New Research Gives Insights into Better Therapeutic Strategies for Spinal Cord Injuries

Data from the National Spinal Cord Injury Association posits that about 450,000 Americans are struggling with spinal cord injury (SCI)-related disabilities. Several other organizations estimate 250,000 persons; a conservative figure when compared to the former.

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The annual estimated number of new cases of SCIs is about 17,000 in the U.S with these injuries having varying degrees of disabilities in the motor, autonomic and sensory functions of the nervous system. The treatment burden of SCIs according to the Centers for Disease Control and Prevention (CDC) is put at $9.7 billion annually.

Spinal cord injuries: cause, signs, and classification

The nervous system is responsible for the motor, autonomic, and sensory functions of the human body. Damages to it in the form of contusions, partial or complete transection, or infection can result in a loss or diminution in the above-mentioned functions due to a largely irreversible process that has no cure.

Road traffic accidents are the commonest cause of SCIs among the younger population. However, in the elderly population, falls account for a great number of cases. Athletics and violent acts are also recognized sources of injuries.

The signs and symptoms vary depending on the degree of cord damage. Complete SCI results in a full loss of the functions below the level of damage while an incomplete SCI can have varying limitations in the functions in the part affected. These functional limitations are graded from ASIA A – E, with A having the worst limitation and E having no limitations.

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Conventional imaging protocol and limitations

Imaging plays an important role in the management of SCIs but presently, there is no method existing that effectively captures the happenings in the damaged cord at the cellular level while not triggering the immune system. In conventional techniques, to improve image resolution, cord tissue had to be removed. This surgical removal of tissue also runs the risk of triggering the immune system that may interfere with the disease process under investigation.

New research and findings

A research team at the Hong Kong University of Science and Technology (HKUST) led by Prof. Qu `Jianan of the Electrical and Computer Engineering, and Prof. Liu Kai of the Division of Life Science, in a paper published in Nature Communications, developed a ground-breaking model for in vivo imaging of the various biological events in cord injury and repair. This technique, performed in animal models (mouse), was shown to be of high resolution, repetitive, stable, long-term, and free from inflammation.

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In the model, the Ligamentum Flavum (LF) is retained to prevent the initiation of inflammation. To prevent the diminution of image quality resulting from the reduction in the depth of permeation and optical dispersion by the LF, they introduced Iodixanol, an FDA-approved non-toxic, optical clearing medium, which extended the imaging sessions to up to 15 sessions over 167 days. Using this method, they discovered that the glia cells, following axonal injury, wrap themselves around the node of Ranvier a distance away from the site of injury to stop further axon degeneration.

Clinical significance

This is an innovation with promising application in the study of SCIs says, Prof. Qu. According to Prof. Liu, by studying in an inflammation-free setting, we could track the microglia from their inactive to active stages including their relationship with degenerating axons. this could revolutionize our management of SCIs


This study at HKUST on in vivo imaging in animal models has created new understandings of the biological basis of SCIs and repair which would, in the long run, result in a better appreciation of the underlying mechanisms of the pathology and the development of better therapeutic strategies.

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Nature Communications (2022). Long-term in vivo imaging of mouse spinal cord through an optically cleared intervertebral window



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