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Acute cervical spinal cord injury

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https://www.readbyqxmd.com/read/29325346/-evidence-based-guideline-for-the-management-of-acute-subaxial-cervical-spine-injury
#1
(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]
https://www.readbyqxmd.com/read/29316845/rho-inhibitor-vx-210-in-acute-traumatic-subaxial-cervical-spinal-cord-injury-design-of-the-spinal-cord-injury-rho-inhibition-investigation-spring-clinical-trial
#2
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
https://www.readbyqxmd.com/read/29303132/surgical-decompression-for-traumatic-spinal-cord-injury-in-a-tertiary-center
#3
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
https://www.readbyqxmd.com/read/29284797/bedside-quantification-of-fat-free-mass-in-acute-spinal-cord-injury-using-bioelectrical-impedance-analysis-a-psychometric-study
#4
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
https://www.readbyqxmd.com/read/29284793/sensitivity-and-specificity-of-the-knee-up-test-for-estimation-of-the-american-spinal-injury-association-impairment-scale-in-patients-with-acute-motor-incomplete-cervical-spinal-cord-injury
#5
Itaru Yugué, Seiji Okada, Takeshi Maeda, Takayoshi Ueta, Keiichiro Shiba
STUDY DESIGN: A retrospective study. OBJECTIVE: Precise classification of the neurological state of patients with acute cervical spinal cord injury (CSCI) can be challenging. This study proposed a useful and simple clinical method to help classify patients with incomplete CSCI. SETTING: Spinal Injuries Centre, Japan. METHODS: The sensitivity and specificity of the 'knee-up test' were evaluated in patients with acute CSCI classified as American Spinal Injury Association Impairment Scale (AIS) C or D...
December 28, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29279749/a-safe-surgical-procedure-for-old-distractive-flexion-injuries-of-the-subaxial-cervical-spine
#6
Osamu Kawano, Takeshi Maeda, Eiji Mori, Itaru Yugue, Takayoshi Ueta, Keiichiro Shiba
Study Design: Retrospective review. Purpose: To describe a safe and effective surgical procedure for old distractive flexion (DF) injuries of the subaxial cervical spine. Overview of Literature: Surgical treatment is required in old cases when a progression of the kyphotic deformity and/or persistent neck pain and/or the appearance of new neurological symptoms are observed. Since surgical treatment is more complicated and dangerous in old cases than in acute distractive-flexion cases, the indications for surgery and the selection of the surgical procedure must be carefully conducted...
December 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29279015/rodent-neural-progenitor-cells-support-functional-recovery-after-cervical-spinal-cord-contusion
#7
John H Brock, Lori Graham, Eileen Staufenberg, Sarah Im, Mark H Tuszynski
Previously others and we have shown that rodent neural progenitor cells (NPCs) can support functional recovery following cervical and thoracic transection injuries. To extend these observations to a more clinically relevant model of spinal cord injury, we performed unilateral mid-cervical contusion injuries in Fischer 344 rats. Two-weeks later, E14-derived syngeneic spinal cord-derived neural progenitor cells were implanted into the lesion cavity. Control animals received either no grafts or fibroblast grafts...
December 26, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29236577/a-focal-cooling-method-for-the-cervical-spinal-cord-a-percutaneous-approach-to-the-dorsal-neck-in-dogs
#8
Kanichiro Kaneko, Yasuharu Noishiki, Kengo Funakoshi, Tomoyuki Saito
For the treatment of acute cervical spinal cord injuries, a local epidural cooling system using a percutaneous technique was proposed. In this animal study, regional low temperature was obtained stably in the cervical epidural space (CED) without decreasing temperatures at the rectum and the thoracic epidural space. Three stainless steel tubes were inserted percutaneously using the lateral approach into 3 serial interspinous spaces of the neck of 12 beagles under radiographic guidance. Two temperature probes were inserted into the CEDs at the level of the middle cooling tube...
December 13, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29205695/diminished-gastric-prokinetic-response-to-ghrelin-in-a-rat-model-of-spinal-cord-injury
#9
E M Besecker, A R White, G M Holmes
BACKGROUND: Patients with cervical or high-thoracic spinal cord injury (SCI) often present reduced gastric emptying and early satiety. Ghrelin provokes motility via gastric vagal neurocircuitry and ghrelin receptor agonists offer a therapeutic option for gastroparesis. We have previously shown that experimental high-thoracic injury (T3-SCI) diminishes sensitivity to another gastrointestinal peptide, cholecystokinin. This study tests the hypothesis that T3-SCI impairs the vagally mediated response to ghrelin...
