Untargeted Metabolomics Analysis of Cerebrospinal Fluid in Patients with Acute Cervical Traumatic Spinal Cord Injury

Traumatic spinal cord injury (TSCI) is a destructive neurological disorder whose complex underlying mechanisms remain incompletely elucidated. To gain deeper insights into the central pathophysiological mechanisms underlying TSCI, this study prospectively recruited a consecutive cohort of 10 participants between February 2023 and August 2024 at the Department of Neurosurgery, Zhongda Hospital. The study consisted of two groups: a spinal cord injury group (SCI group, n=5) comprising patients with acute cervical TSCI, and a control group (CON group, n=5) comprising patients diagnosed with idiopathic normal pressure hydrocephalus (iNPH). For SCI patients, approximately 4 ml of CSF was collected via lumbar puncture immediately following emergency decompression surgery under general anesthesia. For CON patients, an equivalent volume was collected during routine diagnostic lumbar puncture. Half of samples were sent to the Clinical Laboratory of Zhongda Hospital for CSF routine and biochemical tests, and the rest half were kept on ice and immediately processed by centrifugation at 3,000 rpm for 15 minutes at 4 Degree Celsius. The resulting supernatants were carefully aliquoted into sterile cryotubes, labeled, and stored at -80 Degree Celsius for further analysis. We utilized an untargeted metabolomics approach based on an ultra performance liquid chromatography-Tandem mass spectrometry (UPLC-MS/MS) system, all experiments were performed with three technical replicates, and the results are reported as mean values to ensure data reliability.