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Acute cervical spinal cord injury

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https://www.readbyqxmd.com/read/27898477/costs-and-length-of-stay-for-the-acute-care-of-patients-with-motor-complete-spinal-cord-injury-following-cervical-trauma-the-impact-of-early-transfer-to-specialized-acute-sci-center
#1
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
November 24, 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/27881723/intraspinal-microstimulation-and-diaphragm-activation-following-cervical-spinal-cord-injury
#2
Lynne M Mercier, Elisa J Gonzalez-Rothi, Kristi A Streeter, Savannah S Posgai, Alexander S Poirier, David D Fuller, Paul J Reier, David M Baekey
Intraspinal microstimulation (ISMS), using implanted electrodes, can evoke locomotor movements after spinal cord injury (SCI), but has not been explored in the context of respiratory motor output. An advantage over epidural and direct muscle stimulation is the potential of ISMS to selectively stimulate components of the spinal respiratory network. The present study tested the hypothesis that medullary respiratory activity could be used to trigger mid-cervical ISMS and diaphragm motor unit activation in rats with cervical SCI...
November 23, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27881040/a-single-dose-of-docosahexaenoic-acid-increases-the-functional-recovery-promoted-by-rehabilitation-following-cervical-spinal-cord-injury-in-the-rat
#3
Zhuo-Hao Liu, Ping Yip, John V Priestley, Adina T Michael-Titus
Task-specific rehabilitation has been shown to promote functional recovery after acute spinal cord injury (SCI). Recently, the omega-3 polyunsaturated fatty acid, docosahexaenoic acid (DHA), has been shown to promote neuroplasticity after SCI. Here, we investigated whether the combination of a single bolus of DHA with rehabilitation can enhance the effect of DHA or rehabilitation therapy in adult injured spinal cord. We found enhanced functional improvement with DHA in combination with rehabilitation compared to either treatment alone in a rat cervical lateral hemisection SCI model...
November 23, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27843686/effect-of-spinal-cord-compression-on-local-vascular-blood-flow-and-perfusion-capacity-by-alshareef-m-krishna-v-ferdous-j-aishareef-a-kindy-m-kolachalama-vb-et-al
#4
Nancy E Epstein
BACKGROUND: Different degrees of blood flow/vascular compromise occur with anterior, posterior, or circumferential spinal cord compression/spinal cord injury (SCI). SCI is also divided into primary and secondary injury. Primary SCI refers to the original neurological damage to tissues, whereas secondary injury reflects interruption of normal blood flow leading to further inflammatory response/other local changes which contribute to additional neurological injury. METHODS: The authors developed a quantitative "3-D finite element fluid structure interaction model" of spinal cord blood flow to better document the mechanisms of secondary ischemic damage occurring in the spinal cord anteriorly, posteriorly, or circumferentially...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27842476/recurrent-neurologic-deterioration-after-conservative-treatment-for-acute-traumatic-central-cord-syndrome-without-bony-injury-17-operative-cases-report%C3%AF
#5
Wenjie Jin, Xin Sun, Jia Wang, Xingzhen Liu, Xiushuai Shang, Hairong Tao, Tong Zhu, Kangping Shen
The mechanisms of late recurrent neurologic deterioration after conservative treatment for acute traumatic central cord syndrome (ATCCS) remained unclear. 17 operative cases sustaining late recurrent neurologic deterioration after conservative treatment for ATCCS were reviewed to investigate the mechanisms. The assessment of neurological status was based on International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Gender, age, cause of injury, results of image, conservative treatment and operative data, neurological status on different time points were recorded...
November 14, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27834292/mesenteric-vascular-dysregulation-and-intestinal-inflammation-accompanies-experimental-spinal-cord-injury
#6
Emily M Besecker, Gina M Deiter, Nicole Pironi, Timothy K Cooper, Gregory Michael Holmes
Cervical and high thoracic spinal cord injury (SCI) drastically impairs autonomic nervous system function. Individuals with SCI at thoracic spinal-level 5 (T5) or higher often present cardiovascular disorders that include resting systemic arterial hypotension. Gastrointestinal (GI) tissues are critically dependent upon adequate blood flow and even brief periods of visceral hypoxia triggers GI dysmotility. The aim of this study was to test the hypothesis that T3-SCI induces visceral hypoperfusion, diminished postprandial vascular reflexes and concomitant visceral inflammation...
November 9, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27762167/demographic-and-clinical-characteristics-of-persons-with-spinal-cord-injury-in-turkey-one-year-experience-of-a-primary-referral-rehabilitation-center
#7
Özlem Taşoğlu, Engin Koyuncu, Rabia Daylak, Derya Yumuşak Karacif, Zerrin I Nce, Didem Yenigün, Neşe Özgirgin
OBJECTIVE: To define the demographic and clinical characteristics of persons with spinal cord injury, rehabilitated in a primary referral rehabilitation center in Turkey. DESIGN: Retrospective study. SETTING: Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey Methods: Medical records of all patients with spinal cord injury (acute-subacute-chronic) at a single academic referral center over the course of one year were reviewed...
