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The efficacy of erythropoietin on acute spinal cord injury. An experimental study on a rat model

  • Orthopaedic Surgery
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Abstract

Introduction

The accumulated knowledge of erythropoietin (EPO) interaction in neural injury has led to potentially novel therapeutic strategies. Previous experimental studies of recombinant human EPO (rhEPO) administration have shown favorable results after central and peripheral neural injury. In the present study we used the aneurysmal clip model to evaluate the efficacy of two different regimes of rhEPO administration on the functional outcome after severe acute spinal cord injury (ASCI).

Materials and methods

Thirty rats were operated on with posterior laminectomy at thoracic 10th vertebra. Spinal cord trauma produced by extradural placement of the aneurysm clip, for 1 min. Animals were divided into three groups; the first group received a low total EPO dose (EPO-L), (2 doses of 1,000 IU each s.c.). The second group was administered the high total EPO dose (EPO-H), (14 doses of 1,000 IU each s.c.), and the third was the Control group, which received normal saline in the same time fashion with EPO-H group. Follow-up was for 6 weeks. Estimation of the functional progress of each rat was calculated using the locomotor rating scale of Basso et al, with a range from 0 to 21.

Results

After surgery the animals suffered paraplegia with urinary disturbances. Rats that received EPO demonstrated statistically significant functional improvement compared to the Control group, throughout study interval. On the last follow-up at 6 weeks the EPO-L rats achieved a mean score 17.3 ± 1.15, the EPO-H 14.7 ± 1.82, and the control group 8.2 ± 0.78. Comparison between the two EPO groups reveals superior final outcome of the group treated with lower total dose.

Conclusion

Our study supports current knowledge, that EPO administration has a positive effect on functional recovery after experimental ASCI. These data reflect the positive impact of EPO on the pathophysiologic cascade of secondary neural damage. However, we observed a dose-related effect on functional recovery. Interestingly, large doses do not seem to favor the neurological recovery as lower doses do.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, School of Medicine, University of Ioannina, Ioannina, 45110, Greece

    Vasileios A. Kontogeorgakos, Anastasios V. Korompilias, Marios Vekris & Alexandros E. Beris

  2. Department of Neurosurgery, School of Medicine, University of Ioannina, Ioannina, 45110, Greece

    Spyridon Voulgaris

  3. Department of Neurosurgery, Aristotle University of Thessalonica, School of Medicine, AXEPA Hospital, Thessalonica, Greece

    Konstantinos S. Polyzoidis

  4. Department of Haematology, School of Medicine, University of Ioannina, Ioannina, Greece

    Konstantinos Bourantas

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  1. Vasileios A. Kontogeorgakos
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  2. Spyridon Voulgaris
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  3. Anastasios V. Korompilias
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Correspondence to Vasileios A. Kontogeorgakos.

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Kontogeorgakos, V.A., Voulgaris, S., Korompilias, A.V. et al. The efficacy of erythropoietin on acute spinal cord injury. An experimental study on a rat model. Arch Orthop Trauma Surg 129, 189–194 (2009). https://doi.org/10.1007/s00402-008-0594-x

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