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Acute cervical spinal cord injury

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https://www.readbyqxmd.com/read/28904564/the-role-of-pre-reduction-mri-in-the-management-of-complex-cervical-spine-fracture-dislocations-an-ongoing-controversy
#1
Sergiu Botolin, Todd F VanderHeiden, Ernest E Moore, Herbert Fried, Philip F Stahel
BACKGROUND: Cervical spine fracture-dislocations in neurologically intact patients represent a surgical challenge due to the risk of inflicting iatrogenic spinal cord compression by closed reduction maneuvers. The use of MRI for early advanced imaging in these injuries remains controversially debated. CASE PRESENTATION: A 54-year old man sustained a fall over the handlebars of his racing bicycle. The helmeted patient sustained a fall on his head which resulted in a hyperflexion injury of the neck...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28890805/outcome-after-post-acute-spinal-cord-specific-rehabilitation-a-german-single-center-study
#2
Matthias Ponfick
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of this study was to analyze single center outcome measures of spinal cord injury (SCI)-specific rehabilitation (SCISR) in Germany. SETTING: The study was conducted at an SCI specialized rehabilitation center. METHODS: Nonparametric tests for outcome description such as SCIM and length of stay. Logistic regression for outcome prediction was used. RESULTS: One hundred and sixty patients (113 men, 47 women) with a mean age of 64...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28885343/risk-factors-and-the-surgery-affection-of-respiratory-complication-and-its-mortality-after-acute-traumatic-cervical-spinal-cord-injury
#3
Xiao-Xiong Yang, Zong-Qiang Huang, Zhong-Hai Li, Dong-Feng Ren, Jia-Guang Tang
The aim of this study is to estimate the risk factors of both respiratory complication (RC) and mortality after acute traumatic cervical spinal cord injury (TCSCI). Between July 2005 and July 2015, in 181 patients (142 males and 39 females; mean age 41.0 years) with acute TCSCI, we compared the difference and odds ratio in RC group (n = 73) with that of non-RC group (n = 108), and also death group (n = 15) and survival group (n = 166). We collected injury-related information after half a year of injury, which is as follows: the causes of injury, time of surgery, ICU (intensive care unit) days, ventilator days, ASIA (American Spinal Injury Association) classification, neurological injury, CIPS (Clinical Pulmonary Infection Score), and BMI (body mass index)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28872148/incidence-of-traumatic-spinal-cord-injury-in-italy-during-2013-2014-a-population-based-study
#4
S Ferro, L Cecconi, J Bonavita, M C Pagliacci, A Biggeri, M Franceschini
STUDY DESIGN: Observational prospective population-based incidence study. OBJECTIVES: The main objective of this study was to assess the incidence of traumatic spinal cord injuries (TSCIs) and incidence rates, in order to provide estimates by age, gender, characteristics and cause. SETTING: This study was conducted at acute-care spinal cord injury (SCI) hospitals and SCI centers from 11 Italian regions, between 1 October 2013 and 30 September 2014...
September 5, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28818826/test-retest-and-interreader-reproducibility-of-semiautomated-atlas-based-analysis-of-diffusion-tensor-imaging-data-in-acute-cervical-spine-trauma-in-adult-patients
#5
D J Peterson, A M Rutman, D S Hippe, J G Jarvik, F H Chokshi, M R Reyes, C H Bombardier, M Mossa-Basha
BACKGROUND AND PURPOSE: DTI is a tool for microstructural spinal cord injury evaluation. This study evaluated the reproducibility of a semiautomated segmentation algorithm of spinal cord DTI. MATERIALS AND METHODS: Forty-two consecutive patients undergoing acute trauma cervical spine MR imaging underwent 2 axial DTI scans in addition to their clinical scan. The datasets were put through a semiautomated probabilistic segmentation algorithm that selected white matter, gray matter, and 24 individual white matter tracts...