December 5, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29200479/management-of-sub-axial-cervical-spine-injuries
#10
Gautam Zaveri, Gurdip Das
Sub-axial cervical spine injuries are commonly seen in patients with blunt trauma. They may be associated with spinal cord injury resulting in tetraplegia and severe permanent disability. Immobilization of the neck, maintenance of blood pressure and oxygenation, rapid clinical and radiological assessment of all injuries, and realignment of the spinal column are the key steps in the emergency management of these injuries. The role of intravenous methylprednisolone administration in acute spinal cord injuries remains controversial...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29174588/trimethylene-carbonate-caprolactone-conduit-with-poly-p-dioxanone-microfilaments-to-promote-regeneration-after-spinal-cord-injury
#11
Liudmila N Novikova, Mallappa K Kolar, Paul J Kingham, Andreas Ullrich, Sven Oberhoffner, Monika Renardy, Michael Doser, Erhard Müller, Mikael Wiberg, Lev N Novikov
Spinal cord injury (SCI) is often associated with scarring and cavity formation and therefore bridging strategies are essential to provide a physical substrate for axonal regeneration. In this study we investigated the effects of a biodegradable conduit made from trimethylene carbonate and ε-caprolactone (TC) containing poly-p-dioxanone microfilaments (PDO) with longitudinal grooves on regeneration after SCI in adult rats. In vitro studies demonstrated that different cell types including astrocytes, meningeal fibroblasts, Schwann cells and adult sensory dorsal root ganglia neurons can grow on the TC and PDO material...
November 22, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/29164038/timing-of-decompression-in-patients-with-acute-spinal-cord-injury-a-systematic-review
#12
REVIEW
Jefferson R Wilson, Lindsay A Tetreault, Brian K Kwon, Paul M Arnold, Thomas E Mroz, Christopher Shaffrey, James S Harrop, Jens R Chapman, Steve Casha, Andrea C Skelly, Haley K Holmer, Erika D Brodt, Michael G Fehlings
Study Design: Systematic review. Objective: To conduct a systematic review and synthesis of the literature to assess the comparative effectiveness, safety, and cost-effectiveness of early (≤24 hours) versus late decompression (>24 hours) in adults with acute spinal cord injury (SCI). Methods: A systematic search was conducted of Medline, EMBASE, the Cochrane Collaboration Library, and Google Scholar to identify studies published through November 6, 2014...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164037/guidelines-for-the-management-of-degenerative-cervical-myelopathy-and-acute-spinal-cord-injury-development-process-and-methodology
#13
Lindsay A Tetreault, Andrea C Skelly, Joseph R Dettori, Jefferson R Wilson, Allan R Martin, Michael G Fehlings
The Institute of Medicine defines clinical practice guidelines as "statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options." Guidelines help clinicians implement best evidence into practice and encourage informed shared decision making with patients. Guidelines are intended to enhance the quality of patient care by discouraging ineffective and potentially harmful interventions and standardizing practice...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164029/a-clinical-practice-guideline-for-the-management-of-patients-with-acute-spinal-cord-injury-recommendations-on-the-type-and-timing-of-rehabilitation
#14
Michael G Fehlings, Lindsay A Tetreault, Bizhan Aarabi, Paul Anderson, Paul M Arnold, Darrel S Brodke, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, James S Harrop, Gregory Hawryluk, Langston T Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar Kurpad, Brian K Kwon, Ralph J Marino, Allan R Martin, Eric Massicotte, Geno Merli, James W Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Anoushka Singh, Andrea C Skelly, Eve C Tsai, Alexander Vaccaro, Jefferson R Wilson, Albert Yee, Anthony S Burns
Introduction: The objective of this study is to develop guidelines that outline the appropriate type and timing of rehabilitation in patients with acute spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to rehabilitation in patients with acute SCI. A multidisciplinary guideline development group used this information, and their clinical expertise, to develop recommendations for the type and timing of rehabilitation...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29160143/some-autonomic-deficits-of-acute-or-chronic-cervical-spinal-contusion-reversed-by-interim-brainstem-stimulation
#15
Alberto A Vitores, Stephanie S Sloley, Catalina Martinez, Melissa M Carballosa-Gautam, Ian D Hentall
Prolonged electrical stimulation of the hindbrain's nucleus raphe magnus (NRM) or its major midbrain input region, the periaqueductal gray (PAG), was previously found in rats to promote recovery from sensory-motor and histological deficits of acute thoracic spinal cord injury (SCI). Here, some visceral deficits of acute and chronic midline cervical (C5) contusion are similarly examined. Cranially implanted wireless stimulators delivered intermittent 8 Hz, 30-70 µA cathodal pulse trains to a brainstem microelectrode...
