Prédiction et optimisation de la récupération après une lésion médullaire traumatique


Jean-Marc Mac-Thiong

Université de Montréal


Domaine : appareil locomoteur et arthrite

Programme Chercheurs-boursiers cliniciens - Senior

Concours 2018-2019

Spinal cord injury occurring after a traumatic event is associated with unpredictable recovery, but most patients remain with long-term limitations. In the acute phase, the greatest challenges for surgeons are to predict the long-term recovery and find opportunities to improve the recovery.

Accordingly, the current research program seeks to improve the surgical management of traumatic spinal cord injuries and better predict the recovery, by addressing three main themes: 1) develop a novel prediction model of long-term recovery, 2) propose guidelines for determining the optimal timing of surgery, and 3) identify new parameters characterizing the loads and energy transferred to the spinal cord through the injury that are associated with the recovery. For Theme 1, a prediction model of functional and neurological recovery will be developed from data collected during the acute hospitalization, and will be validated to ensure high predictive performance. For Theme 2, a timetable defining the optimal timing of surgery associated with improved recovery will be provided, based on the initial characteristics of the injury. In Theme 3, a computer model depicting the entire process involved in traumatic spinal cord injuries, from the initial compression of the spinal cord to the tissue damage will be developed. The computer model will provide parameters characterizing the loads and energy transferred to the spinal cord that will be inserted into the prediction model and help to define the optimal timing of surgery.

The prediction model will serve clinicians to inform and counsel patients and families on the potential recovery, select appropriate treatments and rehabilitation needs, and set realistic long-term goals. The proposed timetable will help surgeons to timely perform the surgery and optimize the recovery after a traumatic spinal cord injury, while considering available resources, as well as the time required to stabilize the patient, finalize the investigation, and plan surgery.