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Charles H. Tator and Michael G. Fehlings

Additional measures are also required that theoretically could include measures to expand blood volume to counteract the decline in cardiac output or could improve local microcirculation in the cord by counteracting effects such as vasospasm. Posttraumatic SCBF has been improved by a variety of agents including blood transfusion and dopamine, 32 and the combinations of adrenaline and nimodipine 64 or dextran and nimodipine, 47 with the latter combination also producing functional improvement. It is noteworthy that Hardy, et al. , 71 were able to restore

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Gwen Schwartz and Michael G. Fehlings

intraperitoneally through a 0.22-µm sterilizing filter with a 25-gauge 5/8 needle in 0.2 M PBS: 140 mM NaCl, 20 mM Na 2 HPO 4 , pH 7.4. This was performed in a random and blinded fashion. The PBS was used as a vehicle to ensure that the drug solutions retained their pH characteristics after intraperitoneal administration. The volume of PBS vehicle added to the drugs varied depending on weight/volume ratios. In all cases, the injectable volume was 0.6 ml. The concentrations of the drugs were adjusted so that an equal volume of drug was given according to weight (1:1). Riluzole

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Julio C. Furlan and Michael G. Fehlings

pallidus medullary areas, are deemed to be critical in the modulation of the cardiovascular response to various stimuli. 47 , 82 , 89 In addition to the activity of the dorsomedial hypothalamus neurons, the inputs of the paraventricular nucleus neurons, adjacent to the third ventricle, in the hypothalamus are of great importance for cardiovascular regulation. 22 The vagus nerve (cranial nerve X), which is the afferent pathway to the brain for atrial volume receptors, has its first synapse in the nucleus tractus solitarius of the medulla oblongata. 59 Inputs from the

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Henry Ahn and Michael G. Fehlings

above 80 mm Hg. In the setting of underlying spinal cord compression or another pathological entity, which renders the cord at risk for ischemia, we strongly advocate maintenance of spinal cord perfusion through the prevention of hypotension during induction, intraoperatively, and potentially postoperatively. This may require volume resuscitation using crystalloid, maintenance of a normal hematocrit (> 32%), and vasopressors such as dopamine, followed by levophed if needed. Epinephrine should be avoided as it exerts its effects only on the alpha-receptors, and can

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Michael G. Fehlings and Charles H. Tator

spinal cord injury: outcome of surgical and nonsurgical management. Mayo Clin Proc 65 : 949 – 959 , 1990 Murphy KP, Opitz JL, Cabanela ME, et al: Cervical fractures and spinal cord injury: outcome of surgical and nonsurgical management. Mayo Clin Proc 65: 949–959, 1990 74. Noyes DH , Bresnahan JC : Correlation between spinal cord lesion volume and impact parameters. Proc Biophys Soc 33 : H12 , 1981 (Abstract) Noyes DH, Bresnahan JC: Correlation between spinal cord lesion volume and impact parameters. Proc

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Michael G. Fehlings, Charles H. Tator and R. Dean Linden

. Nimodipine was supplied as a 0.02% stock solution in a polyethylene glycol, ethanol, and water diluent. The stock solution was diluted with placebo (diluent alone) to obtain the appropriate concentrations of nimodipine. The infusion syringes were protected from light with aluminum foil, and a sodium vapor lamp was used during dilution and delivery of the drug due to the photosensitivity of nimodipine to normal light. 40 Two Harvard infusion pumps were used to deliver a fixed volume of drug at a constant rate over 1 hour via separate femoral venous access sites: one pump

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Michael G. Fehlings and Jefferson R. Wilson

impact on long-term SCI outcomes. This recognition has sparked an increase in the breadth and volume of preclinical SCI research, leading to the development of a number of promising therapies with significant appeal for translation into the clinic. From the pharmacological side, these therapies include drugs such as the anti-Rho agent Cethrin, the sodium channel–blocking riluzole, and the antiinflammatory minocycline, all of which have shown substantial preclinical efficacy and are currently in the preliminary phases of clinical study. 4 , 8 Transplantation of a

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Michael G. Fehlings and Reza Mobasheri

evaluate interbody fusion following the use of titanium interbody cages and transpedicular instrumentation . Eur Spine J 12 : 378 – 385 , 2003 14 Takahata M , Ito M , Abe Y , Abumi K , Minami A : The effect of anti-resorptive therapies on bone graft healing in an ovariectomized rat spinal arthrodesis model . Bone 43 : 1057 – 1066 , 2008 15 Xue Q , Li H , Zou X , Bünger M , Egund N , Lind M , : The influence of alendronate treatment and bone graft volume on posterior lateral spine fusion in a porcine model . Spine 30 : 1116

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Michael G. Fehlings, Charles H. Tator and R. Dean Linden

recorded from these five normal rats were abolished in all five following cord transection at T-1, thus ruling out the possibility of a volume-conducted signal or stimulus-related artifact ( Fig. 2 ). Fig. 2. The superimposed motor evoked potential (MEP, left ) and somatosensory evoked potential (SSEP, right ) responses from five normal rats (upper) and the respective mean waveforms (center) are shown. Following a complete cord transection at T-1, both the MEP and SSEP responses were abolished (lower) in all five animals. Under halothane anesthesia

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Aria Nouri, Allan R. Martin, David Mikulis and Michael G. Fehlings

severity of impairment in patients with DCM. 5 , 78 , 119 , 120 Geometrical measurement of T2WI hyperintensity can include measuring the area on sagittal (or axial) images, the rostrocaudal sagittal extent, or the volume of signal change (across slices). Most research to date has focused on the number of vertebral levels that the T2WI hyperintensity spans 103 or differentiating between focal or multisegmental changes. 7 , 18 , 60 , 121 The length of the sagittal extent, 5 , 78 , 119 which offers the advantage of obtaining an objective value, was also described more