This review provides a concise outline of the advances made in the care of patients and to the quality of life after a traumatic
Aims. The aim of this study was to determine whether early surgical treatment results in better neurological recovery 12 months after injury than late surgical treatment in patients with acute traumatic
Acute
Acute
Acute
Aims. Non-coding microRNA (miRNA) in extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs) may promote neuronal repair after
Initial treatment of traumatic
Aim. The aim of the study was to define the peculiarities of bone remodeling and identify specific parameters to development to heterotopic ossification. Materials and methods. Markers of bone formation (Osteocalcin, serum type 1 procollagen (N-terminal) (tP1NP)) and bone resorption (serum collagen type 1 cross-linked C-telopeptide (β-CTx)) were determined by the electrochemiluminiscence immunoassay “ECLIA” for Elecsys user cobas immunoassay analyser. In the study were included 23 patients with
Despite advances in treating acute
Aim: To determine whether timing of intervention affects neurological outcome after
Objective: The purpose of this study was to assess whether the use of high dose methylprednisolone (MPS) given to trauma patients with acute
Summary Statement. In this study, we observed that MR16-1, an interleukin-6 inhibitor, recovered phosphatidylcholine containing docosahexaenoic acid at the injury site after
Objective: Syrinx formation is estimated to occur in 20–25% patients after
Introduction: Complete
Purpose: Prospective Observational Population Study to describe the incidence, demographics and pattern of
Our knowledge regarding neurological recovery following
Objective: To assess the result of surgical stabilisation of spine in Spinal cord injured patients. Design: Retrospective review of patients managed and followed at a spinal injury centre. Subjects: Sixty-six patients with
The NASCIS studies reported improved long-term neurological recovery when high dose methylprednisolone was administered following
AO Spine Reference Centre & Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. Traumatic
Silver nanoparticles (AgNPs) possess anti-inflammatory activities and have been widely deployed for promoting tissue repair. Here we explored the efficacy of AgNPs on functional recovery after
Charcot spondyloarthropathy is one of the late complications of traumatic
Introduction: Acute neurological damage from
Introduction The devastating and permanent effects of complete
Introduction: There are several complications associated with
Purpose: Recent studies have examined the systemic inflammation that occurs following
Introduction We have undertaken a retrospective study to identify prognostic factors predictive of neurological recovery after
Primary
Summary Statement. Collagen scaffolds modified with collagen-binding bFGF promotes the neural regeneration in the rat hemisected
Spinal cord damage was compared after an injury was inflicted by three clinically relevant mechanisms (contusion, dislocation, and distraction). A novel SCI multi-mechanism system has been developed. Central hemorrhage was common to all mechanisms. Increased membrane permeability was localized to the injury epicenter in contusion but spread further in distraction. Dislocation showed intermediate characteristics exhibiting both local neuronal losses at the epicenter and extended regions of membrane permeability. These preliminary observations suggest that distinct injury mechanisms result in differences in the primary damage of the spinal cord. This work compared primary damage after
Summary of background data. The development of a spinal deformity, usually affecting the coronal and occasionally the sagittal balance of the spine is a recognised complication of paralysis following a
After
Study Design &
Setting: Prospective multi-center longitudinal cohort study within the ‘European Multicenter Study of Human
Introduction. While there is a desperate need for effective treatments for acute
Recent advances in spinal cord injury(SCI) management have markedly reduced mortality &
morbidity, but concern regarding final neurological outcome is still at large. Global search is for prognostic-factors to predict neurological recovery. We statistically analyzed different variables to review the established and determine newer predictors of neurological recovery in SCI. During 1999–2000, 403 patients were admitted. 91 could be followed up for more than one year. Improvement in the motor score (ASIA) was taken as indicative of functional neurological recovery Prognostic factors were simplified into static(which do not change with time) and dynamic(which may change with time). Variables like age, sex, mode/mechanism of injury and skeletal level were static. These were recorded at admission and correlated for any association with neurological recovery at one year. Variables like neurological level, sacral sparing, duration of spinal shock, reflex recovery, sensory &
motor scores and complications like bedsores, flexor spasms, UTI, URTI, &
DVT were dynamic. These were recorded at admission, at weekly intervals till discharge and at 3 monthly intervals in follow-up. Bivariant &
Regressive analysis of static and dynamic factors was done. No significant correlation of static variables was found with the neurological recovery. On bivariant analysis Pin-prick sparing, intact bladder, spinal shock of <
24 hours and early appearance of deep tendon reflexes were good prognostic factors. Complete lesion, priapism, spinal shock for >
1 week, bedsore within 1 week and flexor spasms within 3 weeks were worst prognostic factor. When regressive linear analysis was done speed of recovery in the initial three weeks was the most important prognostic factor irrespective of other variables studied against the final neurological recovery. All variables affecting neurological recovery have an effect on the speed of recovery, which is the single most important prognostic factor influencing ultimate recovery. The initial 3 weeks following injury were the critical period influencing final neurological &
functional outcome.
