New therapeutic avenues in severe SCI cases

Introduction

In dogs the greatest concern regarding severe spinal cord injury is with thoracolumbar cases; those with severe cervical lesions usually die or are euthanased soon after diagnosis. Dogs with milder thoracolumbar lesions – i.e. those that retain ‘deep pain’ perception have a good prognosis – even those that have sustained fracture-luxations. The difficulties lie with those that are ‘deep pain negative’. For disc-associated cases that lose ‘deep pain perception’ there are various estimates of recovery rate (to walk again) ranging from ~40-85%.¹ Estimates of recovery rates for dogs that are similarly-affected following fractureluxation are hard to come by (very few cases have long-term follow-up) but are often thought to be hopeless and so rarely get surgery or appropriate follow-up. These recovery rates have not changed appreciably over the past 30-40 years, despite improvements in imaging, perhaps because methods of management have not changed either.

There is therefore a clear need to investigate new methods that might improve outcome. About 25 years ago there was optimism that methylprednisolone sodium succinate might provide a superior outcome after acute spinal cord injury,² but this promise has since dissipated, mainly because alternative explanations for the apparent beneficial results in human patients emerged.³ There has been a great deal of research on acute spinal cord injury during the past 30 years but, unfortunately, effective translatable therapeutic interventions have not, so far, been identified. [...]