Effects of hyperbaric oxygen therapy on long-tract neuronal conduction in the acute phase of spinal cord injury

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  • 1 Division of Neurosurgery, F. G. Hall Hyperbaric Laboratory, Duke University Medical Center, Durham, North Carolina
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✓ To study the acute effects of hyperbaric oxygen ventilation (HBO) on long-tract function following spinal cord trauma, the authors employed a technique for monitoring spinal cord evoked potentials (SCEP) as an objective measure of translesion neuronal conduction in cats subjected to transdural impact injuries of the spinal cord. Control animals subjected to injuries of a magnitude of 400 or 500 gm-cm occasionally demonstrated spontaneous return of translesion SCEP within 2 hours of injury when maintained by pentobarbital anesthesia and by ventilation with ambient room air at 1 atmosphere absolute pressure (1 ATA). Animals sustaining corresponding injuries but receiving immediate treatment with HBO at 2 ATA for a period of 3 hours following impact demonstrated variable responses to this treatment modality. Animals sustaining injuries of 400 gm-cm magnitude showed recovery of translesion SCEP in four of five cases, while animals sustaining injuries of 500 gm-cm magnitude responded to HBO treatment by recovery of SCEP no more frequently than did control animals. When the onset of HBO therapy was delayed by 2 hours following impact, there appeared to be no demonstrable protective effect on long-tract neuronal conduction mediated by HBO alone.

The observations suggest that HBO treatments can mediate preservation of marginally injured neuronal elements of the spinal cord long tracts during the early phases of traumatic spinal cord injury. These protective effects may be based upon the reversal of focal tissue hypoxia, or by reduction of tissue edema, or possibly by both of these mechanisms. Increasing magnitudes of impact force and delay in the onset of HBO treatment markedly diminished the protective effects of HBO on long-tract neuronal conduction following traumatic spinal cord injury.

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  • 1.

    Allen AR: Surgery of experimental lesion of spinal cord equivalent to crush injury of fracture dislocation of spinal column. JAMA 57:878880, 1911 Allen AR: Surgery of experimental lesion of spinal cord equivalent to crush injury of fracture dislocation of spinal column. JAMA 57:878–880, 1911

    • Search Google Scholar
    • Export Citation
  • 2.

    Anderson DK, , Means ED, & Waters TR, et al: Spinal cord energy metabolism following compression trauma to the feline spinal cord. J Neurosurg 53:375380, 1980 Anderson DK, Means ED, Waters TR, et al: Spinal cord energy metabolism following compression trauma to the feline spinal cord. J Neurosurg 53:375–380, 1980

    • Search Google Scholar
    • Export Citation
  • 3.

    Balentine JD: Pathology of experimental spinal cord trauma. I. The necrotic lesion as a function of vascular injury. Lab Invest 39:236253, 1978 Balentine JD: Pathology of experimental spinal cord trauma. I. The necrotic lesion as a function of vascular injury. Lab Invest 39:236–253, 1978

    • Search Google Scholar
    • Export Citation
  • 4.

    Balentine JD: Pathology of experimental spinal cord trauma. II. Ultrastructure of axons and myelin. Lab Invest 39:254266, 1978 Balentine JD: Pathology of experimental spinal cord trauma. II. Ultrastructure of axons and myelin. Lab Invest 39:254–266, 1978

    • Search Google Scholar
    • Export Citation
  • 5.

    Bingham WG, , Goldman H, & Friedman SJ, et al: Blood flow in normal and injured monkey spinal cord. J Neurosurg 43:162171, 1975 Bingham WG, Goldman H, Friedman SJ, et al: Blood flow in normal and injured monkey spinal cord. J Neurosurg 43:162–171, 1975

    • Search Google Scholar
    • Export Citation
  • 6.

    Campbell JB, , DeCrescito V, & Tomasula JJ, et al: Experimental treatment of spinal cord contusion in the cat. Surg Neurol 1:102106, 1973 Campbell JB, DeCrescito V, Tomasula JJ, et al: Experimental treatment of spinal cord contusion in the cat. Surg Neurol 1:102–106, 1973

    • Search Google Scholar
    • Export Citation
  • 7.

    Cracco RQ, & Evans B: Spinal evoked potential in the cat: effects of asphyxia, strychnine, cord section and compression. Electroencephalogr Clin Neurophysiol 44:187201, 1978 Cracco RQ, Evans B: Spinal evoked potential in the cat: effects of asphyxia, strychnine, cord section and compression. Electroencephalogr Clin Neurophysiol 44:187–201, 1978

    • Search Google Scholar
    • Export Citation
  • 8.

    De Jesus-Greenberg DA: Acute spinal cord injury and hyperbaric oxygen therapy: a new adjunct in management. J Neurosurg Nurs 12:155160, 1980 De Jesus-Greenberg DA: Acute spinal cord injury and hyperbaric oxygen therapy: a new adjunct in management. J Neurosurg Nurs 12:155–160, 1980

    • Search Google Scholar
    • Export Citation
  • 9.

