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Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury: a prospective self-controlled study

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收录情况: ◇ SCIE ◇ 统计源期刊 ◇ CSCD-C ◇ 卓越:梯队期刊

机构: [1]Kunming International Spine and Spinal Cord Injury Treatment Center, Kunming Tongren Hospital, Kunming, Yunnan Province, China [2]Clinical Center for Spinal Cord Injury, Kunming General Hospital of Chengdu Military Command, Kunming, Yunnan Province, China [3]Department of Laboratory Animal Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai, China [4]Department of Ophthalmology and State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administration Region, China [5]Guangdong-Hongkong-Macau Institute for Central Nervous System Regeneration, Jinan University, Guangzhou, Guangdong Province, China [6]Re-Stem Biotechnology, Co., Ltd., Suzhou, Jiangsu Province, China [7]Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA [8]Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
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Although a large number of trials in the SCI field have been conducted, few proven gains have been realized for patients. In the present study, we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord injury (SCI) subjects clinically diagnosed as complete or American Spinal Injury Association Impairment Scale (AIS) Class A (AIS-A). A total of 320 clinically complete SCI subjects (271 male and 49 female), aged 16-60 years, received early (<= 7 days, n = 201) or delayed (8-30 days, n = 119) surgical interventions to reduce intraspinal or intramedullary pressure. Fifteen days post-surgery, all subjects received a weight-bearing walking training with the "Kunming Locomotion Training Program (KLTP)" for a duration of 6 months. The neurological deficit and recovery were assessed using the AIS scale and a 10-point Kunming Locomotor Scale (KLS). We found that surgical intervention significantly improved AIS scores measured at 15 days post-surgery as compared to the pre-surgery baseline scores. Significant improvement of AIS scores was detected at 3 and 6 months and the KLS further showed significant improvements between all pair-wise comparisons of time points of 15 days, 3 or 6 months indicating continued improvement in walking scores during the 6-month period. In conclusion, combining surgical intervention within 1 month post-injury and weight-bearing locomotor training promoted continued and statistically significant neurological recoveries in subjects with clinically complete SCI, which generally shows little clinical recovery within the first year after injury and most are permanently disabled. This study was approved by the Science and Research Committee of Kunming General Hospital of PLA and Kunming Tongren Hospital, China and registered at ClinicalTrials.gov (Identifier: NCT04034108) on July 26, 2019.

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 2 区 细胞生物学 2 区 神经科学
最新[2023]版:
大类 | 2 区 医学
小类 | 3 区 细胞生物学 3 区 神经科学
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出版当年[2020]版:
Q2 CELL BIOLOGY Q2 NEUROSCIENCES
最新[2023]版:
Q1 NEUROSCIENCES Q2 CELL BIOLOGY

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第一作者机构: [1]Kunming International Spine and Spinal Cord Injury Treatment Center, Kunming Tongren Hospital, Kunming, Yunnan Province, China [2]Clinical Center for Spinal Cord Injury, Kunming General Hospital of Chengdu Military Command, Kunming, Yunnan Province, China
通讯作者:
通讯机构: [1]Kunming International Spine and Spinal Cord Injury Treatment Center, Kunming Tongren Hospital, Kunming, Yunnan Province, China [2]Clinical Center for Spinal Cord Injury, Kunming General Hospital of Chengdu Military Command, Kunming, Yunnan Province, China
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