August 17, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28798719/fulminant-acute-ascending-hemorrhagic-myelitis-treated-with-eculizumab
#6
Nang Boe Ohnmar Hsam, Klemens Angstwurm, Sebastian Peters, Kornelius Fuchs, Gerhard Schuierer, Ulrich Bogdahn, Robert Weissert
We describe an 18-year-old patient who developed back pain, rapidly ascending sensomotory deficits, bladder dysfunction, Lhermitte's sign, absent abdominal reflexes of all three levels, brisk tendon reflexes, and positive Babinski's sign. Magnetic resonance imaging of the spinal cord showed a long segment of cervical and thoracic intramedullary signal hyperintensity suggesting a longitudinally extensive transverse myelitis possibly within the course of a fast progressing ascending immune-mediated hemorrhagic myelopathy...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28771534/neural-stem-cell-mediated-recovery-is-enhanced-by-chondroitinase-abc-pretreatment-in-chronic-cervical-spinal-cord-injury
#7
Hidenori Suzuki, Christopher S Ahuja, Ryan P Salewski, Lijun Li, Kajana Satkunendrarajah, Narihito Nagoshi, Shinsuke Shibata, Michael G Fehlings
Traumatic spinal cord injuries (SCIs) affect millions of people worldwide; the majority of whom are in the chronic phase of their injury. Unfortunately, most current treatments target the acute/subacute injury phase as the microenvironment of chronically injured cord consists of a well-established glial scar with inhibitory chondroitin sulfate proteoglycans (CSPGs) which acts as a potent barrier to regeneration. It has been shown that CSPGs can be degraded in vivo by intrathecal Chondroitinase ABC (ChABC) to produce a more permissive environment for regeneration by endogenous cells or transplanted neural stem cells (NSCs) in the subacute phase of injury...
2017: PloS One
https://www.readbyqxmd.com/read/28761518/factors-affecting-outcome-of-acute-cervical-spine-injury-a-prospective-study
#8
Bhavanam Hanuma Srinivas, Alugolu Rajesh, A K Purohit
BACKGROUND: Injury to the spine and spinal cord is one of the common cause of disability and death. Several factors affect the outcome; but which are these factors (alone and in combination), are determining the outcomes are still unknown. The aim of the study was to evaluate the factors influencing the outcome following acute cervical spine injury. MATERIALS AND METHODS: A prospective observational study at single-center with all patients with cervical spinal cord injury (SCI), attending our hospital within a week of injury during a period of October 2011 to July 2013 was included for analysis...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28732686/health-conditions-impact-on-function-health-related-quality-of-life-and-life-satisfaction-following-traumatic-spinal-cord-injury-a-prospective-observational-registry-cohort-study
#9
Carly S Rivers, Nader Fallah, Vanessa K Noonan, David Gt Whitehurst, Carolyn Schwartz, Joel Finkelstein, B Catharine Craven, Karen Ethans, Colleen O'Connell, Catherine Truchon, Chester Ho, A Gary Linassi, Christine Short, Eve Tsai, Brian Drew, Henry Ahn, Marcel F Dvorak, Jérôme Paquet, Michael G Fehlings, Luc Noreau
OBJECTIVE: To analyze relationships among injury, demographic and environmental factors on function, HRQoL and life satisfaction in individuals with traumatic SCI. DESIGN: prospective observational registry cohort study SETTING: 31 acute and rehabilitation SCI centres PARTICIPANTS: Participants (N=340) from the Rick Hansen Spinal Cord Injury Registry (RHSCIR) who were prospectively recruited from 2004-2014 were included. The model cohort included 340 participants: 79...
July 18, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28724333/the-impact-of-acute-management-on-the-occurrence-of-medical-complications-during-the-specialized-spinal-cord-injury-acute-hospitalization-following-motor-complete-cervical-spinal-cord-injury
#10
Andréane Richard-Denis, Debbie Erhmann Feldman, Cynthia Thompson, Jean-Marc Mac-Thiong
CONTEXT/OBJECTIVE: Determine the impact of early admission and complete perioperative management in a specialized spinal cord injury (SCI) trauma center (SCI-center) on the occurrence of medical complications following tetraplegia. DESIGN: A retrospective comparative cohort study of prospectively collected data involving 116 individuals was conducted. Group 1 (N=87) was early managed in a SCI-center promptly after the trauma, whereas Group 2 (N=29) was surgically and preoperatively managed in a non-specialized (NS) center before being transferred to the SCI-center...