    Dohrmann GJ, , Wagner FC Jr, & Bucy PC: Transitory traumatic paraplegia. Electron microscopy of early alterations in myelinated nerve fibers. J Neurosurg 36:407415, 1972 Dohrmann GJ, Wagner FC Jr, Bucy PC: Transitory traumatic paraplegia. Electron microscopy of early alterations in myelinated nerve fibers. J Neurosurg 36:407–415, 1972

    • Search Google Scholar
    • Export Citation
  • 10.

    Green BA, & Wagner FC Jr: Evolution of edema in the acutely injured spinal cord: a fluorescence microscopic study. Surg Neurol 1:98101, 1973 Green BA, Wagner FC Jr: Evolution of edema in the acutely injured spinal cord: a fluorescence microscopic study. Surg Neurol 1:98–101, 1973

    • Search Google Scholar
    • Export Citation
  • 11.

    Griffiths IR, , Trench JG, & Crawford RA: Spinal cord blood flow and conduction during experimental cord compression in normotensive and hypotensive dogs. J Neurosurg 50:353360, 1979 Griffiths IR, Trench JG, Crawford RA: Spinal cord blood flow and conduction during experimental cord compression in normotensive and hypotensive dogs. J Neurosurg 50:353–360, 1979

    • Search Google Scholar
    • Export Citation
  • 12.

    Hartzog JT, , Fisher RG, & Snow C: Spinal cord trauma: effect of hyperbaric oxygen therapy. Proc Veterans Adm Spinal Cord Inj Conf 17:7071, 1969 Hartzog JT, Fisher RG, Snow C: Spinal cord trauma: effect of hyperbaric oxygen therapy. Proc Veterans Adm Spinal Cord Inj Conf 17:70–71, 1969

    • Search Google Scholar
    • Export Citation
  • 13.

    Holbach KH, , Wassmann H, & Hohenlüchter KL, et al: Clinical course of spinal lesions treated with hyperbaric oxygenation (HO). Acta Neurochir 31:297298, 1975 Holbach KH, Wassmann H, Hohenlüchter KL, et al: Clinical course of spinal lesions treated with hyperbaric oxygenation (HO). Acta Neurochir 31:297–298, 1975

    • Search Google Scholar
    • Export Citation
  • 14.

    Hukuda S, , Mochizuki T, & Ogata M: Effects of hypertension and hypercarbia on spinal cord tissue oxygen in acute experimental spinal cord injury. Neurosurgery 6:639643, 1980 Hukuda S, Mochizuki T, Ogata M: Effects of hypertension and hypercarbia on spinal cord tissue oxygen in acute experimental spinal cord injury. Neurosurgery 6:639–643, 1980

    • Search Google Scholar
    • Export Citation
  • 15.

    Jones RF, , Unsworth IP, & Marosszeky JE: Hyperbaric oxygen and acute spinal cord injuries in humans. Med J Aust 2:573575, 1978 Jones RF, Unsworth IP, Marosszeky JE: Hyperbaric oxygen and acute spinal cord injuries in humans. Med J Aust 2:573–575, 1978

    • Search Google Scholar
    • Export Citation
  • 16.

    Kelly DL Jr, , Lassiter KRL, & Calogero JA, et al: Effects of local hypothermia and tissue oxygen studies in experimental paraplegia. J Neurosurg 33:554563, 1970 Kelly DL Jr, Lassiter KRL, Calogero JA, et al: Effects of local hypothermia and tissue oxygen studies in experimental paraplegia. J Neurosurg 33:554–563, 1970

    • Search Google Scholar
    • Export Citation
  • 17.

    Kelly DL Jr, , Lassiter KRL, & Vongsvivut A, et al: Effects of hyperbaric oxygenation and tissue oxygen studies in experimental paraplegia. J Neurosurg 36:425429, 1972 Kelly DL Jr, Lassiter KRL, Vongsvivut A, et al: Effects of hyperbaric oxygenation and tissue oxygen studies in experimental paraplegia. J Neurosurg 36:425–429, 1972

    • Search Google Scholar
    • Export Citation
  • 18.

    Kobrine AI, , Evans DE, & Rizzoli HV: The effects of ischemia on long-tract neural conduction in the spinal cord. J Neurosurg 50:639644, 1979 Kobrine AI, Evans DE, Rizzoli HV: The effects of ischemia on long-tract neural conduction in the spinal cord. J Neurosurg 50:639–644, 1979

    • Search Google Scholar
    • Export Citation
  • 19.

