{"title":"Effects of decompression surgery and erythropoietin combination on a rat model of compressive myelopathy.","authors":"Yuki Shiratani, Takeo Furuya, Yuki Nagashima, Yasunori Toki, Masataka Miura, Sho Okimatsu, Juntaro Maruyama, Kyota Kitagawa, Takaki Inoue, Atsushi Yunde, Satoshi Maki, Seiji Ohtori","doi":"10.1016/j.jos.2025.06.013","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Cervical spondylotic myelopathy (CSM) is a degenerative condition caused by spinal cord compression, leading to significant neurological impairments. While decompression surgery is the gold standard for treating CSM, recovery is often incomplete, prompting the need for adjunct therapies. Erythropoietin (EPO), widely used for anemia treatment, has shown beneficial effects on the nervous system. This study evaluates the combined effects of decompression surgery and EPO administration in a rat model of compressive myelopathy.</p><p><strong>Methods: </strong>We developed a rat model of compressive myelopathy using a gradually expanding polymer sheet at C4-C5 levels. Rats were divided into three groups: Control (sham surgery, weekly saline injections), Decompression (decompression surgery, weekly saline injections), and Decompression + EPO (decompression surgery, weekly EPO injections). Motor function, myelination, and axonal integrity were evaluated over eight weeks using Basso, Beattie, and Bresnahan (BBB) scores, grid runway tests, and histological analyses.</p><p><strong>Results: </strong>The decompression + EPO group exhibited significantly better motor function, with higher BBB scores and fewer hindlimb drops in grid runway tests compared to the Control group. Histological analyses revealed enhanced myelination in the corticospinal tract, as shown by Luxol Fast Blue (LFB) staining and myelin basic protein (MBP) staining, along with increased axonal growth marked by growth-associated protein 43 (GAP-43) expression.</p><p><strong>Conclusion: </strong>Combining decompression surgery with EPO administration significantly improved motor recovery and promoted spinal cord myelination in a rat model of compressive myelopathy. These findings suggest EPO as a promising adjunct to surgical treatment in CSM, warranting further clinical investigation.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jos.2025.06.013","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Cervical spondylotic myelopathy (CSM) is a degenerative condition caused by spinal cord compression, leading to significant neurological impairments. While decompression surgery is the gold standard for treating CSM, recovery is often incomplete, prompting the need for adjunct therapies. Erythropoietin (EPO), widely used for anemia treatment, has shown beneficial effects on the nervous system. This study evaluates the combined effects of decompression surgery and EPO administration in a rat model of compressive myelopathy.
Methods: We developed a rat model of compressive myelopathy using a gradually expanding polymer sheet at C4-C5 levels. Rats were divided into three groups: Control (sham surgery, weekly saline injections), Decompression (decompression surgery, weekly saline injections), and Decompression + EPO (decompression surgery, weekly EPO injections). Motor function, myelination, and axonal integrity were evaluated over eight weeks using Basso, Beattie, and Bresnahan (BBB) scores, grid runway tests, and histological analyses.
Results: The decompression + EPO group exhibited significantly better motor function, with higher BBB scores and fewer hindlimb drops in grid runway tests compared to the Control group. Histological analyses revealed enhanced myelination in the corticospinal tract, as shown by Luxol Fast Blue (LFB) staining and myelin basic protein (MBP) staining, along with increased axonal growth marked by growth-associated protein 43 (GAP-43) expression.
Conclusion: Combining decompression surgery with EPO administration significantly improved motor recovery and promoted spinal cord myelination in a rat model of compressive myelopathy. These findings suggest EPO as a promising adjunct to surgical treatment in CSM, warranting further clinical investigation.
脊髓型颈椎病（CSM）是一种由脊髓压迫引起的退行性疾病，导致严重的神经损伤。虽然减压手术是治疗脊髓型颈椎病的金标准，但恢复往往不完全，这促使需要辅助治疗。促红细胞生成素（EPO）广泛用于贫血治疗，对神经系统有良好的作用。本研究评估减压手术和EPO给药对压缩性脊髓病大鼠模型的联合作用。方法：我们在C4-C5水平使用逐渐扩大的聚合物片建立了大鼠压缩性脊髓病模型。将大鼠分为对照组（假手术，每周生理盐水注射）、减压组（减压手术，每周生理盐水注射）和减压+ EPO组（减压手术，每周EPO注射）。运动功能、髓鞘形成和轴突完整性在8周内通过Basso、Beattie和Bresnahan （BBB）评分、网格跑道测试和组织学分析进行评估。结果：与对照组相比，减压+ EPO组表现出更好的运动功能，BBB评分更高，后肢在网格跑道测试中的下降更少。组织学分析显示皮质脊髓束髓鞘形成增强，Luxol Fast Blue （LFB）染色和髓鞘碱性蛋白（MBP）染色显示，同时生长相关蛋白43 （GAP-43）表达的轴突生长增加。结论：减压手术联合EPO治疗可显著改善压缩性脊髓病大鼠的运动恢复，促进脊髓髓鞘形成。这些发现表明EPO作为CSM手术治疗的一种有希望的辅助手段，值得进一步的临床研究。
期刊介绍：
The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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