Spinal cord separation: MRI evidence of healing after omentum-collagen reconstruction.
BACKGROUND
Animal experimentation has demonstrated that omental-collagen bridge reconstruction of a transected spinal cord in cats can result in the growth of axons crossing the transection site which resulted in the return of motor and sensory activity. This paper raises the possibility that a comparable spinal cord reconstruction model could be possible for human application.


METHODS
Cats had their spinal cord transected at the T-9 level. This led to a gap at the transection site that was filled with semi-liquid collagen, followed by omental transposition onto the underlying collagen bridge, which had subsequently hardened. A comparable technique was used on a patient who had, as reported by magnetic resonance imaging (MRI), a complete spinal cord transection at the T-6 level.


RESULTS
Reconstruction of a transected spinal cord in cats using an omental-collagen bridge resulted in axons that grew across the transection site at the rate of 1 mm/day. Several animals developed forelimb and hindlimb locomotion. The patient in this paper had omental-collagen reconstruction of her cord and has clinically progressed to the point where she can ambulate with the use of a walker. The patient had a spinal cord defect of 4 cm, which, with multiple MRI studies, has shown the longitudinal development of a spinal cord connection in the area of the omental-collagen bridge that connects the proximal and distal ends of the transected spinal cord.


CONCLUSIONS
This report suggests that a transected spinal cord has the ability to heal when the spinal cord separation is reconstructed using an omental-collagen bridge. This technique has led to neurological improvement.
Goldsmith
Harry S
HS
University of Nevada School of Medicine, PO Box 493, Glenbrook, NV 89413, USA. hlgldsmith@aol.com
Fonseca
Arnie
A
Porter
John
J
D020341:Absorbable Implants; D000328:Adult; D000818:Animals; D002415:Cats; D003094:Collagen / Q000494:pharmacology / Q000627:therapeutic use*; D004195:Disease Models, Animal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009416:Nerve Regeneration / Q000187:drug effects* / Q000502:physiology; D009852:Omentum / Q000637:transplantation; D011182:Postoperative Care / Q000379:methods; D013119:Spinal Cord Injuries / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
D003094:Collagen