title: Nitric Oxide Metabolite Concentration in Cerebrospinal Fluid: Useful as a Prognostic Marker?
abstract: METHODS
  Prospective study.
  
  
  OBJECTIVE
  To establish the significance of cerebrospinal fluid (CSF) nitric oxide metabolite (NOx) concentration in acute spinal cord injury (SCI) patients to assess the neurological severity and prognosis.
  
  
  BACKGROUND
  Quantitative analysis of specific biomarkers in CSF will assess neurological severity more accurately and permit the formulation of a more precise management plan.
  
  
  METHODS
  Forty SCI patients represented the cases and 20 lower limb injury patients were the controls. NOx concentration in CSF was measured at week 1, 2, and 4 by Griess method. Magnetic resonance imaging (MRI, T2-weighted) done in each case to measure cord edema and neurological severity was assessed using the Frankel classification.
  
  
  RESULTS
  CSF NOx concentration peaked at week 2 and declined to normal by week 4. The concentration remained normal in controls. Mean NOx concentration was directly proportional to the severity of acute SCI as correlated with cord edema seen in MRI and neurological severity assessed.
  
  
  CONCLUSIONS
  CSF NOx concentration can be considered a specific quantitative biomarker in acute stage of SCI to predict the severity and prognosis of SCI patients.
authors: Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors: Saurabh
authors: S
authors: Singh
authors: Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors: Jyoti
authors: J
authors: Prakash
authors: Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors: Rakesh
authors: R
authors: Singh
authors: Department of Radiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors: Ashish
authors: A
authors: Verma
authors: Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors: Hemant
authors: H
authors: Bansal
keywords: Cerebrospinal fluid; Cord edema; Magnetic resonance imaging; Neurological severity; Nitric oxide; Recovery