Early neurosurgery for spinal cord contusions before and after

来源 :第三届国际神经再生高峰论坛暨第五届脊髓损伤治疗与临床试验国际交流会(INRS2013 & 5th ISCITT) | 被引量 : 0次 | 上传用户:youyanma
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  A.Before Spinal cord contusion is characterized by partial damage of the spinal cord,sparing particularly the nerve fibers joining the spinal segments proximal and distal to the injury site.Primary injury to the spinal cord induces a secondary injury that continuously expands until finally reaches a size many fold of the original injury.The logical treatment for spinal cord contusion should be debridement of the injury site at a relatively early stage,thereby virtually terminates further expansion of the injury.Meanwhile,the evacuated cavity will collapse,resulting in intramedullary decompression which provides a favorable environment for functional recovery of the spinal cord.Although I knew the pathological development of spinal cord contusion for years,why did I never think of this surgery? I was asked one day to help the Kunming Army General Hospital in transplantation of fetal Schwann cells for chronic spinal cord injury.I watched the operation and told them that there was little hope for the transplanted Schwann cells to pass across the wall of the cavity to get access to the spinal cord tissue.I asked them: "Why dont you do the operation at an earlier stage?" With this question,the idea of early neurosurgery for spinal cord contusion appeared in my mind.I then designed the operation together with Kunming Army General Hospital.The lesson I learned was: 1) if I hope to translate my work from bench to bedside,I must take the standpoint of a clinician.2) even though I write at the end of my paper that my findings may have clinical application,it seldom happened,if any at all."According to statistic analysis,from 1979-1983,the authors of 101 papers published in six top international journals of basic biological research (Science,Nature,Cell,J Biol Chem,J Exp Med,and J Clin Invst) claimed that their discoveries might have great potential for clinical application,.....Twenty years later,only one has an important impact on current medical practice".(Translated from Chen Zhu).
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