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Bowel management for spinal patient

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https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#1
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28893706/hypertension-acute-stent-thrombosis-and-paraplegia-6%C3%A2-months-after-thoracic-endovascular-aortic-repair-for-blunt-thoracic-aortic-injury-in-a-22-year-old-patient
#2
Ombretta Martinelli, Federico Faccenna, Alban Malaj, Jihad Jabbour, Salvatore Venosi, Roberto Gattuso, Bruno Gossetti, Luigi Irace
Thoracic endovascular aortic repair (TEVAR) is a less invasive option for managing traumatic injuries of the descending aorta in polytraumatized patients. Concerns arise when treating young patients with TEVAR. A 22-year-old male was admitted to the emergency department following a high-impact road traffic collision. Whole-body computed tomography (CT) scan documented multiple injuries, including rupture of descending thoracic aorta just below the isthmus. There was no evidence of paraplegia or stroke. We decided to treat him in an endovascular fashion with a Zenith Cook (Cook Incorporated, Bloomington, IN) endograft...
September 9, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28840071/chronic-thoracolumbar-subdural-empyema-case-report-and-surgical-management
#3
Azam Basheer, Mohamed Macki, Morenikeji Buraimoh, Asim Mahmood
BACKGROUND: Spinal cord abscesses and spinal subdural empyemas are rare and difficult to treat. CASE DESCRIPTION: A 35-year-old male presented to an outside institution with 2 months of progressive low back pain, weakness, and bowel incontinence; he was diagnosed with an L4 epidural abscess that was poorly managed. When the patient presented to our institution, magnetic resonance imaging (MRI) revealed a well-organized chronic subdural abscess at the thoracolumbar junction...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28834891/interdisciplinary-rehabilitation-for-a-patient-with-incomplete-cervical-spinal-cord-injury-and-multimorbidity-a-case-report
#4
Robert D Vining, Donna M Gosselin, Jeb Thurmond, Kimberlee Case, Frederick R Bruch
RATIONALE: This report describes interdisciplinary rehabilitation for a 51-year-old male recovering from incomplete cervical spinal cord injury (SCI) and multiple comorbidities following an automobile accident. PATIENT CONCERNS: The patient was admitted to a rehabilitation specialty hospital approximately 2 months post SCI and 2 separate surgical fusion procedures (C3-C6). DIAGNOSES: Clinical presentation at the rehabilitation hospital included moderate to severe motor strength loss in both upper and lower extremities, a percutaneous endoscopic gastronomy tube (PEG), dysphagia, bowel/bladder incontinence, dependence on a mechanical lift and tilting wheelchair due to severe orthostatic hypotension, and pre-existing shoulder pain from bilateral joint degeneration...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28777282/intrawound-vancomycin-powder-associated-with-reduced-surgical-site-infection-in-rib-based-distraction-surgery
#5
Justin M Haller, John A Heflin, David A Hulet, Qian Ding, Angela P Presson, John T Smith
BACKGROUND: Despite clinical reports of improved pulmonary function and reduced spinal deformity with rib-based distraction surgery in early-onset scoliosis (EOS) patients, infection remains a common complication, reported as high as 32% in some studies. The purpose of this study was to evaluate intrawound vancomycin powder in pediatric patients managed with rib-based distraction for EOS. METHODS: This was a single institution retrospective cohort study of EOS patients treated with rib-based distraction...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28733159/the-impact-of-a-bladder-training-video-versus-standard-urotherapy-on-quality-of-life-of-children-with-bladder-and-bowel-dysfunction-a-randomized-controlled-trial
#6
N Brownrigg, L H Braga, M Rickard, F Farrokhyar, B Easterbrook, A Dekirmendjian, K Jegatheeswaran, J DeMaria, A J Lorenzo
INTRODUCTION: Bladder and bowel dysfunction (BBD) can negatively impact the quality of life (QoL) of children. Urotherapy is an accepted treatment option for BBD; however, literature that examines the impact of management options on QoL in this population is scarce. OBJECTIVE: To determine whether a bladder training video (BTV) is non-inferior to standard urotherapy (SU) in improving QoL in children with BBD. METHODS: Children aged 5-10 years and who scored ≥11 on the Vancouver Non-Neurogenic Lower Urinary Tract Dysfunction/Dysfunctional Elimination Syndrome Questionnaire (NLUTD/DES) were recruited from a pediatric tertiary care center...
