Metabolites Offer Prognostic Tool in Spinal Cord Injury

Nitric oxide metabolites in the cerebrospinal fluid correlate with injury severity and motor recovery

THURSDAY, Aug. 20 (HealthDay News) -- The concentration of nitric oxide metabolites in the cerebrospinal fluid (CSF [NOx]) of people with spinal cord injury correlates to the severity of their injury and is a predictor of neurologic recovery, according to a study reported in the Aug. 15 issue of Spine.

Shinji Kimura, M.D., of Niigata University Medical and Dental Hospital in Japan, and colleagues monitored levels of CSF [NOx] in 96 patients with spinal cord injury, including 76 with incomplete cervical cord injury and 20 with thoracic cord injury, as well as an injury-free control group of 40 subjects. Over a mean follow-up of 11 months, severity of neurologic impairment and degree of recovery were assessed using Frankel's classification and the American Spinal Injury Association motor score.

The researchers found that at initial exam, levels of CSF [NOx] did not differ significantly among the cervical cord injury, thoracic cord injury, or control groups. At five to 14 days, the CSF [NOx) in the Frankel A and B classes were significantly higher in the cervical cord injury group than in the control group. Also, in the cervical cord injury group at five to 14 days, CSF [NOx] correlated significantly with motor score and neurologic recovery.

"The present study indicates that [NOx] at the early subacute stage (approximately five to 14 days) after trauma significantly correlates with neurologic recovery in cervical cord injury, although this correlation was not observed in every cervical cord injury case. Therefore, the [NOx] at five to 14 days after spinal cord injury is a possible quantitative predictor for neurologic recovery in cervical cord injury," the authors write.

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