July 19, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28683592/functional-outcomes-in-individuals-undergoing-very-early-5%C3%A2-h-and-early-5-24%C3%A2-h-surgical-decompression-in-traumatic-cervical-spinal-cord-injury-analysis-of-neurological-improvement-from-the-austrian-spinal-cord-injury-study
#11
Georg Mattiassich, Maria Gollwitzer, Franz Gaderer, Martina Blocher, Michael Osti, Markkus Lill, Reinhold Ortmaier, Thomas Haider, Wolfgang Hitzl, Herbert Resch, Stephanie Aschauer-Wallner
Our study aim was to assess the neurological outcomes of surgical decompression and stabilization within 5 and 24 h after injury. We performed a multi-center, retrospective cohort study in adolescents and adults 15-85 years of age presenting cervical spinal cord injury (CSCI) at one of 6 Austrian trauma centers participating in the Austrian Spinal Cord Injury Study (ASCIS). Neurological outcomes were measured using the American Spinal Injury Association Impairment Scale (AIS) grade according to the International Standards For Neurological Classification Of Spinal Cord Injury (ISNCSCI) form after at least 6 months of follow-up (FU)...
August 10, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28673831/risk-factors-for-laryngeal-penetration-aspiration-in-patients-with-acute-traumatic-cervical-spinal-cord-injury
#12
Tiina Ihalainen, Irina Rinta-Kiikka, Teemu M Luoto, Tuomo Thesleff, Mika Helminen, Anna-Maija Korpijaakko-Huuhka, Antti Ronkainen
BACKGROUND CONTEXT: Laryngeal penetration-aspiration, the entry of material into the airways, is considered the most severe subtype of dysphagia and is common among patients with acute cervical spinal cord injury (SCI). PURPOSE: The aim of this study was to investigate risk factors for penetration-aspiration in patients with acute traumatic cervical spinal cord injury (TCSCI). STUDY DESIGN: This is a prospective cohort study. PATIENT SAMPLE: Thirty-seven patients with TCSCI were included in the study...
June 30, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28673827/the-impact-of-spine-stability-on-cervical-spinal-cord-injury-with-respect-to-demographics-management-and-outcome-a-prospective-cohort-from-a-national-spinal-cord-injury-registry
#13
Jérôme Paquet, Carly S Rivers, Dilnur Kurban, Joel Finkelstein, Jin W Tee, Vanessa K Noonan, Brian K Kwon, R John Hurlbert, Sean Christie, Eve C Tsai, Henry Ahn, Brian Drew, Christopher S Bailey, Daryl R Fourney, Najmedden Attabib, Michael G Johnson, Michael G Fehlings, Stefan Parent, Marcel F Dvorak
BACKGROUND CONTEXT: Emergent surgery for patients with a traumatic spinal cord injury (SCI) is seen as the gold standard in acute management. However, optimal treatment for those with the clinical diagnosis of central cord syndrome (CCS) is less clear, and classic definitions of CCS do not identify a unique population of patients. PURPOSE: The study aimed to test the authors' hypothesis that spine stability can identify a unique group of patients with regard to demographics, management, and outcomes, which classic CCS definitions do not...