November 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29141498/incidence-and-natural-progression-of-neurogenic-shock-following-traumatic-spinal-cord-injury
#16
Ian A Ruiz, Jordan W Squair, Aaron A Phillips, Christine D Lukac, Dayan Huang, Patrick Oxciano, Dong Yan, Andrei V Krassioukov
Neurogenic shock, a distributive type of circulatory shock following spinal cord injury (SCI), results in profound hypotension. The consequent hemodynamic instability complicates clinical management, delays surgical intervention, and impacts neurological outcome. Moreover, the reported incidence of this condition varies significantly. Here, we establish the true incidence of neurogenic shock by comparing the most common clinical definitions used to diagnose the condition. Further, we characterize the acute progression and recovery of neurogenic shock...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29138486/the-impact-of-a-specialized-spinal-cord-injury-center-as-compared-with-non-specialized-centers-on-the-acute-respiratory-management-of-patients-with-complete-tetraplegia-an-observational-study
#17
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Martin Albert, Jean-Marc Mac-Thiong
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To compare the proportion of tracheostomy placement and duration of mechanical ventilation (MV) in patients with a complete cervical spinal cord injury (SCI) that were managed early or lately in a specialized acute SCI-center. The second objective was to determine the impact of the timing of admission to the SCI-center on the MV support duration. SETTING: A single Level-1 trauma center specialized in SCI care in Quebec (Canada)...
November 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29138091/longitudinal-electrophysiological-changes-after-cervical-hemi-contusion-spinal-cord-injury-in-rats
#18
Zucheng Huang, Rong Li, Junhao Liu, Zhiping Huang, Yong Hu, Xiaoliang Wu, Qingan Zhu
OBJECTIVE: To evaluate the longitudinal somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) characterization from acute to chronic injury following cervical hemi-contusion spinal cord injury (SCI) in rats, and correlate the MEPs & SEPs to the behavioral outcomes. METHODS: Fifteen adult male Sprague-Dawley rats were subjected to the hemi-contusion spinal cord injury at C5. Forelimb MEPs & SEPs were applied to 5 animals before injury and 3h, 1d, 3d, 1w, 2w, 4w and 8w after injury respectively...
November 11, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29088944/the-impact-of-blood-pressure-management-after-spinal-cord-injury-a-systematic-review-of-the-literature
#19
Yamaan S Saadeh, Brandon W Smith, Jacob R Joseph, Sohaib Y Jaffer, Martin J Buckingham, Mark E Oppenlander, Nicholas J Szerlip, Paul Park
OBJECTIVE Spinal cord injury (SCI) results in significant morbidity and mortality. Improving neurological recovery by reducing secondary injury is a major principle in the management of SCI. To minimize secondary injury, blood pressure (BP) augmentation has been advocated. The objective of this study was to review the evidence behind BP management after SCI. METHODS This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Using the PubMed database, the authors identified studies that investigated BP management after acute SCI...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29066098/brown-s%C3%A3-quard-syndrome-and-cervical-post-traumatic-subarachnoid-hematoma
#20
Fernando Rascón-Ramírez, Josué M Avecillas-Chasín, Albert Trondin, M Javier Arredondo
Cervical Traumatic SSH are very rare in literature. They are usually caused by cardiopulmonary diseases that increase vascular pressure causing spinal vessels rupture. In thoracolumbar spine, the spinal puncture is the most common cause. The ventrolateral position is even more unusual. In traumatic brain injury (TBI), an abrupt extension-flexion movement could have caused the rupture of subarachnoid vessels. This, accompanied by the slowed blood "wash out" (probably due to the previous osteoarthrosis and spinal canal stenosis), led to the formation of an organized clot, which caused an acute spinal cord compression syndrome...
October 20, 2017: Neurocirugía
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