October 20, 2016: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/27670805/identification-of-patients-with-cervical-sci-suitable-for-early-nerve-transfer-to-achieve-hand-opening
#8
J W Simcock, J A Dunn, N T Buckley, K D Mohammed, G P Beadel, A G Rothwell
STUDY DESIGN: Retrospective audit. OBJECTIVES: The objective of this study was to identify the proportion of patients with cervical spinal cord injury who would potentially benefit from nerve transfer surgery to gain active hand opening, and to determine when a safe nerve transfer decision can be made. SETTING: Christchurch, New Zealand. METHODS: Case note review of the first 12 months following acute cervical spinal cord injury (2007-2012)...
September 27, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27642819/traumatic-sports-related-cervical-spine-injuries
#9
Varun Puvanesarajah, Rabia Qureshi, Jourdan M Cancienne, Hamid Hassanzadeh
Cervical spine trauma in the athlete is not an insignificant occurrence with possibly catastrophic results. Football remains one of the most common and most well studied sporting activities associated with spine injuries. Transient spinal cord and peripheral nerve injuries may manifest as quadriparesis or burners/stingers with symptoms that resolve completely. More severe spinal cord injuries, typically from axial loading on the cervical spine, will cause bilateral symptoms with residual neurological deficit...
September 16, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27630612/monitoring-upper-limb-recovery-after-cervical-spinal-cord-injury-insights-beyond-assessment-scores
#10
Michael Brogioli, Sophie Schneider, Werner L Popp, Urs Albisser, Anne K Brust, Inge-Marie Velstra, Roger Gassert, Armin Curt, Michelle L Starkey
BACKGROUND: Preclinical investigations in animal models demonstrate that enhanced upper limb (UL) activity during rehabilitation promotes motor recovery following spinal cord injury (SCI). Despite this, following SCI in humans, no commonly applied training protocols exist, and therefore, activity-based rehabilitative therapies (ABRT) vary in frequency, duration, and intensity. Quantification of UL recovery is limited to subjective questionnaires or scattered measures of muscle function and movement tasks...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27626139/vagal-control-of-breathing-pattern-after-midcervical-contusion-in-rats
#11
Kun-Ze Lee, Hsiang-Chun Kuo
The present study was designed to establish a midcervical contusion model that can simulate long-term respiratory deficits, and investigate the breathing pattern during vagal-mediated respiratory reflexes following midcervical contusion. Moderate and severe (impactor height: 6.25 or 12.5 mm) contusion was induced at midline C3-4 spinal cord in adult Sprague-Dawley rats. The ventilatory behaviors of unanesthetized were evaluated by whole body plethysmography at 1 day and 1, 2, 4, and 8 weeks post-injury. The tidal volume was decreased and frequency was increased in contused animals compared with uninjured animals at the acute injury state...
October 13, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27621643/does-surgical-treatment-within-4-hours-after-trauma-have-an-influence-on-neurological-remission-in-patients-with-acute-spinal-cord-injury
#12
Bahram Biglari, Christopher Child, Timur Mert Yildirim, Tyler Swing, Tim Reitzel, Arash Moghaddam
BACKGROUND: The proper timing for surgery in patients with acute spinal cord injury is controversial. This study was conducted to detect if there is an advantage in early (within the first 4 hours after trauma) compared to late (between 4 and 24 hours after trauma) surgery on neurological outcome. METHODS: In this single institution prospective cohort study, data were analyzed from 51 spinal cord injured patients with an average age of 43.4 (±19.2) years. The influence of early (29 patients within the first 4 hours) as opposed to late (22 patients between 4 and 24 hours) decompression was evaluated by comparing data for neurological outcome...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27618607/pulmonary-dysfunction-in-patients-after-cervical-spinal-cord-injury-serial-follow-up-measurement-within-the-first-year-post-injury
#13
Jan Sulc, Krystof Slaby, Zuzana Hlinkova, Pavel Kolar, Jiri Kozak, Jiri Kriz
OBJECTIVES: Respiratory complications are most common cause of morbidity/mortality in patients with cervical spinal cord injury (cSCI) due to respiratory muscle weakness and lower diaphragm position resulting in limited availability of inspiration, reduced thorax mobility and limited forced expiration. Differences in respiratory dysfunctions (RDs) in patients with motor complete versus incomplete cSCI were assessed. DESIGN: Prospective longitudinal study, serial measurement...
July 16, 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/27616315/imaging-of-spinal-cord-injury-acute-cervical-spinal-cord-injury-cervical-spondylotic-myelopathy-and-cord-herniation
#14
Kiran Talekar, Michael Poplawski, Rahul Hegde, Mougnyan Cox, Adam Flanders
We review the pathophysiology and imaging findings of acute traumatic spinal cord injury (SCI), cervical spondylotic myelopathy, and briefly review the much less common cord herniation as a unique cause of myelopathy. Acute traumatic SCI is devastating to the patient and the costs to society are staggering. There are currently no "cures" for SCI and the only accepted pharmacologic treatment regimen for traumatic SCI is currently being questioned. Evaluation and prognostication of SCI is a demanding area with significant deficiencies, including lack of biomarkers...
