Supraspinal fiber outgrowth and apparent synaptic remodelling across transected-reconstructed feline spinal cord

Spinal cord separation: MRI evidence of healing after omentum–collagen reconstruction

INTRODUCTION

Animal experimentation has demonstrated that omental-collagen bridge reconstruction of a transected spinal cord in cats can result in the growth of axons crossing the transection site which resulted in the return of motor and sensory activity. This paper raises the possibility that a comparable spinal cord reconstruction model could be possible for human application.

METHODS

Cats had their spinal cord transected at the T-9 level. This led to a gap at the transection site that was filled with semi-liquid collagen, followed by omental transposition onto the underlying collagen bridge, which had subsequently hardened. A comparable technique was used on a patient who had, as reported by magnetic resonance imaging (MRI), a complete spinal cord transection at the T-6 level.

RESULTS

Reconstruction of a transected spinal cord in cats using an omental-collagen bridge resulted in axons that grew across the transection site at the rate of 1 mm/day. Several animals developed forelimb and hindlimb locomotion. The patient in this paper had omental-collagen reconstruction of her cord and has clinically progressed to the point where she can ambulate with the use of a walker. The patient had a spinal cord defect of 4 cm, which, with multiple MRI studies, has shown the longitudinal development of a spinal cord connection in the area of the omental-collagen bridge that connects the proximal and distal ends of the transected spinal cord.

CONCLUSION

This report suggests that a transected spinal cord has the ability to heal when the spinal cord separation is reconstructed using an omental-collagen bridge. This technique has led to neurological improvement.

The evolution of omentum transposition: from lymphedema to spinal cord, stroke and Alzheimer's disease

It is now well established that the omentum incorporates into its tissues a variety of biological factors that exert a favorable effect on the central nervous system. Physiological characteristics of the omentum include edema absorption, fibrotic inhibition, blood-brain barrier penetration and, of major importance, angiogenic activity. Over several decades, studies have shown increasing clinical uses of the omentum following its placement on various structures within the body. This paper details the evolution of omental transposition (OT) up to the present at which time OT is being applied to the brain of Alzheimer disease (AD) patients. Success in this area raises the possibility that the omentum may prove to be a present-day treatment for patients with AD until future pharmaceutical and/or genetic forms of treatment are developed.

An Appraisal of Ongoing Experimental Procedures in Human Spinal Cord Injury

Clinicians and scientists in the field of spinal cord injury research and medicine are poised to begin translating promising new experimental findings into treatments for people. Advances in experimental regeneration research have led to several transplantation strategies that promote axonal regrowth and partial functional recovery in animal models of injury. In this review, we summarize current knowledge regarding various invasive experimental treatments that have been or are now being applied clinically. Various questions about the timeliness, safety, and benefits of the procedures are under discussion within the spinal cord injury (SCI) research community. We also describe guidelines for carrying out optimal clinical trials and efforts to establish specific international guidelines to translate preclinical treatment strategies into clinical trials in SCI. The clinical trial process and the role that clinical professionals have in advising individuals regarding participation in experimental procedures also is discussed.

The neurochemical basis for the applications of the greater omentum in neurosurgery

The omentum has been utilized in neurosurgery for over 30 years. However, the anatomical and physiological bases for its applications have not been described in great detail. In this paper, we will review the current status of the omentum applications for the management of central nervous system disorders.

Coerulospinal fiber regeneration in transected feline spinal cord

After complete cat spinal cord transection, a collagen matrix was used to bridge the gap. Vascular supply was increased to the transection site with an omental pedicle. Before hardening, either 4-aminopyridine, laminin, glia maturation factor, or lipid angiogenic factor were mixed into the collagen. Surgically reconstructed animals were compared to transection-only controls and observed for 90 days. Fluoro-Gold was injected distal to the transection site on day 75. Immunocytochemical examination of brain and spinal cord tissue was done on day 90. Examination revealed supraspinal catecholaminergic fibers present in the collagen bridge and distal cord tissue only in cats with surgical reconstruction. Fluoro-Gold particles were found localized in locus coeruleus and other noradrenergic pontine neurons. Distal to the transection, double immunostaining with synaptophysin and tyrosine hydroxylase or dopamine-beta-hydroxylase revealed dot-like deposits closely apposed to preganglionic sympathetic neurons suggestive of synaptic connectivity to these targets. Results indicate that considerable outgrowth of specific supraspinal fibers can be induced following spinal transection and reconstruction, and that such fibers may be extending and contacting appropriate distal target tissue in the cord.