namely ‘reduction’ and ‘decompression’, involves realigning the spinal column and removing any bone fragments compressing the spinal cord. However, these procedures do not address the potential for the cord to swell up against the relatively inelastic dura mater. Duraplasty and surgical expansion of the dura may allow the spinal cord to swell beyond the normal dural restrictions, and thus reduce or eliminate ITP elevation. This study will use a clinically relevant sheep model of contusion SCI to investigate the effect of duraplasty on ITP, edema, and tissue survival following traumatic SCI. This new large animal model will be an important preclinical tool, and due to its scale will provide experimental results most likely to be translatable to the clinical environment. The multidisciplinary approach combining expertise in neuroscience, biomedical engineering, and neurosurgery, will provide an excellent understanding of the scientific field, rigorous research design and application, expert engineered experimental modelling, and surgical, monitoring and imaging techniques that are clinically relevant and readily translatable.
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