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Acute cervical spinal cord injury

Christian B Theodotou, George M Ghobrial, Andrew L Middleton, Michael Y Wang, Allan D Levi
BACKGROUND: Cervical facet dislocations are among the most common traumatic spinal injuries. Posterior, anterior, and combined surgical approaches have been described and are widely debated. OBJECTIVE: To demonstrate efficacy in anterior-only surgical management for subaxial cervical facet dislocations. METHODS: A consistent surgical algorithm for cervical facet dislocation was applied over a 19-yr period and analyzed retrospectively in adults with acute unilateral or bilateral facet dislocation of the subaxial cervical spine...
March 14, 2018: Neurosurgery
Ying-Na Qi, Ming-Sheng Tan, Yan-Lei Wang, Wei Wang, Xin-Jie Wu, Qing-Ying Hao, Ping Yi, Feng Yang, Xiang-Sheng Tang
OBJECTIVE: To investigate the effect and mechanism of Buyanghuanwu decoction on platelet activating factor expression in spinal cord tissue of model of acute upper cervical spinal cord injury in rats. METHODS: Sixty SPF grade 3-month-old female Wistar rats were randomly divided into sham operation group, model group, methylprednisolone group and Buyanghuanwu decoction (Traditional Chinese Medicine group, TCM), with 15 rats in each group. The first day after the modeling, the methylprednisolone group were treated by injection of the tail vein for a total of 24 h, the first dose of 30 mg/kg, followed by a dose of 5...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Ming-Sheng Tan, Yan-Lei Wang, Ying-Na Qi, Chun-Ke Dong, Wei Wang, Ping Yi, Feng Yang, Xiang-Sheng Tang, Qing-Ying Hao
OBJECTIVE: To explore the effect and underlying mechanism of decompression(DE)combined with Governor Vessel(GV)electro-acupuncture(EA) on rats with acute severe upper cervical spinal cord compression injury. METHODS: Thirty SPF rats were randomly divided into 5 groups(control group A, B and experiment group C, D, E), 6 rats in each group. The model of acute severe upper cervical spinal cord compression injury were made by forcing a balloon catheter put in atlas pillow clearance...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Tiina Ihalainen, Teemu M Luoto, Irina Rinta-Kiikka, Antti Ronkainen, Anna-Maija Korpijaakko-Huuhka
STUDY DESIGN: Prospective cohort study. OBJECTIVES: This prospective cohort study aims to evaluate the recovery of penetration/aspiration and functional feeding outcome in patients with acute TCSCI. SETTING: Tampere University Hospital, Tampere, Finland METHODS: Forty-six patients with TCSCI were enrolled. All the patients received speech therapeutic interventions based on their clinical needs and were examined with a videofluoroscopic swallowing study (VFSS) at enrollment...
March 12, 2018: Spinal Cord
A Taha, S L M Bakker
In patients with pre-existent cervical spinal canal stenosis, minimal trauma, leading to neck hyperextension, can cause a significant increase of spinal cord compression. However, spinal cord injury is generally associated with major trauma and is usually not expected in patients with minor trauma. The resulting symptoms are diverse, making it even more difficult to diagnose. To illustrate the variety in symptoms at presentation, we describe two male patients aged 66 and 69. Rapid diagnosis is important as acute neurosurgical intervention may be indicated...
2018: Nederlands Tijdschrift Voor Geneeskunde
Kerstin Johansson, Åke Seiger, Malin Forsén, Jeanette Holmgren Nilsson, Lena Hartelius, Ellika Schalling
BACKGROUND: Respiratory muscle impairment following cervical spinal cord injury (CSCI) may lead to reduced voice function, although the individual variation is large. Voice problems in this population may not always receive attention since individuals with CSCI face other, more acute and life-threatening issues that need/receive attention. Currently there is no consensus on the tasks suitable to identify the specific voice impairments and functional voice changes experienced by individuals with CSCI...
February 24, 2018: International Journal of Language & Communication Disorders
Aria Nouri, Lindsay Tetreault, Satoshi Nori, Allan R Martin, Anick Nater, Michael G Fehlings
BACKGROUND: Congenital spinal stenosis (CSS) of the cervical spine is a risk factor for acute spinal cord injury and development of degenerative cervical myelopathy (DCM). OBJECTIVE: To develop magnetic resonance imaging (MRI)-based criteria to diagnose preexisting CSS and evaluate differences between patients with and without CSS. METHODS: A secondary analysis of international prospectively collected data between 2005 and 2011 was conducted...