October 2016: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/27597767/spinal-cord-injury-is-associated-with-enhanced-peripheral-chemoreflex-sensitivity
#15
Amy T Bascom, Abdulghani Sankari, M Safwan Badr
Sleep-disordered breathing (SDB) is prevalent in individuals with chronic spinal cord injury (SCI), but the exact mechanism is unknown. The aim of this study was to investigate whether peripheral chemoreceptors activity is enhanced in individuals with chronic SCI compared to abled-bodied control subjects using CO2 and O2 chemical tests. In protocol (1) 30 subjects (8 cervical [cSCI], 7 thoracic [tSCI] and 15 able-bodied [AB]) were studied to determine the ventilatory response to hyperoxia during wakefulness in the supine position...
September 2016: Physiological Reports
https://www.readbyqxmd.com/read/27593761/posterior-cervical-pedicle-screw-rod-plate-instrumentation-combined-with-unilateral-open-door-laminoplasty-for-the-treatment-of-acute-cervical-spinal-cord-compression-injury-report-of-five-cases
#16
Zhang Li, Sun Yu, Jiang Yongchong, Wang Yong
All patients were acute, multi-segment cervical spinal cord compression injury secondary to lower cervical fracture. These patients underwent emergency posterior cervical pedicle screw-rod/plate instrumentation combined with unilateral open-door laminoplasty. Well-placed pedicle screws and good cervical canal dilation were achieved in all patients, as assessed by radiography. Patients were followed up for 6-10 months and showed at least one class improvement in spinal impairment. These cases suggest that simple posterior cervical pedicle screw-rod/plate instrumentation combined with extensive unilateral open-door laminoplasty could repair acute, multi-segment cervical spinal cord compression injury secondary to lower cervical fracture if the cervical sequence is well preserved and does not require restoration...
September 21, 2015: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27591101/an-acute-cervical-subdural-hematoma-as-the-complication-of-acupuncture-case-report-and-literature-review
#17
Keyvan Eghbal, Fariborz Ghaffarpasand
BACKGROUND: Several injuries in the cervical region as complications of acupuncture have been previously reported in the literature, including cord and medulla oblongata injuries, subdural empyema, and cervical hematoma. Spinal cord subdural hematoma is a rare condition mainly associated with coagulopathy, trauma, and iatrogenic procedures. We herein report an acute cervical subdural hematoma after cervical acupuncture for neck and shoulder pain. CASE DESCRIPTION: A 74-year-old woman presented with progressive quadriparesis and sensory deficit after receiving acupuncture in the neck and shoulder...
August 31, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27573517/changes-in-synaptic-transmission-of-substantia-gelatinosa-neurons-after-spinal-cord-hemisection-revealed-by-analysis-using-in%C3%A2-vivo-patch-clamp-recording
#18
Yuji Kozuka, Mikito Kawamata, Hidemasa Furue, Takashi Ishida, Satoshi Tanaka, Akiyoshi Namiki, Michiaki Yamakage
BACKGROUND: After spinal cord injury, central neuropathic pain develops in the majority of spinal cord injury patients. Spinal hemisection in rats, which has been developed as an animal model of spinal cord injury in humans, results in hyperexcitation of spinal dorsal horn neurons soon after the hemisection and thereafter. The hyperexcitation is likely caused by permanent elimination of the descending pain systems. We examined the change in synaptic transmission of substantia gelatinosa neurons following acute spinal hemisection by using an in vivo whole-cell patch-clamp technique...
2016: Molecular Pain
https://www.readbyqxmd.com/read/27556002/neurogenic-fever-after-acute-traumatic-spinal-cord-injury-a-qualitative-systematic-review
#19
REVIEW
Katherine E Savage, Christina V Oleson, Gregory D Schroeder, Gursukhman S Sidhu, Alexander R Vaccaro
STUDY DESIGN: Systematic review. OBJECTIVE: To determine the incidence, pathogenesis, and clinical outcomes related to neurogenic fevers following traumatic spinal cord injury (SCI). METHODS: A systematic review of the literature was performed on thermodysregulation secondary to acute traumatic SCI in adult patients. A literature search was performed using PubMed (MEDLINE), Cochrane Central Register of Controlled Trials, and Scopus. Using strict inclusion and exclusion criteria, seven relevant articles were obtained...
September 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27533063/multi-day-recordings-of-wearable-sensors-are-valid-and-sensitive-measures-of-function-and-independence-in-human-spinal-cord-injury
#20
Michael Brogioli, Werner L Popp, Sophie Schneider, Urs Albisser, Anne K Brust, Angela Frotzler, Roger Gassert, Armin Curt, Michelle L Starkey
Wearable sensor assessment tools have proven to be reliable in measuring function in normal and impaired movement disorders during well-defined assessment protocols. While such assessments can provide valid and sensitive measures of upper limb activity in spinal cord injury (SCI), no assessment tool has yet been introduced into unsupervised daily recordings to complement clinical assessments during rehabilitation. The objective of this study was to measure the overall amount of upper-limb activity in subjects with acute SCI using wearable sensors and relate this to lesion characteristics, independence, and function...
October 12, 2016: Journal of Neurotrauma
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