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Acute cervical spinal cord injury

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
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
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
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
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
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
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
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
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
Keyvan Eghbal, Fariborz Ghaffarpasand
BACKGROUND: Several injuries in 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 following 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 neck and shoulder...
August 30, 2016: World Neurosurgery
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
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
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
S Le Pape, R Gauthé, C Latrobe, J Leroux, X Roussignol, M Ould-Slimane
An episode of acute decompensation of cervical myelopathy occurred after an injury without fracture of an os odontoideum associated with a compressive retro-odontoid cyst. The 51-year-old female patient presented Fränkel C, Nurick grade 4 neurological status and pyramid syndrome. The initial MRI demonstrated an intramedullary T2 hyperintense signal in the context of spinal cord narrowing. The retro-odontoid cyst demonstrates atlantoaxial instability related to the os odontoideum. Harms C1-C2 arthrodesis without laminectomy was performed and the cyst disappeared completely...
October 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Yogesh Kumar, Daichi Hayashi
Magnetic resonance imaging (MRI) has been playing an increasingly important role in the spinal trauma patients due to high sensitivity for detection of acute soft tissue and cord injuries. More and more patients are undergoing MRI for spinal trauma in the emergency settings, thus necessitating the interpreting physicians to be familiar with MRI findings in spinal trauma. In this pictorial review, we will first describe the normal anatomy of various ligamentous structures. Indications of MRI in spinal trauma as well as the role of MRI in diagnosing spinal cord and soft tissue injuries will then be discussed...
2016: BMC Musculoskeletal Disorders
Sunil Kukreja, Jan Schwab, Francis Farhadi
INTRODUCTION: The influence of initial clinical and imaging parameters on long-term outcomes following spinal cord injury (SCI) has been examined in previous studies, often with inconsistent or contradictory findings. In this study, we evaluated a comprehensive set of admission parameters and analyzed their relationships with long-term neurological recovery. METHODS: Institutional databases were used to retrospectively identify consecutive patients with cervical SCI admitted between 2008 and 2015...
August 2016: Neurosurgery
H A Anton, W C Miller, A F Townson, B Imam, N Silverberg, S Forwell
STUDY DESIGN: Prospective cohort study. OBJECTIVES: To determine the prevalence and course of fatigue following acute spinal cord injury (SCI) during rehabilitation and after discharge. SETTING: Tertiary spinal cord rehabilitation facility. METHODS: Fifty-two patients with traumatic SCI were assessed after admission to rehabilitation and followed until 6-months post discharge into the community. Fatigue was measured using the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale for Spinal Cord Injury (MFIS-SCI) at admission, discharge and 6 months after discharge...
June 28, 2016: Spinal Cord
Brian K Kwon, Femke Streijger, Nader Fallah, Vanessa Noonan, Lise M Belanger, Leanna Ritchie, Scott J Paquette, Tamir Ailon, Michael C Boyd, John Street, Charles G Fisher, Marcel F Dvorak
Neurologic impairment after spinal cord injury (SCI) is currently measured and classified by functional examination. Biological markers that objectively classify injury severity and predict outcome would greatly facilitate efforts to evaluate acute SCI therapies. The purpose of this study was to determine how well inflammatory and structural proteins within the CSF of acute traumatic SCI patients predicted American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade conversion and motor score improvement over 6 months...
June 27, 2016: Journal of Neurotrauma
Tsuneaki Takao, Seiji Okada, Yuichiro Morishita, Takeshi Maeda, Kensuke Kubota, Ryosuke Ideta, Eiji Mori, Itaru Yugue, Osamu Kawano, Hiroaki Sakai, Takayoshi Ueta, Keiichiro Shiba
STUDY DESIGN: Retrospective case series. PURPOSE: To clarify the influence of cervical spinal canal stenosis (CSCS) on neurological functional recovery after traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation. OVERVIEW OF LITERATURE: The biomechanical etiology of traumatic CSCI remains under discussion and its relationship with CSCS is one of the most controversial issues in the clinical management of traumatic CSCI...
June 2016: Asian Spine Journal
Ibrahim Gundogdu, Erhan Arif Ozturk, Ebru Umay, Ozgur Zeliha Karaahmet, Ece Unlu, Aytul Cakci
PURPOSE: Following repeated weaning failures in acute care services, spinal cord injury (SCI) patients who require prolonged mechanical ventilation and tracheostomy are discharged to their homes or skilled nursing facilities, with a portable mechanical ventilator (MV) and/or tracheostomy tube (TT) with excess risk of complications, high cost and low quality of life. We hypothesized that many difficult-to-wean patients with cervical SCI can be successfully managed in a rehabilitation clinic...
June 23, 2016: Disability and Rehabilitation
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