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Spinal Cord Series and Cases

Oliver Enke, Jasan Dannaway, Matthew Tait, Charles H New
Introduction: Incidental durotomy is a relatively common complication of spine surgery. Prevalence ranges from 3 to 5% in primary and 7 to 17% in revision procedures. Despite this relatively common occurrence the subsequent development of pseudomeningoceles following lumbar spine surgery is reported to be between 0.07 and 2%. Giant pseudomeningoceles (GP) are rare and therefore we report our experience with a case. Case presentation: We report a case of an iatrogenic GP post revision lumbar surgery that extended 19 cm in length...
2018: Spinal Cord Series and Cases
Kentaro Haraya, Katsuhisa Yamada, Terufumi Kokabu, Akira Iwata, Tsutomu Endo, Hideki Sudo, Norimasa Iwasaki, Masahiko Takahata
Introduction: Postoperative infection is a potentially devastating complication of spine surgery and an appropriate strategy and timely decision-making are essential for successful treatment of deep surgical site infection (SSI) after spinal instrumentation surgeries. However, there is a lack of consensus on implant removal or retention. We report on a case of deep SSI after posterior lumbar interbody fusion (PLIF) surgery in which we achieved clinical cure by debridement and removal of the interbody fusion cage without removing the percutaneously inserted pedicle screws (PPS)...
2018: Spinal Cord Series and Cases
Sandra Huguet, Natàlia Ibáñez, Martí Bernaus, Lluís Font-Vizcarra
Introduction: Septic arthritis of a facet joint (SAFJ) is a rare entity and frequently underdiagnosed. It is most frequently localised in the lumbar segment. Case presentation: A 48-year-old woman presented at our emergency room with a chief complaint of lumbar pain and perineal hypoesthesia. An urgent lumbar Magnetic Resonance Imaging (MRI) was performed showing no signs of compressive pathology. Intravenous painkillers were administered improving her clinical symptoms, so she was discharged from the emergency department to be followed at our out-patient clinic...
2018: Spinal Cord Series and Cases
Sonja de Groot, Ingrid Kouwijzer, Marjolein Baauw, Rogier Broeksteeg, Linda J Valent
Study design: Single-group pre-test post-test study. Objectives: Examine the change in (1) fitness and body composition due to self-guided training in preparation for the HandbikeBattle in people with spinal cord injury (SCI); and (2) whether these possible body composition changes are associated with changes in fitness. Setting: Handcycling teams of Dutch rehabilitation centers training for the HandbikeBattle, a handcycling race on an Austrian mountain...
2018: Spinal Cord Series and Cases
Sami Ullah, Irfan Qamar, Ahmad Zaheer Qureshi, Amani Abu-Shaheen, Asim Niaz
Study design: Retrospective study. Objective: To identify demographic features, clinical characteristics, and complications associated with spinal cord injuries/disorders (SCI/D) among elderly individuals at a rehabilitation hospital and to measure the functional outcomes of rehabilitation. Setting: Rehabilitation hospital in King Fahad Medical City (KFMC), Riyadh, Saudi Arabia. Methods: The study was conducted in elderly individuals (aged ≥65 years) with SCI/D, admitted to an inpatient rehabilitation program between October 2014 and 2015...
2018: Spinal Cord Series and Cases
Thomas Edwards, J P Barfield, Grace M Niemiro, Joseph W Beals, Elizabeth M Broad, Robert W Motl, Michael De Lisio, Nicholas A Burd, Lara A Pilutti
Study Design: Observational study. Objectives: To characterize the cardiorespiratory and metabolic response of elite wheelchair racing (WCR) athletes during a 25 km, field-based time trial. Settings: University laboratory and field racing course in Urbana, Illinois, USA. Methods: Seven elite WCR athletes (4 men/3 women) with spinal cord injury completed an incremental exercise test to exhaustion on a computerized wheelchair roller system to determine peak cardiorespiratory capacity in the laboratory...
2018: Spinal Cord Series and Cases
Vesna Miloshevska Jakimovska, Emil Kostovski, Fin Biering-Sørensen, Ingeborg Beate Lidal
Study design: Cross-sectional study. Objectives: To gain insights into fracture rate and musculoskeletal ailments among Norwegians with a spinal cord injury (SCI) acquired more than 20 years ago. Settings: Sunnaas Hospital, Nesoddtangen, Norway. Methods: 165 persons with SCI were interviewed in 2004-2005 by questionnaires and clinical examination. Descriptive statistics and a logistic regression analysis were performed to identify variables associated with bone fractures and musculoskeletal ailments...
2018: Spinal Cord Series and Cases
Samantha Sechrist, Sarah Lavoie, Cria-May Khong, Benjamin Dirlikov, Kazuko Shem
Study design: Prospective observational. Objectives: To explore participants' experience, satisfaction, and utility of telemedicine. Setting: Spinal cord injury (SCI) rehabilitation clinic at a county hospital. Methods: Participants in this study received telemedicine appointments for routine scheduled care and/or urgent consults with a spinal cord injury specialist via iPad on FaceTime. Demographic changes, health care utilization, and medical complications were assessed...
2018: Spinal Cord Series and Cases
Amir Awwad, Renan E Ibrahem Adam, Chandni Patel, James D Thomas
Introduction: Spinal epidural lipomatosis (SLE) is an abnormal accumulation of unencapsulated fat. The association of chronic steroid therapy is described as well as obesity and Cushing's syndrome. SLE has a range of neurological presentations such as back pain, myelopathy, and cauda equina syndrome. Surgical decompression is known to improve symptomatic cases and prevent further deterioration. Case presentation: An elderly male patient with background history of high-risk metastatic prostate cancer and long-term treatment with steroids and hormonal therapy presented with acute on chronic back pain and neurological symptoms...