The question of prolonged bracing following injury in patients diagnosed with SCIWORA remains controversial. Proponents of the ‘Segmental Spinal Instability’ hypothesis claim that there is occult ligamentous injury leading to instability and a risk of recurrent injury. Published reports of recurrent SCIWORA involve patients with minor, transient neurological symptoms and normal MRI findings. The contradicting ‘differential stretch hypothesis’ is based on the premise that the spinal column will deform elastically, exceeding the elastic deforming potential of the more fragile spinal cord, but will return to its baseline stability. The purpose of this study is to evaluate the need for bracing in patients with SCIWORA based on MRI evidence of instability. A retrospective chart review was performed for a series of eleven patients with documented SCIWORA that presented to Red Cross Children's Hospital over the past 8 years. Details regarding mode of injury, age at presentation, neurological deficit at presentation, MRI findings and long term prognosis were documented. MRI's were reviewed by the authors as well as a consultant radiologist.Purpose of study:
Methods:
We report a case of local compression-induced transient femoral nerve palsy in a 46-year-old man. He had previously undergone surgical release of the soft tissues anterior to both hip joints because of contractures following spinal injury. An MRI scan confirmed a synovial cyst originating from the left hip joint, lying adjacent to the femoral nerve. The cyst expanded on standing, causing a transient femoral nerve palsy. The symptoms resolved after excision of the cyst.
The definition &
etiology of spinal shock remain controversial. Time passed after trauma in initial recovery of any reflex is duration of spinal shock and this duration varies among patients. The factors influencing this duration and its clinical significance are not well studied. 116 patients in spinal shock following SCI were studied for duration of spinal shock with many variables &
statistical analysis was done. Mean duration of spinal shock (MD of SS) was shorter in children, shorter in malnourished, shorter in untrained/laborers, shorter in patients admitted early and shorter in patients without any complications. “MD of SS” was not influenced by sex of patient, associated injuries and by different modalities of treatment. On statistical analysis of duration of spinal shock with neurological level as a variable “MD of SS “was 1.7 days in cervical cord lesions, 8.2 days in upper thoracic, 15 days in lower thoracic and 17 days in lumbar cord lesions. Such an arithmetical progression was also found at each segmental level i.e. the duration of spinal shock progressively increased at every segmental level. “MD of SS” was 1.36days at C4, 1.60 at C5, 1.72 at C6, 8.1 at T6, 12.4 at T8, 13.1 at T10, 15.3 at T12 &
21.6 at L2. Higher or proximal the SCI lesion, shorter is the spinal shock duration. Neurological level based segmental progression of spinal shock duration remains unanswered. Does the duration of spinal shock dependant on the cord length/neuronal mass involved/spared?
From 1981 to 1986 we treated 413 patients for acute spinal-cord injuries. We reviewed 356 patients followed for a minimum of two years of whom 71 (20%) developed heterotopic ossification around one or more joints. Heterotopic ossification occurred more often in male patients (23%) than in female (10%), and was most frequent in the 20- to 30-year age group. It was also more common after injuries of the lower cervical or thoracic spine than after those of the lumbar spine. Patients with severe neurological deficits (Frankel grades A and B) showed significantly more heterotopic ossification but there was no correlation with the number or severity of associated head and limb injuries. Serum calcium levels did not change significantly in either group for 30 weeks after injury, but the erythrocyte sedimentation rate and the alkaline phosphatase level were significantly increased at six weeks in patients with heterotopic ossification.
Summary Statement. The mechanism of
Spinal infections with and without aSCI represent a severe disease with a high lethality rate of up to 17%. The current treatment recommendations include an antimicrobial therapy and if necessary in combination with operative procedures. Aims of this study are the analysis of risk factors and treatment concepts and to compare the outcome of patients suffering a spinal infection with and without an aSCI. Monocentric prospective case study from 2013 – 2015. Patients were examined using a diagnostic algorithm (CT-thorax/abdomen, MRI total-spine, blood cultures, dental chart, echocardiogram). A calculated antimicrobial therapy was initially administered and later changed according to the antibiotic resistance. Additional operative procedures were performed with respect to the clinical and radiological findings.Aim
Method
Neurogenic heterotopic ossification (NHO) is
a disorder of aberrant bone formation affecting one in five patients sustaining
a
The August 2024 Spine Roundup. 360. looks at: Laminectomy adjacent to instrumented fusion increases adjacent segment disease; Influence of the timing of surgery for cervical
Pressure ulcers are a common occurrence in individuals with
The identification of the extent of neural damage
in patients with acute or chronic