August 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28716325/peripheral-and-sacral-neuromodulation-in-the-treatment-of-neurogenic-lower-urinary-tract-dysfunction
#7
REVIEW
Paholo G Barboglio Romo, Priyanka Gupta
Sacral and peripheral neuromodulation are minimally invasive surgical procedures that are third-line therapy options for the treatment of patients with idiopathic overactive bladder syndrome. There has been interest in their efficacy in the management of neurogenic lower urinary tract dysfunction (NLUTD). Contemporary data suggest promising outcomes for urinary and bowel symptoms in carefully selected patients with spinal cord injury and/or multiple sclerosis. This article reviews the current literature regarding urinary and bowel outcomes in patients with NLUTD and also discusses contemporary studies that suggest that treatment during particular stages of neurologic injury may prevent long-term urinary sequelae...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28639937/a-multicentre-randomised-controlled-trial-of-intravenous-immunoglobulin-compared-with-standard-therapy-for-the-treatment-of-transverse-myelitis-in-adults-and-children-strive
#8
Michael Absoud, Peter Brex, Olga Ciccarelli, Onyinye Diribe, Gavin Giovannoni, Jennifer Hellier, Rosemary Howe, Rachel Holland, Joanna Kelly, Paul McCrone, Caroline Murphy, Jackie Palace, Andrew Pickles, Michael Pike, Neil Robertson, Anu Jacob, Ming Lim
BACKGROUND: Transverse myelitis (TM) is an immune-mediated disorder of the spinal cord that affects adults and children and that causes motor, sensory and autonomic dysfunction. There is a prolonged recovery phase, which may continue for many years. Neuromyelitis optica (NMO) is an uncommon relapsing inflammatory central nervous system condition in which TM can be the first presenting symptom. As TM and NMO affect many patients in the prime of their working life, the disorder can impose a significant demand on health resources...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28547859/giant-cell-tumor-of-the-mobile-spine-occurring-in-pregnancy-a-case-report-and-literature-review
#9
Kai Zheng, Ming Xu, Bing Wang, Xiu-Chun Yu, Yong-Cheng Hu
Giant cell tumor (GCT) is a benign, locally aggressive tumor that rarely occurs in the spine. They usually occur in patients between 20 and 40 years of age; some patients with GCT present in hospital with pregnancy. The management of these patients can be challenging. The current study reports a case of GCT located in the sixth thoracic vertebra of a 31-year-old female at 34 weeks of gestation. An osteolytic lesion, 3.5 cm × 3.5 cm in diameter, was identified on CT. An MRI test of the lesion revealed a soft tissue mass involving the T 6-7 vertebrae, extending to the right pedicle of the T 6 vertebra and causing significant spinal cord compression...
May 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28545800/outcomes-and-satisfaction-in-pediatric-patients-with-chait-cecostomy-tubes
#10
Mark D Bevill, Kristine Bonnett, Angela Arlen, Christopher Cooper, Cheryl Baxter, Douglas W Storm
INTRODUCTION: Patients with spina bifida and other spinal dysraphisms commonly suffer from fecal incontinence and constipation, which can be treated with antegrade continence enemas. Currently, information regarding outcomes and satisfaction in children who have Chait cecostomy tubes is lacking. The aim of our study was to evaluate the effectiveness of Chait cecostomy tubes in management of constipation in children with spinal dysraphisms. MATERIALS AND METHODS: A questionnaire was completed by patients and/or their families during office visits at the University of Iowa or Nationwide Children's Hospital during follow-up pediatric urology office visits...
