Hyperbaric oxygen therapy after spinal cord injury. A systematic literature review
Abstract
Hyperbaric oxygen therapy is the inhalation of 100% pure O2 at increased pressure, i.e. at ambient pressure greater than 1 atm. The basic principles of hyperbaric oxygen therapy (ΗΒΟΤ) are based on the way in which the various gases – and especially O2 - behave and act upon the tissues and fluids of the human body, under the influence of different conditions of volume and pressure. Spinal cord injury (SCI) is a very serious and complicated medical condition which greatly disrupts the patient’s life. Historically, this condition has been associated with very high morbidity and mortality rates.
In the present study, the latest research data on the effectiveness of this method regarding spinal cord injuries was studied. In order to achieve this purpose, the research tool of systematic literature review was chosen.
Discussion: The systematic literature review resulted in the detection of 13 relevant published articles after 2015. There were 3 randomized controlled studies, 2 non-randomized clinical studies, 4 case series and 4 case reports. In total, 557 patients participated in the study. The main result of the study was that HBOT is a totally safe and without any clinically significant side effects adjuvant therapy for the treatment of SCIs, producing various degrees of improvement of the motor and sensory neurological condition of the patients suffering from various types of SCIs, along with their psychological condition.
Conclusion: Hyperbaric oxygen treatment is a totally safe adjuvant treatment method for patients suffering from spinal cord injuries, having the potential to improve both the neurological status (motor and sensory) and the psychological condition of the affected patients. Further research is needed to obtain specific guidelines in relation to the indications and the application protocols of the method.
Downloads
References
Jain, K. K. and Baydin, S. (2017) Textbook of hyperbaric medicine. Springer.
Edwards, M. L. (2010). Hyperbaric oxygen therapy. Part 1: history and principles. Journal of Veterinary Emergency and Critical Care (San Antonio, Tex.: 2001), 20(3) pp. 284–288.
Quadri, S. A., Farooqui, M., Ikram, A., Zafar, A., Khan, M. A., Suriya, S. S., Claus, C. F., Fiani, B., Rahman, M., Ramachandran, A., Armstrong, I. I. T., Taqi, M. A. and Mortazavi, M. M. (2020).Recent update on basic mechanisms of spinal cord injury. Neurosurgical Review, 43(2) pp. 425–441.
PRISMA Flow Diagram. [cited 2022 Mar 25]. Available from: http://prisma-statement.org/prismastatement/flowdiagram.aspx
Tseng W-S, Huang N-C, Huang W-S, Lee H-C. Brown-Séquard syndrome: a rare manifestation of decompression sickness. Occup Med (Lond). 2015 Dec;65(9):758–60.
Onen MR, Yuvruk E, Karagoz G, Naderi S. Efficiency of Hyperbaric Oxygen Therapy in Iatrogenic Spinal Infections. Spine (Phila Pa 1976). 2015 Nov;40(22):1743–8.
Xu L, Ding X, Liao M. Non-traumatic acute paraplegia associated with a CT-guided needle biopsy in a silicotic nodule: A case report. Mol Clin Oncol. 2016 Mar;4(3):453–5.
Feng J-J, Li Y-H. Effects of hyperbaric oxygen therapy on depression and anxiety in the patients with incomplete spinal cord injury (a STROBE-compliant article). Medicine (Baltimore). 2017 Jul;96(29):e7334.
Parotto M, Ouzounian M, Fedorko L, Oreopoulos G, Lindsay T, Katznelson R. Hyperbaric oxygen therapy for spinal cord ischaemia after complex aortic repair - a retrospective review. Anaesthesiol Intensive Ther. 2018;50(2):103–9.
Tan J-W, Zhang F, Liu H-J, Li Z. Hyperbaric oxygen ameliorated the lesion scope and nerve function in acute spinal cord injury patients: A retrospective study. Clin Biochem. 2018 Mar;53:1–7.
Chen Y, Fan Z, Liao L, Lin Y. Effect Analysis of Hyperbaric Oxygen Therapy with Methylprednisolone on Prevention of Spinal Cord Ischemia-Reperfusion Injury. J Coll Physicians Surg Pak. 2019 Oct;29(10):1016–7.
Wilson JRF, Schiavo S, Middleton WJ, Massicotte EM, De Moraes MV, Katznelson R. The Treatment of Perioperative Spinal Cord Injury With Hyperbaric Oxygen Therapy: A Case Report. Spine (Phila Pa 1976). 2020 Sep 1;45(17):E1127–31.
Ashton C, Banham N, Needham M. Acute spontaneous spinal cord infarction: Utilisation of hyperbaric oxygen treatment, cerebrospinal fluid drainage and pentoxifylline. Diving Hyperb Med. 2020 Dec 20;50(4):325–31.
Marrosu F, Mancosu S, Lai G, Fraschini M, Muroni A, Demuru M, et al. Reshaping cortical connectivity in traumatic spinal cord injury: a novel effect of hyperbaric oxygen therapy. Spinal Cord Ser Cases. 2021 Sep 9;7(1):80.
Li HX, Cui J, Fan JS, Tong JZ. An observation of the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen in treating acute spinal cord injury. Pak J Med Sci. 2021 Apr;37(2):320–4.
Bünül SD, Sarıkaya CE, Öztürk O, Sarıkaya C. A brief case series of radiation associated myelopathy. Neurosciences (Riyadh). 2021 Oct;26(4):392–5.
Zhang Z, Li Q, Yang X, Li B, Zhou Y, Hu T, et al. Effects of hyperbaric oxygen therapy on postoperative recovery after incomplete cervical spinal cord injury. Spinal Cord. 2022 Feb;60(2):129–34.
Patel NP, Huang JH. Hyperbaric oxygen therapy of spinal cord injury. Med Gas Res. 2017 Jun;7(2):133–43.
Bracken MB. Steroids for acute spinal cord injury. Cochrane Database Syst Rev. 2012 Jan 18;1:CD001046.
Holbach KH, Wassmann H, Linke D. The use of hyperbaric oxygenation in the treatment of spinal cord lesions. Eur Neurol. 1977;16(1–6):213–21.
Jones RF, Unsworth IP, Marosszeky JE. Hyperbaric oxygen and acute spinal cord injuries in humans. Med J Aust. 1978 Dec 2;2(12):573–5.
Huang L, Zhang Q, Fu C, Liang Z, Xiong F, He C, et al. Effects of hyperbaric oxygen therapy on patients with spinal cord injury: A systematic review and meta-analysis of Randomized Controlled Trials. J Back Musculoskelet Rehabil. 2021;34(6):905–13.