July 1, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28669296/a-neurophysiological-approach-to-nerve-transfer-to-restore-upper-limb-function-in-cervical-spinal-cord-injury
#14
Ross M Mandeville, Justin M Brown, Geoffrey L Sheean
A successful nerve transfer surgery can provide a wealth of benefits to a patient with cervical spinal cord injury. The process of surgical decision making ideally uses all pertinent information to produce the best functional outcome. Reliance on clinical examination and imaging studies alone can miss valuable information on the state of spinal cord health. In this regard, neurophysiological evaluation has the potential to effectively gauge the neurological status of even select pools of anterior horn cells and their axons to small nerve branches in question to determine the potential efficacy of their use in a transfer...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28653674/effects-of-orthotic-therapeutic-electrical-stimulation-in-the-treatment-of-patients-with-paresis-associated-with-acute-cervical-spinal-cord-injury-a-randomized-control-trial
#15
K Iwahashi, T Hayashi, R Watanabe, A Nishimura, T Ueta, T Maeda, K Shiba
STUDY DESIGN: A randomized controlled trial. OBJECTIVES: To determine the effects of orthotic therapeutic electrical stimulation (TES) on the hand in patients with paresis associated with acute cervical spinal cord injury. SETTING: Spinal Injuries Center, Fukuoka, Japan. METHODS: The study included patients treated for spinal cord injuries (Frankel classification, grades B and C) at our institution within 1 week post injury between May 2011 and December 2014...
June 27, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28631744/traumatic-cervical-spinal-cord-injury-a-prospective-clinical-study-of-laryngeal-penetration-and-aspiration
#16
T Ihalainen, I Rinta-Kiikka, T M Luoto, E A Koskinen, A-M Korpijaakko-Huuhka, A Ronkainen
STUDY DESIGN: Prospective cohort study. OBJECTIVES: Dysphagia is a relatively common secondary complication in patients with traumatic cervical spinal cord injuries (TCSCI). The purpose of this study was to determine the incidence of aspiration and penetration in patients with acute TCSCI. SETTING: Tampere University Hospital, Tampere, Finland. METHODS: A total of 46 patients with TCSCI were evaluated with a videofluoroscopic swallowing study (VFSS)...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28628531/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
#17
COMPARATIVE STUDY
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...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28592693/nongenomic-actions-of-17-%C3%AE-estradiol-restore-respiratory-neuroplasticity-in-young-ovariectomized-female-rats
#18
Brendan J Dougherty, Elizabeth S Kopp, Jyoti J Watters
Gonadal steroids modulate CNS plasticity, including phrenic long-term facilitation (pLTF), a form of spinal respiratory neuroplasticity resulting in increased phrenic nerve motor output following exposure to acute intermittent hypoxia (aIH; three 5 min episodes, 10.5% O2). Despite the importance of respiratory system neuroplasticity, and its dependence on estrogen in males, little is known about pLTF expression or mechanisms of estrogen signaling in females. Here, we tested the hypotheses that (1) pLTF expression in young, gonadally intact female rats would be expressed during estrous cycle stages in which 17β-estradiol (E2) is naturally high (e...
July 12, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28578120/intraspinal-pressure-monitoring-and-extensive-duroplasty-in-the-acute-phase-of-traumatic-spinal-cord-injury-a-systematic-review
#19
REVIEW
Tomasz Tykocki, Łukasz Poniatowski, Marcin Czyż, Michael Koziara, Guy Wynne-Jones
OBJECTIVE: The prognosis in cervical spinal cord injury is poor, and surgical and neurointensive care management need further improvement. Monitoring of the intraspinal pressure (ISP) at an early stage after traumatic spinal cord injury (tSCI) is useful clinically. MATERIALS AND METHODS: Obtaining continuous spinal cord perfusion pressure (SCPP) measurements based on the difference between mean arterial pressure and ISP allows offering best medical and surgical treatment during this critical phase of tSCI...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28570271/delayed-decompression-exacerbates-ischemia-reperfusion-injury-in-cervical-compressive-myelopathy
#20
Pia M Vidal, Spyridon K Karadimas, Antigona Ulndreaj, Alex M Laliberte, Lindsay Tetreault, Stefania Forner, Jian Wang, Warren D Foltz, Michael G Fehlings
Degenerative cervical myelopathy (DCM) is the most common progressive nontraumatic spinal cord injury. The most common recommended treatment is surgical decompression, although the optimal timing of intervention is an area of ongoing debate. The primary objective of this study was to assess whether a delay in decompression could influence the extent of ischemia-reperfusion injury and alter the trajectory of outcome in DCM. Using a DCM mouse model, we show that decompression acutely led to a 1.5- to 2-fold increase in levels of inflammatory cytokines within the spinal cord...
June 2, 2017: JCI Insight
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