Analysis of The Sensitivity and Reproducibility Of The Basso, Beattie, Bresnahan (BBB) Scale in Wistar Rats

OBJECTIVE: To evaluate the sensitivity and reproducibility of the Basso, Beattie, Bresnahan functional scale in the assessment of the locomotor capacity of rats after spinal cord injury. METHODS: Thirty male Wistar rats underwent laminectomy and mild, moderate or severe spinal cord contusions using the New York University Weight Drop Impactor. The mice were followed for 28 days, after which time each rat was placed in an 80x80x30 cm³ clear box lined with a blue non-slippery material and stimulated to move. Their movement was video-recorded by three digital cameras operating simultaneously. Identical copies of the edited videos were given to six independent evaluators who were blinded with regards to the degree of injury severity. Each evaluator made a determination of the locomotor capacity of the rats using the Basso, Beattie, Bresnahan functional scale. RESULTS: We determined the sensitivity of the method to differences among the evaluators as well as between the results achieved on the left and right hind paws of rats subjected to either mild, moderate or severe injuries by comparing the functional outcomes and reproducibility using non-parametric correlation tests. CONCLUSIONS: The Basso, Beattie, Bresnahan scale showed high reproducibility and satisfactory sensitivity for identifying mild injuries; satisfactory reproducibility and non-satisfactory sensitivity for moderate injuries; and reduced reproducibility and non-satisfactory sensitivity for severe injuries

Effects of Methylprednisolone And Ganglioside GM-1 on a Spinal Lesion: A Functional Analysis

OBJECTIVES: The pharmacological effects of methylprednisolone (MP) and ganglioside GM-1 on spinal injuries have been thoroughly investigated, but only a few studies have evaluated the interaction between these two drugs. METHODS: Twenty-four Wistar rats were subjected to contusive injury of the spinal cord produced by the NYU system. These animals were divided into four groups: group I was injected with MP; group II was injected with GM-1; group III was injected with MP together with GM-1; and group control received physiological serum. The animals were evaluated with regard to their recovery of locomotive function by means of the BBB test on the second, seventh and fourteenth days after receiving the contusive injury to the spinal cord. They were sacrificed on the fourteenth day. RESULTS: This study demonstrated that the MP and GM-1 groups presented functional results that were better than those of the control group, although the enhanced recovery of group II (GM-1) relative to the control group was not statistically significant (p>0.05). The most notable recovery of locomotive function was observed in the group that received MP alone (p<0.05). The group that received MP together with GM-1 presented results that were better than those of the control group (p<0.05). CONCLUSION: Administration of methylprednisolone alone or with GM-1 was shown to be effective for recovery of locomotive function. Combined administration of these drugs resulted in better outcomes than administration of methylprednisolone alone

Predictive factors for perioperative blood transfusion in surgeries for correction of idiopathic, neuromuscular or congenital scoliosis

OBJECTIVE: To evaluate the association of clinical and demographic variables in patients requiring blood transfusion during elective surgery to treat scoliosis with the aim of identifying markers predictive of the need for blood transfusion. METHODS: Based on the review of medical charts at a public university hospital, this retrospective study evaluated whether the following variables were associated with the need for red blood cell transfusion (measured by the number of packs used) during scoliosis surgery: scoliotic angle, extent of arthrodesis (number of fused levels), sex of the patient, surgery duration and type of scoliosis (neuromuscular, congenital or idiopathic). RESULTS: Of the 94 patients evaluated in a 55-month period, none required a massive blood transfusion (most patients needed less than two red blood cell packs). The number of packs was not significantly associated with sex or type of scoliosis. The extent of arthrodesis (r = 0.103), surgery duration (r = 0.144) and scoliotic angle (r = 0.004) were weakly correlated with the need for blood transfusion. Linear regression analysis showed an association between the number of spine levels submitted to arthrodesis and the volume of blood used in transfusions (p = 0.001). CONCLUSION: This study did not reveal any evidence of a significant association between the need for red blood cell transfusion and scoliotic angle, sex or surgery duration in scoliosis correction surgery. Submission of more spinal levels to arthrodesis was associated with the use of a greater number of blood packs

