Recent findings from the ISCoPe study indicate that, after severe contusion to the spinal cord, edema originating in the spinal cord accumulates and compresses the tissue against the surrounding dura mater, despite decompressive laminectomy. It is hypothesized that this compression results in restricted flow of cerebrospinal fluid (CSF) in the subarachnoid space and central canal and ultimately collapses local vasculature, exacerbating ischemia and secondary injury. Here we developed a surgically mounted osmotic transport device (OTD) that rests on the dura and can osmotically remove excess fluid at the injury site. Tests were performed in 4-h studies immediately following severe (250 kD) contusion at T8 in rats using the OTD. A 3-h treatment with the OTD after 1-h post injury significantly reduced spinal cord edema compared to injured controls. A first approximation mathematical interpretation implies that this modest reduction in edema may be significant enough to relieve compression of local vasculature and restore flow of CSF in the region. In addition, we determined the progression of edema up to 28 days after insult in the rat for the same injury model. Results showed peak edema at 72 h. These preliminary results suggest that incorporating the OTD to operate continuously at the site of injury throughout the critical period of edema progression, the device may significantly improve recovery following contusion spinal cord injury.

中文翻译：

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植入式渗透转运装置可减轻严重挫伤脊髓损伤后的水肿

ISCoPe 研究的最新发现表明，在脊髓严重挫伤后，尽管进行了椎板切除术，但起源于脊髓的水肿会积聚并压迫周围的硬脑膜组织。据推测，这种压迫会导致蛛网膜下腔和中央管中脑脊液 (CSF) 的流动受限，并最终使局部脉管系统塌陷，加剧缺血和继发性损伤。在这里，我们开发了一种手术安装的渗透转运装置 (OTD)，它位于硬脑膜上，可以渗透去除损伤部位的多余液体。使用 OTD 在大鼠 T8 处发生严重 (250 kD) 挫伤后立即在 4 小时研究中进行测试。与受伤的对照组相比，受伤后 1 小时后用 OTD 治疗 3 小时可显着减少脊髓水肿。第一近似数学解释意味着水肿的这种适度减少可能足以减轻局部脉管系统的压迫并恢复该区域的脑脊液流动。此外，对于相同的损伤模型，我们确定了大鼠在侮辱后长达 28 天的水肿进展。结果显示在 72 小时出现峰值水肿。这些初步结果表明，在整个水肿进展的关键时期，结合 OTD 在损伤部位连续运行，该装置可以显着改善挫伤脊髓损伤后的恢复。对于相同的损伤模型，我们确定了大鼠在侮辱后长达 28 天的水肿进展。结果显示在 72 小时出现峰值水肿。这些初步结果表明，在整个水肿进展的关键时期，结合 OTD 在损伤部位连续运行，该装置可以显着改善挫伤脊髓损伤后的恢复。对于相同的损伤模型，我们确定了大鼠在侮辱后长达 28 天的水肿进展。结果显示在 72 小时出现峰值水肿。这些初步结果表明，在整个水肿进展的关键时期，结合 OTD 在损伤部位连续运行，该装置可以显着改善挫伤脊髓损伤后的恢复。