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Researchers identify a key factor that influences spinal cord surgery success.
Posted On: February 17, 2016
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Patients with cervical spondolytic myelopathy can experience a wide range of symptoms from mild neck pain and numbness in the hands to difficulty standing.
Cervical spondolytic myelopathy (CSM) is the leading cause of spinal cord injury in individuals over the age of 55. It occurs when the spinal cord becomes compressed due to chronic and progressive deterioration of the spine.
Surgery can alleviate some of the symptoms associated with CSM and improve the quality of life for patients with the disease. However, many patients continue to have residual neurological dysfunction despite surgery and operative intervention has a low but definite risk of neurological complications.
By using an experimental model of CSM, Krembil Senior Scientist Dr. Michael Fehlings and his team have been able to determine why decompression surgeries can sometimes lead to neurological decline.
They found that CSM post-surgery complications are partly caused by a rapid increase in blood flow, which occurs when the pressure on the spinal cord is removed. Administering riluzole—a drug that has been shown to protect the health of neurons—can protect the spine from injury after the surgery and reduce the risk of any additional neurological decline.
“Our report identifies a silent, and thus far unrecognized factor that may account for the rate of post-surgical complications in patients with CSM,” explains Dr. Fehlings. “Based on these findings, we have launched a large-scale North American clinical trial to determine whether riluzole can improve outcomes for patients with CSM following decompression surgery.”
This work was supported by the Cervical Spine Research Society, the Canadian Institutes of Health Research, the Gerry and Tootsie Halbert Regeneration Chair, AOSpine North America and the Toronto General & Western Hospital Foundation.
Riluzole blocks perioperative ischemia-reperfusion injury and enhances postdecompression outcomes in cervical spondylotic myelopathy. Karadimas SK, Laliberte AM, Tetreault L, Chung YS, Arnold P, Foltz WD, Fehlings MG. Science Translational Medicine. 2015 December 2 [Pubmed abstract]
Surgery can alleviate some of the symptoms associated with CSM and improve the quality of life for patients with the disease. However, many patients continue to have residual neurological dysfunction despite surgery and operative intervention has a low but definite risk of neurological complications.
By using an experimental model of CSM, Krembil Senior Scientist Dr. Michael Fehlings and his team have been able to determine why decompression surgeries can sometimes lead to neurological decline.
They found that CSM post-surgery complications are partly caused by a rapid increase in blood flow, which occurs when the pressure on the spinal cord is removed. Administering riluzole—a drug that has been shown to protect the health of neurons—can protect the spine from injury after the surgery and reduce the risk of any additional neurological decline.
“Our report identifies a silent, and thus far unrecognized factor that may account for the rate of post-surgical complications in patients with CSM,” explains Dr. Fehlings. “Based on these findings, we have launched a large-scale North American clinical trial to determine whether riluzole can improve outcomes for patients with CSM following decompression surgery.”
This work was supported by the Cervical Spine Research Society, the Canadian Institutes of Health Research, the Gerry and Tootsie Halbert Regeneration Chair, AOSpine North America and the Toronto General & Western Hospital Foundation.
Riluzole blocks perioperative ischemia-reperfusion injury and enhances postdecompression outcomes in cervical spondylotic myelopathy. Karadimas SK, Laliberte AM, Tetreault L, Chung YS, Arnold P, Foltz WD, Fehlings MG. Science Translational Medicine. 2015 December 2 [Pubmed abstract]