February 16, 2018: Neurosurgery
Peta Skeers, Camila R Battistuzzo, Jillian M Clark, Stephen Bernard, Brian J C Freeman, Peter E Batchelor
BACKGROUND: Spinal cord injury in the cervical spine is commonly accompanied by cord compression and urgent surgical decompression may improve neurological recovery. However, the extent of spinal cord compression and its relationship to neurological recovery following traumatic thoracolumbar spinal cord injury is unclear. The purpose of this study was to quantify maximum cord compression following thoracolumbar spinal cord injury and to assess the relationship among cord compression, cord swelling, and eventual clinical outcome...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
Prince Antwi, Ryan Grant, Gregory Kuzmik, Khalid Abbed
BACKGROUND: "White cord syndrome" is a very rare condition thought to be the result of acute reperfusion of chronically ischemic areas of the spinal cord. Its hallmark is the presence of intramedullary hyperintense signal on T2-weighted MRI sequences in a patient with unexplained neurologic deficits following a spinal cord decompression. The syndrome is rare and has been reported previously in two patients following anterior cervical decompression and fusion. CASE DESCRIPTION: Here, we report an additional case of this complication in a 68-year-old man who developed acute left-sided hemiparesis after posterior cervical decompression and fusion for cervical spondylotic myelopathy...
February 13, 2018: World Neurosurgery
Belgin Erhan, Rahsan Kemerdere, Osman Kizilkilic, Berrin Gunduz, Murat Hanci
Background: Paraplegia following thoracic spinal surgery or abdominal operations is usually attributed to spinal cord ischemia due to interruption of the segmental spinal vascular supply. Alternatively, the etiology of spinal cord ischemia following cervical surgery is less clear. Case Description: A 14-year-old male became acutely tetraplegic with a C4 sensory level and sphincteric dysfunction 12 h following surgery for tracheal stenosis due to prior intubation...
2018: Surgical Neurology International
Ying Jin, Jed S Shumsky, Itzhak Fischer
The goal of this study was to compare the efficacy of human glial restricted progenitors (hGRPs) in promoting axonal growth of different tracts. We examined the potential of hGRPs grafted into a cervical (C4) dorsal column lesion to test sensory axons, and into a C4 hemisection to test motor tracts. The hGRPs, thawed from frozen stocks, were suspended in a PureCol matrix and grafted acutely into a C4 dorsal column or hemisection lesion. Control rats received PureCol only. Five weeks after transplantation, all transplanted cells survived in rats with the dorsal column lesion but only about half of the grafts in the hemisection...
January 31, 2018: Brain Research
Tony McDonald, Kathy Stiller
Objective To investigate the feasibility and safety and, to a lesser extent efficacy, of inspiratory muscle training (IMT) for patients with acute complete cervical or thoracic spinal cord injury (SCI). Design Prospective, observational pilot study comprising a series of case reports. Setting Tertiary care, public hospital. Participants Seven adult subjects with an acute complete cervical or thoracic SCI. Interventions Participants received IMT as soon as their respiratory condition was stable. A high-resistance, low-repetition program of IMT using a POWERbreathe KH1 device was instituted...
February 5, 2018: Journal of Spinal Cord Medicine
Robert Chase Cornelison, Elisa Gonzalez-Rothi, Stacy L Porvasnik, Steven M Wellman, James H Park, David D Fuller, Christine E Schmidt
Spinal cord injury (SCI) affects a quarter million individuals in the United States, and there is currently no clinical treatment. Both fresh and acellular peripheral nerve grafts can induce spinal axon regeneration and support functional recovery in experimental injury models. Nonetheless, a scaffold that can be injected into a spinal contusion would be far less invasive to apply. We aimed to develop the first injectable acellular nerve graft for promoting repair after contusion SCI. 
 Approach: We report a method to enzymatically solubilize optimized acellular (OA) nerve - a decellularized peripheral nerve graft developed in our laboratory and currently used clinically - to obtain an injectable solution that undergoes thermal gelation under physiological conditions...
