Cerebrospinal Fluid (CSF) Drainage and Cytokine Profiling in the Treatment of Acute Spinal Cord Injury (SCI) - A Pilot Study

This pilot study will evaluate the safety and feasibility of a clinical trial protocol for cerebrospinal fluid (CSF) drainage as a potential treatment for patients with acute spinal cord injury. Specifically, the investigators will evaluate:

• patient eligibility and recruitment for such a study and how soon CSF drainage can be instituted in such patients;
• adverse events and safety of CSF drain insertion and drainage in the setting of acute spinal cord injury;
• neurologic recovery after injury; and
• cytokine expression within the CSF and blood after injury.

Following informed consent, patients with spinal cord injuries who agree to participate in the study will have a lumbar CSF drain placed and be randomized to either:

• CSF drainage to maintain a constant intrathecal pressure; or
• no CSF drainage.

Both groups will have CSF and blood sampled at pre-defined intervals in order to evaluate CSF cytokine expression after acute spinal cord injury. For comparison against the injured condition, CSF and blood from a normal group of uninjured individuals will be obtained. These individuals will be patients undergoing hip or knee surgery under a spinal anesthetic, where a small sample of CSF can be taken when their intrathecal space is accessed for the anesthesia.