Canadian-American Spinal Cord Perfusion Pressure and Biomarker Study
Spinal Cord Injuries | SPINAL Fracture | Acute Spinal Cord Injury | Acute Spinal ParalysisThis multicenter study will enroll 100 patients with acute traumatic cervical and thoracic SCI who have a lumbar intrathecal catheter inserted within 24 hours of their injury. The lumbar intrathecal catheter will be inserted pre-operatively for the measurement of ITP and the collection of cerebrospinal fluid (CSF) samples. SCPP will be calculated as the difference between MAP and the ITP.
There are two important distinct yet related objectives in this prospective interventional study.
1. Determine the effect of SCPP maintenance ≥ 65 mmHg in acute SCI on neurologic recovery as measured by ASIA Impairment Scale (AIS) grade conversion and motor score improvement.
2. Collect CSF and blood samples for the measurement of neurochemical biomarkers and storage for future biomarker discovery and validation studies.
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Conditions de participation
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Sexe:
ALL -
Âges admissibles:
17 and up
Critères de participation
Inclusion Criteria:
* Male or Female ≥ 17 (or the provincial age of majority - depending on local REB guidelines)
* Complete (AIS A) or incomplete (AIS B, C) acute traumatic spinal cord injury.
* Bony spinal levels between C0 and T12 inclusive.
* Blunt (non-penetrating) spinal cord injury treated either surgically or non-surgically
* Lumbar intrathecal catheter to be inserted as part of clinical hemodynamic management and CSF sample collected within 48 hours of injury
* Initial blood sample collected within 24 hours of injury
Exclusion Criteria:
* Motor incomplete spinal cord injury AIS D (i.e. at least half (half or more) of the key muscle functions below the neurological level of injury (NLI) have a muscle grade greater than or equal to 3/5)
* Spinal cord injury with sensory deficit only (i.e. no motor deficit)
* Penetrating spinal cord injury (including gunshot wounds)
* Isolated radiculopathy
* Isolated cauda equina injury or spinal injury below L1
* Associated injury (soft tissue or bony) to the lumbar spine where the intrathecal catheter would be placed
* Associated traumatic conditions that would interfere with the outcome assessment (e.g., traumatic brain injury, chest, pelvis, abdomen, or femur injury requiring operative intervention)
* Pre-existing neurodegenerative disorder, such as Parkinson's disease, Alzheimer's disease, Huntington's disease, multiple sclerosis, amyotrophic lateral sclerosis
* Pre-existing thromboembolic disease or coagulopathy, such as hemophilia, von Willebrand disease
* Presence of systemic disease that might interfere with patient safety, compliance or evaluation of the condition under study (e.g., clinically significant cardiac disease, HIV, Hep B or C) HTLV-1
* Pre-existing inflammatory or autoimmune disorder (e.g. rheumatoid arthritis, systemic lupus, psoriasis, or ankylosing spondylitis
* Any other medical condition that in the investigator's opinion would render the protocol procedures dangerous or impair the ability of the patient to receive protocol therapy
* Female patients who are pregnant
Lieu de l'étude
Hopital Du Sacre-Coeur de Montreal
Hopital Du Sacre-Coeur de MontrealMontreal, Quebec
Canada
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Pascal Mputu
St. Michael's Hospital
St. Michael's HospitalToronto, Ontario
Canada
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Cecilia He
Vancouver General Hospital
Vancouver General HospitalVancouver, British Columbia
Canada
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Halifax Infirmary - QEII
Halifax Infirmary - QEIIHalifax, Nova Scotia
Canada
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- Étude parrainée par
- University of British Columbia
- Participants recherchés
- Plus d'informations
- ID de l'étude:
NCT03911492