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J Thorac Cardiovasc Surg 2008;136:1038-1043
© 2008 The American Association for Thoracic Surgery

Cardiopulmonary Support and Physiology

Effects of carbamazepine on spinal cord ischemia

Mustafa Srlak, MD^a, Sadik Erylmaz, MD^a, Mustafa Bahadr Inan, MD^a,_*, Yusuf Sinan Srn, DVM^b, Omer Besalt, DVM, PhD^c, Levent Yazcoglu, MD^a, Evren Ozcnar, MD^a, Esra Erdeml, MD^d, Refik Tasoz, MD^a, Atilla Halil Elhan, PhD^e, Bulent Kaya, MD^a, Umit Ozyurda, MD^a

^a Department of Cardiovascular Surgery, Ankara University School of Medicine, Ankara, Turkey
^b Department of Veterinary Medicine, 19 Mayis University, Samsun, Turkey
^c Department of Veterinary Medicine, Ankara University, Ankara, Turkey
^d Department of Histology and Embryology, Ankara University School of Medicine, Ankara, Turkey
^e Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey

Received for publication September 30, 2007; revisions received November 28, 2007; accepted for publication December 18, 2007.

^_* Address for reprints: Mustafa Bahadr Inan, MD, Ankara University Medical School, Department of Cardiovascular Surgery Ankara-Turkey. (Email: mbahadirinan{at}gmail.com).

Background: Prophylactic treatment with carbamazepine has been shown to reduce the cerebral damage and neurologic deficit in ischemic conditions. A randomized controlled study based on a rabbit model was designed to study the effect of carbamazepine on a spinal cord ischemic reperfusion injury.

Methods: Thirty New Zealand rabbits were randomly assigned to 1 of the 2 groups (n = 15 per group): group I (control group) and group II (carbamazepine group). Spinal cord ischemia was induced by infrarenal aortic crossclamp for 25 minutes in both groups. Functional evaluation with the Tarlov score during a 2-day observation period and histopathologic assessment of the lumbar spinal cord were performed. Changes in spinal cord morphology were observed with hematoxylin-eosin staining and electron microscopy. Gray matter damage was assessed on the basis of the number of normal neurons in the ventral horn.

Results: Diffuse destruction of gray matter with moderate to severe vacuolization and essentially no normal ganglion cells was observed in the spinal cord of rabbits in the control group, whereas specimens of rabbits assigned to the carbamazepine group showed ganglion cells with normal nuclei and cytoplasm (P < .0001). Neurologic impairment was significantly attenuated in the carbamazepine group compared with the Tarlov scores of the control group (P < .0001 at day 2).

Conclusion: Carbamazepine may protect the spinal cord from ischemic reperfusion injury that is associated with ameliorated neurologic and histopathologic results.