Controlled medial branch anesthetic block in the diagnosis of chronic lumbar facet joint pain: the value of a three-month follow-up

OBJECTIVES: To verify the incidence of facetary and low back pain after a controlled medial branch anesthetic block in a three-month follow-up and to verify the correlation between the positive results and the demographic variables. METHODS: Patients with chronic lumbar pain underwent a sham blockade (with a saline injection) and then a controlled medial branch block. Their symptoms were evaluated before and after the sham injection and after the real controlled medial branch block; the symptoms were reevaluated after one day and one week, as well as after one, two and three months using the visual analog scale. We searched for an association between the positive results and the demographic characteristics of the patients. RESULTS: A total of 104 controlled medial branch blocks were performed and 54 patients (52%) demonstrated >;50% improvements in pain after the blockade. After three months, lumbar pain returned in only 18 individuals, with visual analogue scale scores >;4. Therefore, these patients were diagnosed with chronic facet low back pain. The three-months of follow-up after the controlled medial branch block excluded 36 patients (67%) with false positive results. The results of the controlled medial branch block were not correlated to sex, age, pain duration or work disability but were correlated with patient age (

Regeneração medular: a ação do neurotrophin-3 sobre a lesão medular de ratos

OBJECTIVE: For many years, it was believed that medullary regeneration could not occur, although currently there are many trials using neurotrophic factors, stem cells, fetal medulla grafts, peripheral nerve grafts, and antibodies against myelin-associated proteins that demonstrate the existence of the possibility of spinal cord regeneration. The purpose of this study was to investigate the action of neurotrophin-3, a novel neurotrophic factor. METHODS: The New York University impactor, a standardized device for delivery of spinal cord injuries was used on 33 rats, which were divided into 2 groups: a control group receiving distilled water intraperitoneally and a treatment group receiving neurotrophin-3 intraperitoneally. RESULTS: Using the Basso, Beattie, and Bresnahan scale, the locomotor recovery curve for the neurotrophin-3 treated group was superior to that of the control group (P < 0.05); the administration of neurotrophin-3 was associated with the absence of deaths, while the control group showed a 28.5% (P = 0.026) mortality rate. Other parameters (hematuria rate and histological analysis) showed no significant differences. CONCLUSIONS: Based on these results, it appears that a strong relationship exists between the use of neurotrophin-3 in rats with spinal cord injury and better functional recovery.OBJETIVO: Por muitos anos acreditou-se que a regeneração medular não fosse factível. Atualmente porém, existem várias experiências utilizando fatores neurotróficos, células troncos, enxerto de medula fetal, enxerto de nervo periférico e anticorpos contra proteínas associadas a mielina que sugerem o contrário. Esta pesquisa estudou a ação de um dos mais novos neurotróficos, o Neurotrophin-3. MÉTODOS: As lesões medulares foram realizadas através do New York University impator, método experimental de produção de lesão medular padronizada. Foram utilizados 33 ratos divididos em 2 grupos. Um grupo controle com administração intraperitoneal de água destilada e um grupo tratamento, tratado com Neurotrophin-3 por via intraperitoneal. RESULTADOS: Observamos que a curva de recuperação locomotora, segundo a escala de Basso, Beattie e Bresnahan, do grupo Neurotrophin-3 foi superior à do grupo controle (p < 0,05); a administração de Neurotrophin-3 determinou ausência de mortes no grupo tratamento, enquanto o grupo controle apresentou taxa de mortalidade de 28,5% (p = 0,026). Os outros parâmetros (taxa de hematúria e análise histológica) não apresentaram diferenças estatisticamente significantes. CONCLUSÕES: Existe forte relação entre a aplicação de Neurotrophin-3 em ratos com lesão medular e melhor recuperação funcional