Medical Student Medical College of Wisconsin Medical College of Wisconsin Wauwatosa, WI, US
Introduction: Although spinal cord decompression is the primary treatment for Degenerative Cervical Myelopathy (DCM), 44% of patients report residual neurological impairments and 9.3% sustain functional decline postoperatively. Prior studies have attributed this to DCM-induced ischemia followed by decompression-induced reperfusion injury. Nimodipine, a calcium channel blocker that increases neuronal tolerance to ischemia, may improve postoperative outcomes by reducing ischemia-reperfusion injury.
Methods: Forty-one adult C57BL/6J mice were divided into following groups: DCM-mice receiving nimodipine with decompression (Dcom+NMD), decompression only (Sham+VC). A validated DCM-model was created by inserting a 120μm aromatic polyether sheet under C4-C5 epidural space, inducing ossification and spinal cord compression. At 12-weeks, a subset underwent decompression via laminectomy to remove polyether-induced osteoid, while sham surgeries followed identical steps without osteoid removal. Nimodipine mice received daily 10mg/kg subcutaneous injections starting one-week before decompression/sham surgery and for three-weeks postoperatively. Bi-weekly functional assessments included Ladder-Walk for skilled motor function, Catwalk-XLT for gait metrics, Open-Field Test for unskilled locomotor activity, and Grip Strength Meter for forelimb strength. Intergroup functional assessments were analyzed using two-way ANOVA after Geisser-Greenhouse correction, with significance set at p< 0.05.
Results: Dcom+NMD showed faster postoperative Ladder-Walk crossing speeds (1.08cm/s, p=0.02) with fewer forelimb errors (-0.11error/bar, p=0.001)than decompression alone. Dcom+NMD had longer cumulative movement duration in Open-Field (70.67s, p=0.03) and decreased hindlimb print length in Catwalk-XLT (0.094cm, p=0.008) postoperatively. Although Dcom+NMD had higher grip strength, it was not statistically significant.
Conclusion : Perioperative nimodipine improved locomotion and limb function in DCM-mice undergoing decompression, suggesting it may be an effective adjuvant therapy to enhance postoperative neurological recovery in DCM.
.jpg)
