Canadian-American Spinal Cord Perfusion Pressure and Biomarker Study

Description

This 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.

Conditions

Acute Spinal Cord Injury, Acute Spinal Paralysis, Spinal Cord Injuries, SPINAL Fracture

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Study Overview

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Study Details

Study overview

This 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.

Canadian-American Spinal Cord Perfusion Pressure and Biomarker Study

Canadian-American Spinal Cord Perfusion Pressure and Biomarker Study

Condition
Acute Spinal Cord Injury
Intervention / Treatment

-

Contacts and Locations

San Francisco

Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States, 94110

Omaha

University of Nebraska Medical Center, Omaha, Nebraska, United States, 68198

Albuquerque

University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States, 87131

Pittsburgh

University Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States, 15213

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility 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
  • * 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

Ages Eligible for Study

17 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

University of British Columbia,

Brian Kwon, MD, PhD, PRINCIPAL_INVESTIGATOR, University of British Columbia, Faculty of Medicine

Study Record Dates

2025-12