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Effects of MLC901 in Chronic SCI - Animal Experimental
1109 13:35-13:45
Spine/304A
Effect of MLC901 in Chronic Spinal Cord Injury – An Experimental Animal Study Dewa Putu Wisnu Wardhana1 1Neurosurgery Division, Department of Surgery, Faculty of Medicine, Universitas Udayana, Udayana University Hospital, 80361, Badung, Bali, Indonesia Introduction: Chronic spinal cord injury (SCI) leads to long-term disability due to irreversible damage to spinal cord tissues and the limited regenerative capacity of the central nervous system. Current treatments primarily focus on managing symptoms rather than promoting recovery. MLC901, a compound derived from traditional Chinese medicine, has shown neuroprotective effects in acute neurological conditions, suggesting its potential for treating chronic SCI. This study investigates the effects of MLC901 on motor function recovery and neural tissue preservation in a rodent model of chronic SCI. Methods: Adult rodents were subjected to a standardized SCI procedure to induce chronic injury. After establishing chronic SCI, the Wistars were randomly divided into two groups: the MLC901 treatment group and the control group. MLC901 was administered orally at a dosage previously determined in preliminary studies. Motor function was assessed using the Basso Beattie Bresnahan (BBB) locomotor rating scale at regular intervals. NG2 expression, Caspase-3 expression, levels of IL-10 and histological analysis was performed to evaluate tissue damage, neuronal survival, and inflammatory markers. We performed multivariate analysis on SPSS 25 version. Results: The MLC901-treated group demonstrated significant improvements in motor function, as evidenced by higher BBB scores compared to the control group (p<0.001). The findings demonstrated a statistically significant disparity in the average NG2 expression (−52.00 ± 20.03; p ≤ 0.05), as well as Caspase-3 expression (−94.89 ± 8.57; p ≤ 0.05), which exhibited a lower magnitude. The levels of IL-10 (8.96 ± 3.98; p ≤ 0.05) were observed to be higher, along with an elevation in BBB score (7.67 ± 0.89; p ≤ 0.05. Histological analysis revealed reduced glial scar formation and greater preservation of spinal cord tissue in the treated animals (p<0.05). Immunohistochemistry showed decreased expression of pro-inflammatory cytokines and increased markers of neurogenesis. These findings suggest that MLC901 enhances functional recovery by modulating inflammation and promoting tissue repair. Discussion: The results of this study indicate that MLC901 may offer therapeutic benefits in chronic SCI by reducing secondary damage and facilitating neuroregeneration. The observed improvements in motor function and tissue preservation highlight the potential of MLC901 as a treatment strategy. However, further research is needed to optimize dosing regimens and assess long-term safety. Additionally, clinical trials are essential to determine the translational potential of MLC901 in human patients with chronic SCI. Conclusion: MLC901 shows promise as a neuroprotective and regenerative agent in chronic SCI. Its ability to improve motor outcomes and mitigate tissue damage warrants further investigation and consideration for future therapeutic applications in SCI management. Keywords: Chronic spinal cord injury, MLC901, neuroprotection, motor function recovery, neurogenesis, inflammation, Wistar model.

Overcoming the Possible Limitation and Complications of Cervical Laminoplasty
1109 09:00-09:10
Spine/304A
Overcoming the Possible Limitations and Complications of Cervical Laminoplasty Dewa Putu Wisnu Wardhana1 1Neurosurgery Division, Department of Surgery, Faculty of Medicine, Universitas Udayana, Udayana University Hospital, 80361, Badung, Bali, Indonesia Introduction: Cervical laminoplasty is a commonly performed surgical procedure aimed at decompressing the spinal cord in patients suffering from cervical spondylotic myelopathy and other conditions that result in spinal canal stenosis. While effective in alleviating neurological symptoms, the procedure is not without limitations and complications. These include axial neck pain, decreased range of motion, postoperative kyphosis, and hardware-related issues. This study aims to identify and propose strategies to overcome these potential challenges, thereby improving surgical outcomes and patient quality of life. Methods: A comprehensive literature review was conducted to assess the common complications and limitations associated with cervical laminoplasty. The review included studies that reported on surgical techniques, patient outcomes, and complications. Strategies for mitigating these issues were identified and analysed. The effectiveness of modified surgical techniques, improved fixation materials, and the role of minimally invasive approaches were evaluated. Additionally, the importance of patient selection, preoperative planning, and postoperative care protocols was examined. Results: The review revealed that modifications to the classic laminoplasty technique, such as double-door and single-door approaches, significantly reduced the incidence of postoperative complications like kyphosis and axial neck pain. The use of newer fixation materials, including titanium plates and expandable implants, showed promise in decreasing hardware-related complications. Minimally invasive techniques were associated with reduced tissue trauma, leading to lower rates of postoperative pain and quicker recovery times. Preoperative imaging and careful patient selection were crucial in minimizing risks, while tailored rehabilitation programs enhanced recovery and reduced the likelihood of long-term complications. Discussion: The findings suggest that by adopting advanced surgical techniques and improving preoperative and postoperative care, many of the limitations and complications associated with cervical laminoplasty can be mitigated. The use of minimally invasive approaches and modern fixation materials has shown considerable potential in enhancing patient outcomes. However, these strategies require further validation through prospective studies and clinical trials. Additionally, the development of standardized protocols for patient selection and postoperative care will be critical in ensuring consistent and favourable outcomes. Conclusion: Overcoming the limitations and complications of cervical laminoplasty requires a multifaceted approach involving surgical innovation, careful patient selection, and comprehensive postoperative care. By implementing these strategies, the safety and efficacy of cervical laminoplasty can be significantly improved, leading to better patient outcomes and quality of life. Further research is necessary to refine these approaches and establish best practices for this commonly performed procedure. Keywords: Cervical laminoplasty, spinal cord decompression, minimally invasive surgery, fixation materials, postoperative care.