Spinal cord injury, Decompressive Surgery, Hypothermia, Trauma/ Neurotrauma
To develop acute treatments for spinal cord injury.
Our research has a primary focus on acute care for spinal cord injured patients. Traumatic spinal cord injury (SCI) generally affects young people, many of whom have severe paralysis and functional deficits with ongoing complex social, psychological, and medical needs.
In the majority of cases the initial vertebral injury is compounded by secondary compression of the spinal cord. Patients generally undergo spinal surgery to decompress and stabilise the spine. Animal and clinical data demonstrate that urgent relief of cord compression appears to greatly improve outcome. However, urgent decompression can be difficult to achieve in humans because of logistical difficulties. Our group has demonstrated in animal models of SCI, that hypothermia can suspend the progressive damage caused to the spinal cord by compression, thereby allowing decompressive surgery to be performed in a clinically achievable time frame (Batchelor et al. 2010, 2011).
The primary objective of our group is to undertake a multicentre clinical trial of Immediate Cooling followed by Emergency Decompression (ICED). The aim of the ICED trial is to determine whether the combination of hypothermia and early decompression can improve outcomes in patients with severe cervical SCI.
The ICED trial is comprised of 3 projects encompassing process of care, development of a rapid neurologic assessment for paramedics (SPEED), and a safety and feasibility trial of hypothermia and early decompressive surgery. A future multi-centre trial of hypothermia and early surgery is also planned, pending the results of the safety and feasibility trial.
Current Project Funding
Selected Recent Publications
For full list of publications, visit Pubmed.
Battistuzzo CR, Smith K, Skeers P, Armstrong A, Clark J, Agostinello J, Cox S, Bernard S, Freeman BJC, Dunlop SA and Batchelor PE. Early Rapid Neurological Assessment for Acute Spinal Cord Injury Trials. J Neurotrauma 33(21):1936-1945, 2016.
Battistuzzo CR, Armstrong A, Clark J, Worley L, Sharwood L, Lin P, Rooke G, Skeers P, Nolan S, Geraghty T, Nunn A, Brown DJ, Hill S, Alexander J, Millard M, Cox SF, Rao S, Watts A, Goods L, Allison GT, Agostinello J, Cameron PA, Mosley I, Liew SM, Geddes T, Middleton J, Buchanan J, Rosenfeld JV, Bernard S, Atresh S, Patel A, Schouten R, Freeman BJ, Dunlop SA, Batchelor PE. Early Decompression following Cervical Spinal Cord Injury: Examining the Process of Care from Accident Scene to Surgery. J Neurotrauma 33(12):1161-1169, 2016.
Skeers P, Battistuzzo CR, Clark JM, Bernard S, Freeman BJC, and Batchelor PE. Acute Thoracolumbar Spinal Cord Injury: Relationship of Cord Compression to Neurological Outcome. Journal of Bone and Joint Surgery (Am)100(4):305-315, 2018.
Agostinello J, Battistuzzo CR and Batchelor PE. Early clinical predictors of pneumonia in critically ill spinal cord injured individuals: a retrospective cohort study. Spinal Cord 57(1): 41-48, 2019.
Agostinello J, Battistuzzo CR, Skeers P, Bernard S and Batchelor PE. Early Spinal Surgery Following Thoracolumbar Spinal Cord Injury: Process of Care From Trauma to Theater. Spine (Phil Pa 1976) 42(10):E617-E623, 2017.
Batchelor PE, Kerr NF, Gatt AM, Cox SF, Ghasem-Zadeh A, Wills TE, Sidon TK and Howells DW. Intracanal pressure in compressive spinal cord injury: reduction with hypothermia. J Neurotrauma 28(5):809-820, 2011.
Batchelor PE, Kerr NF, Gatt AM, Aleksoska E, Cox SF, Ghasem-Zadeh A, Wills TE and Howells DW. Hypothermia prior to decompression: buying time for treatment of acute spinal cord injury. J Neurotrauma 27(8): 1357-68, 2010.
Batchelor PE, Skeers P, Antonic A, Wills TE, Howells DW, Macleod MR and Sena ES. Systematic review and meta-analysis of therapeutic hypothermia in animal models of spinal cord injury. PLoS One 8(8): e71317, 2013
Batchelor PE, Wills TE, Skeers P, Battistuzzo CR, Macleod MR, Howells DW and Sena ES. Meta-analysis of pre-clinical studies of early decompression in acute spinal cord injury: a battle of time and pressure. PLoS One 8(8): e72659, 2013.
Antonic A, Sena ES, Lees JS, Wills TE, Skeers P, Batchelor PE, Macleod MR and Howells DW. Stem cell transplantation in traumatic spinal cord injury: a systematic review and meta-analysis of animal studies. PLoS Biology 11(12): e1001738, 2013.