    Kobrine AI, , Evans DE, & Rizzoli HV: Effects of progressive hypoxia on long tract neural conduction in the spinal cord. Neurosurgery 7:369375, 1980 Kobrine AI, Evans DE, Rizzoli HV: Effects of progressive hypoxia on long tract neural conduction in the spinal cord. Neurosurgery 7:369–375, 1980

    • Search Google Scholar
    • Export Citation
  • 20.

    Kobrine AI, , Evans DE, & Rizzoli HV: Experimental acute balloon compression of the spinal cord. Factors affecting disappearance and return of the spinal evoked response. J Neurosurg 51:841845, 1979 Kobrine AI, Evans DE, Rizzoli HV: Experimental acute balloon compression of the spinal cord. Factors affecting disappearance and return of the spinal evoked response. J Neurosurg 51:841–845, 1979

    • Search Google Scholar
    • Export Citation
  • 21.

    Maeda N: Experimental studies on the effect of decompression procedures and hyperbaric oxygenation for the treatment of spinal cord injury. J Nara Med Assoc 16:429447, 1965 Maeda N: Experimental studies on the effect of decompression procedures and hyperbaric oxygenation for the treatment of spinal cord injury. J Nara Med Assoc 16:429–447, 1965

    • Search Google Scholar
    • Export Citation
  • 22.

    Mullen JB, , Higgins AC, & Pearlstein R: Effects of hyper-baric oxygen on the evoked electrospinogram in experimental spinal cord contusion: preliminary report. Surg Forum 31:458461, 1980 Mullen JB, Higgins AC, Pearlstein R: Effects of hyper-baric oxygen on the evoked electrospinogram in experimental spinal cord contusion: preliminary report. Surg Forum 31:458–461, 1980

    • Search Google Scholar
    • Export Citation
  • 23.

    Osterholm JL: The pathophysiological response to spinal cord injury. The current status of related research. J Neurosurg 40:533, 1974 Osterholm JL: The pathophysiological response to spinal cord injury. The current status of related research. J Neurosurg 40:5–33, 1974

    • Search Google Scholar
    • Export Citation
  • 24.

    Senter HJ: Spinal cord blood flow in experimental spinal cord trauma, in Marguth F, , Brock M, & Kazner E, et al (eds): Neurovascular Surgery. Specialized Neurosurgical Techniques. Advances in Neurosurgery, Vol 7. Berlin/Heidelberg/New York: Springer-Verlag, 1979, pp 245280 Senter HJ: Spinal cord blood flow in experimental spinal cord trauma, in Marguth F, Brock M, Kazner E, et al (eds): Neurovascular Surgery. Specialized Neurosurgical Techniques. Advances in Neurosurgery, Vol 7. Berlin/Heidelberg/New York: Springer-Verlag, 1979, pp 245–280

    • Search Google Scholar
    • Export Citation
  • 25.

    Sukoff MH, , Hollin SA, & Espinosa OE, et al: The protective effect of hyperbaric oxygenation in experimental cerebral edema. J Neurosurg 29:236241, 1968 Sukoff MH, Hollin SA, Espinosa OE, et al: The protective effect of hyperbaric oxygenation in experimental cerebral edema. J Neurosurg 29:236–241, 1968

    • Search Google Scholar
    • Export Citation
  • 26.

    Wagner FC Jr, , Dohrmann GJ, & Bucy PC: Histopathology of transitory traumatic paraplegia in the monkey. J Neurosurg 35:272276, 1971 Wagner FC Jr, Dohrmann GJ, Bucy PC: Histopathology of transitory traumatic paraplegia in the monkey. J Neurosurg 35:272–276, 1971

    • Search Google Scholar
    • Export Citation
  • 27.

    Yeo JD, , Lowry C, & McKenzie B: Preliminary report on ten patients with spinal cord injuries treated with hyperbaric oxygen. Med J Aust 2:572573, 1978 Yeo JD, Lowry C, McKenzie B: Preliminary report on ten patients with spinal cord injuries treated with hyperbaric oxygen. Med J Aust 2:572–573, 1978

    • Search Google Scholar
    • Export Citation
  • 28.

    Yeo JD, , Stabback S, & McKenzie B: Experimental spinal cord injury, in Proceedings of the 6th International Congress on Hyperbaric Medicine, 1977, pp 223232 Yeo JD, Stabback S, McKenzie B: Experimental spinal cord injury, in Proceedings of the 6th International Congress on Hyperbaric Medicine, 1977, pp 223–232

    • Search Google Scholar
    • Export Citation
  • 29.

    Yeo JD, , Stabback S, & McKenzie B: A study of the effects of hyperbaric oxygen on the experimental spinal cord injury. Med J Aust 2:145147, 1977 Yeo JD, Stabback S, McKenzie B: A study of the effects of hyperbaric oxygen on the experimental spinal cord injury. Med J Aust 2:145–147, 1977

    • Search Google Scholar
    • Export Citation

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