gms | German Medical Science

Objective: Prediction of functional outcome following surgery performed for subacute spinal cord compression of various reasons is still a considerable problem. Several clinical parameters such as the initial extent of paresis are commonly used to estimate outcome but a prognosis that is individually valid for the affected patient is not possible that way. The purpose of this paper therefore is to examine whether serial serum measurements of S100B and NSE permit an individually valid prediction of functional outcome in a set-up of experimental subacute spinal cord compression.

Methods: Using a dynamic model for experimental spinal cord compression, paraparesis of different extents was produced in 22 white rabbits. 8 animals served as control. Venous blood samples for S100B and NSE were taken before operative decompression of the spinal cord and regularly thereafter. The individual time course of both markers was correlated with functional outcome. Outcome was rated as favourable in case of neurological amelioration with maintenance or recovery of gait function while a lacking restoration of walking ability was regarded as unfavourable outcome.

Results: Whereas NSE serum levels showed no relevant differences in both outcome groups S100B values differed significantly. In animals with favourable outcome S100b was either always normal or it was initially increased but normalised within 3 days. Contrariwise it was increased throughout in animals with unfavourable outcome showing only a slow decrease (P<0.0001).

Conclusions: NSE seemingly does not have any prognostic significance in the event of subacute spinal cord compression. In contrast S100B appears to be a reliable biochemical marker that permits an individually valid prediction of functional outcome.