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Spinal Cord Injury: Progress, Promise, and Priorities
Is used for anterograde and retrograde tracing of axons: a substance is injected above or below the location of the injury to determine if the neuron transports it up past the injury location
Uses electron microscopy to look at the morphology of the spinal cord at very high resolution
Uses antibody staining to determine the protein distribution in cells
Assessments cannot be made in real time
Cannot be performed with living animals
Real-time imaging of the spinal cord
Uses MRI, CT, and PET, which are safe, noninvasive methods that provide detailed images of hard-to-view areas of the spine
Resolution is not high enough to detect changes to individual cells
Genetically encoded reporter molecules
Axon regrowth and formation of functional connections are visualized by use of genetically encoded reporter molecules in intact animal models or in isolated spinal cord preparations
Requires a correlation to improvements in physiological function
NOTE: Abbreviations: BBB = Basso, Beattie, and Bresnahan; BMS = Basso Mouse Scale; CT = computed tomography; MEPs = motor evoked potential; MRI = magnetic resonance imaging; PET = positron emission tomography; SSEP = somatosensory evoked potential.
in the outcome score. However, the scale has several limitations as it assesses only the functional recovery of the hind limbs and not other elements of fine motor control that are required for coordinated activity regulated by the spinal cord; does not examine the recovery of sensory modalities, including pain and temperature sensations; does not assess other complications that arise as a result of spinal cord injuries, including bowel and bladder function, pain, or sexual capacity; and is not linear.
Outcome Measures Used to Assess Spinal Cord Injury in Humans
Clinicians have available more than 30 assessment tests and surveys that they can use to examine individuals with spinal cord injuries (see Appendix D), including the American Spinal Injury Association (ASIA) scale and measures that assess all the major complications associated with spinal cord injuries. As discussed in further detail in Chapter 5, each of these measures assesses a specific aspect of recovery from spinal cord injury or evaluates the individual’s quality of life and is not designed to examine all the major complications that arise because of a spinal cord injury.