January 30, 2018: Biomedical Materials
H Francis Farhadi, Sunil Kukreja, Amy Janelle Minnema, Lohith Vatti, Meera Gopinath, Luciano Prevedello, Cheng Chen, Huiyun Xiang, Jan Schwab
Variable and unpredictable spontaneous recovery can occur following acute cervical traumatic spinal cord injury (tSCI). Despite the critical clinical and interventional trial planning implications of this tSCI feature, baseline measures to accurately predict neurologic recovery are not well defined. In this study, we used data derived from 99 consecutive patients (78 male, 21 female) with acute cervical tSCIs to assess the sensitivity and specificity of various clinical and radiologic factors in predicting recovery at one year after injury...
January 23, 2018: Journal of Neurotrauma
Jean-Claude Stamegna, Kevin Sadelli, Guy Escoffier, Stéphane D Girard, Antoine D Veron, Amandine Bonnet, Michel Khrestchatisky, Patrick Gauthier, Francois Roman
The transplantation of Olfactory Ecto-Mesenchymal Stem Cells (OEMSCs) could be a helpful therapeutic strategy for spinal cord repair. Using an acute rat model of high cervical contusion that provokes a persistent hemi-diaphragmatic and foreleg paralysis, we evaluated the therapeutic effect of a delayed syngeneic transplantation (two days post-contusion) of OEMSCs within the injured spinal cord. Respiratory function was assessed using diaphragmatic electromyography and neuro-electrophysiological recordings of phrenic nerves (innervating the diaphragm)...
January 22, 2018: Journal of Neurotrauma
Wout Füssenich, Sven Hirschfeld Araujo, Birgitt Kowald, Allard Hosman, Marc Auerswald, Roland Thietje
STUDY DESIGN: Retrospective, single centre cohort study. OBJECTIVES: To determine factors associated with ventilator weaning success and failure in patients with acute spinal cord injury (SCI); determine length of time and attempts required to wean from the ventilator successfully and determine the incidence of pneumonia. SETTING: BG Klinikum Hamburg, Level 1 trauma centre, SCI Department, Germany. METHODS: From 2010 until 2017, 165 consecutive patients with cervical SCI, initially dependent on a ventilator, were included and weaned discontinuously via tracheal cannula...
January 16, 2018: Spinal Cord
(no author information available yet)
In order to provide the clinical guidelines of acute subaxial cervical spine injury for the Chinese orthopedic surgeons, the Spine Trauma Group of Chinese Association of Orthopedic Surgeons compiled this guidelines.The guidelines apply to adult patients with acute (less than 3 weeks) subaxial cervical spine and/(or) spinal cord or nerve root injuries. The Study Group wrote the guidelines by setting up questions, determining search words, screening literatures according to inclusion and exclusion criteria, analyzing the included literatures, confirming evidence levels and then providing recommendations...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Michael G Fehlings, Kee D Kim, Bizhan Aarabi, Marco Rizzo, Lisa M Bond, Lisa McKerracher, Alexander Vaccaro, David O Okonkwo
Traumatic spinal cord injury (SCI) is associated with a lifetime of disability stemming from loss of motor, sensory, and autonomic functions; these losses, along with increased comorbid sequelae, negatively impact health outcomes and quality of life. Early decompression surgery after SCI can enhance patient outcomes but does not directly facilitate neural repair and regeneration. Currently, there are no FDA-approved pharmacologic therapies to augment motor function and functional recovery in individuals with traumatic SCI...
January 9, 2018: Journal of Neurotrauma
O A Ojo, E O Poluyi, B S Owolabi, O O Kanu, M O Popoola
BACKGROUND: There are controversies regarding the importance and timing of spinal cord decompression following trauma. Documented evidence shows that early decompression in the setting of acute spinal cord injury (SCI) improves neurologic outcomes. Our objective was to evaluate the outcome of posttraumatic spinal cord decompression with or without spinal stabilization in our region. METHODOLOGY: We performed a cross-sectional study on adult patients who presented with acute spinal cord compression of traumatic etiology within a 2-year period...
November 2017: Nigerian Journal of Clinical Practice
Maya G Panisset, Kate Desneves, Leigh C Ward, Jillian Rafferty, Helena Rodi, Geoff Roff, Doa El-Ansary, Mary P Galea
STUDY DESIGN: Psychometric. OBJECTIVES: Assess the validity of bioimpedance-based measures of fat-free mass (FFM) in acute SCI and of current definitions of obesity based on body mass index (BMI). SETTING: Australia. METHODS: All admissions within eight weeks of a new traumatic SCI were screened. 29% were eligible. 71% of those consented. Twenty participants (18 male) completed deuterium dilution (DD) and bioimpedance-based measurements of FFM...
December 28, 2017: Spinal Cord
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