Randomized, blinded, placebo-controlled clinical trial of n-acetylcysteine in dogs with spinal cord trauma from acute intervertebral disc disease

Study design.: The effect of N-acetylcysteine administration intravenously before hemilaminectomy surgery on neurologic outcome and 15F2t isoprostane excretion in dogs was examined in a blinded, placebo-controlled trial. Objective.: To determine the effect of N-acetylcysteine administration on urinary 15F2t isoprostane excretion and neurologic outcome following hemilaminectomy for intervertebral disc disease. Summary of background data.: Oxidative stress is a mediator of secondary injury to the spinal cord following trauma. Acute intervertebral disc disease is associated with increased oxidative damage in dogs. N-acetylcysteine has preserved neurologic function following experimental spinal cord injury. Methods.: Seventy dogs with naturally occurring acute intervertebral disc disease were administered either with saline placebo or N-acetylcysteine intravenously before hemilaminectomy surgery. Serial neurologic examinations were performed before and 1, 2, 7, 14, and 42 days following treatment. Urinary excretion of 15F2t isoprostane excretion was determined before treatment and 1 hour after surgery. Results.: Analysis of subjective data did not reveal any significant effect of N-acetylcysteine on neurologic outcome or rate of improvement of neurologic score in the 42 days following treatment. Urinary 15F2t isoprostane excretion was not significantly different between treatment groups (P > 0.05). Conclusion.: N-acetylcysteine intravenously before hemilaminectomy has no effect on urinary 15F2t isoprostane excretion or neurologic outcome. Treatment of dogs with the antioxidant N-acetylcysteine before hemilaminectomy, while not detrimental, does not affect neurologic outcome in the 42 days following surgery.