2018: Spinal Cord Series and Cases
Eyrún Arna Kristinsdóttir, Sigrún Knútsdóttir, Kristinn Sigvaldason, Halldór Jónsson, Páll E Ingvarsson
Study design: A retrospective epidemiological study. Setting: Landspítali University Hospital, Iceland. Objectives: Assessment of epidemiological data and risk factors for traumatic spinal fractures (SFs) and associated spinal cord injury (SCI). Methods: A retrospective review of hospital admissions due to traumatic SFs during a 5-year period, with analysis of epidemiological parameters and occurrence of concomitant SCI...
2018: Spinal Cord Series and Cases
Phani Krishna Karthik Yelamarthy, Tarush Rustagi, Rajat Mahajan, Vishwajeet Singh, Kalidutta Das, Murari Lal Bansal, Bibhudendu Mohapatra, Harvinder Singh Chhabra
Background: Charcot spinal arthropathy (CSA), a destructive spinal pathology, is seen in patients with impaired sensation. Superimposed infection in the affected spinal segments can lead to a challenge in the diagnosis and management. Spinal cord injury (SCI) is the leading cause of CSA as persons with SCI have significantly impaired sensation. Though infection of the CSA is rare, SCI persons are prone to superimposed infection of the Charcot spine. We report atypical presentations of three cases of CSA with superimposed infection...
2018: Spinal Cord Series and Cases
Pasang Doma Sherpa, Luppana Kitrungrote, Wipa Sae-Sia
Study design: Descriptive cross-sectional study. Objective: This study aims to determine the factors predicting quality of life among Nepalese family caregivers of people with spinal cord injury (SCI) having low back pain. Setting: Eight districts of the Bagmati Zone of Nepal. Methods: Sixty-five family caregivers of people with SCI having chronic low back pain were recruited from January to March 2017. The factors examined as independent variables included monthly household income, daily caregiving hours, functional independence of people with SCI, low back pain intensity, and functional disability of family caregivers...
2018: Spinal Cord Series and Cases
Fin Biering-Sørensen, Stacey Cohen, Gianna Maria Rodriguez, Kelly Tausk, Josh Martin
Study design: Presentation of implementation of International Spinal Cord Injury (SCI) Data Sets, International Standards for Neurological Classification of SCI (ISNCSCI), and other structured SCI tools in to the Electronic Medical Record (EMR) Epic. Objectives: To describe the implementation of SCI tools in Epic at Rigshospitalet, University of Hospital, Capital Region of Denmark, and the ambitions for the future development of SCI related structured data and their reporting in the Epic EMR to be able to standardize data collection to facilitate research within institutions and collaboratively with other institutions locally and globally...
2018: Spinal Cord Series and Cases
Richard Acland
Cannabis use in medicine continues to confound practitioners. There is confusing interpretation of the efficacy and adverse event data, highlighting the complexity of this unique plant. Cannabis may have a neuroprotective role in SCI.
2018: Spinal Cord Series and Cases
Daniel E Graves
Cannabis is an effective treatment for pain following spinal cord injury that should be available to patients and researchers. The major argument against the rescheduling of cannabis is that the published research is not convincing. This argument is disingenuous at best, given that the evidence has been presented and rejected at many points during the political dialog. Moreover, the original decision to criminalize cannabis did not utilize scientific or medical data. There is tension between the needs of a society to protect the vulnerable by restricting the rights of others to live well and with less pain...
2018: Spinal Cord Series and Cases
Thomas N Bryce
Most people with spinal cord injury (SCI) have chronic pain and effective treatments have not been identified. Within the first two decades of the 21st century, opioids have been commonly prescribed in an attempt to manage pain after SCI, however, the risks and absence of benefit of opioids have become more apparent as opioid crises have developed around the world. This perspective is an argument for why opioids should no longer be prescribed to treat chronic pain after SCI.
2018: Spinal Cord Series and Cases
Peter Wayne New
The controversial issue of prescribing opioids to people with spinal cord damage who have severe pain is discussed in this paper. The reasons for concern regarding the increase in opioid prescription over recent years are outlined, along with a summary of the major potential adverse outcomes associated with opioids, such as falls, respiratory suppression, adverse endocrine effects, cognitive impairment, and the potential for opioid abuse, addiction and death. Situations when opioids are more appropriate are considered to be in the immediate post-trauma or post-operative periods...
2018: Spinal Cord Series and Cases
Stefan G Kertesz, Ajay Manhapra
The high prevalence of pain in patients with spinal cord injury, coupled with a national recalibration of opioid prescribing, presents a challenge. Prescribers may attempt to taper opioids, where observable harms from the prescribed opioid appear to outweigh benefits, a stance endorsed by the 2016 Guideline for Prescribing Opioids for Chronic Pain, issued by the Centers for Disease Control and Prevention. Different considerations apply when clinicians wish to reduce doses in adherent and stable patients, absent their consent...
2018: Spinal Cord Series and Cases
Marcalee Alexander
No abstract text is available yet for this article.
2018: Spinal Cord Series and Cases
Elly M F Waals, Marcel W M Post, Koenraad Peers, Carlotte Kiekens
Introduction: Living with SCI remains a challenge and some patients fear or are faced with an inability to master this challenge sufficiently to regain a satisfactory quality of life. The suicide rate within the population with SCI is elevated compared with the general population. Especially now that life expectancy of persons with SCI and age at onset of SCI are increasing, caregivers of persons with SCI can be confronted with requests for end-of-life care or even assistance in dying...
2018: Spinal Cord Series and Cases
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