August 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28540144/spondylitis-transmitted-from-infected-aortic-grafts-a-review
#11
REVIEW
Panayiotis D Megaloikonomos, Thekla Antoniadou, Leonidas Dimopoulos, Marcos Liontos, Vasilios Igoumenou, Georgios N Panagopoulos, Efthymia Giannitsioti, Andreas Lazaris, Andreas F Mavrogenis
Graft infection following aortic aneurysms repair is an uncommon but devastating complication; its incidence ranges from <1% to 6% (mean 4%), with an associated perioperative and overall mortality of 12% and 17.5-20%, respectively. The most common causative organisms are Staphylococcus aureus and Escherichia coli; causative bacteria typically arise from the skin or gastrointestinal tract. The pathogenetic mechanisms of aortic graft infections are mainly breaks in sterile technique during its implantation, superinfection during bacteremia from a variety of sources, severe intraperitoneal or retroperitoneal inflammation, inoculation of bacteria during postoperative percutaneous interventions to manage various types of endoleaks, and external injury of the vascular graft...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28532916/spinal-intramedullary-tuberculosis-with-concurrent-supra-and-infratentorial-intracranial-disease-in-a-9-month-old-boy-case-report-and-comprehensive-review-of-the-literature
#12
REVIEW
Michael George Zaki Ghali, Visish M Srinivasan, Marc J Kim, Archana Malik
BACKGROUND: Tuberculous involvement of the spinal cord parenchyma is an exceedingly rare clinical entity; even more so is concurrent intracranial tuberculosis (TB). Spinal intramedullary TB presents with a characteristic subacute myelopathy, with slowly progressive paraplegia, sensory deficits, and/or bowel and bladder dysfunction. Diagnosis is strongly suspected with a clinical history of known TB in conjunction with characteristic findings on magnetic resonance imaging. Management involves multiagent antitubercular chemotherapy without or with operative intervention...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28447605/traumatic-spinal-cord-injury
#13
REVIEW
Christopher S Ahuja, Jefferson R Wilson, Satoshi Nori, Mark R N Kotter, Claudia Druschel, Armin Curt, Michael G Fehlings
Traumatic spinal cord injury (SCI) has devastating consequences for the physical, social and vocational well-being of patients. The demographic of SCIs is shifting such that an increasing proportion of older individuals are being affected. Pathophysiologically, the initial mechanical trauma (the primary injury) permeabilizes neurons and glia and initiates a secondary injury cascade that leads to progressive cell death and spinal cord damage over the subsequent weeks. Over time, the lesion remodels and is composed of cystic cavitations and a glial scar, both of which potently inhibit regeneration...
April 27, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28441311/feasibility-and-outcome-of-an-accelerated-recovery-protocol-in-asian-adolescent-idiopathic-scoliosis-patients
#14
Chris Yin Wei Chan, Shweh Fern Loo, Jun Yin Ong, Kulathunga Arachchige Lisitha, M Shahnaz Hasan, Chee Kean Lee, Chee Kidd Chiu, Mun Keong Kwan
STUDY DESIGN: Prospective cohort study OBJECTIVE.: To determine the feasibility of an accelerated recovery protocol for Asian Adolescent Idiopathic Scoliosis (AIS) patients undergoing posterior spinal fusion (PSF). SUMMARY OF BACKGROUND DATA: There has been successful implementation of an accelerated recovery protocol for AIS patients undergoing PSF in the western population. No similar studies have been reported in the Asian population. METHODS: 74 AIS (65F, 9 M) patients scheduled for PSF surgery were recruited...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28382215/central-cord-syndrome-from-blast-injury-after-gunshot-wound-to-the-spine-a-case-report-and-a-review-of-the-literature
#15
Juan Galloza, Juan Valentin, Edwardo Ramos
INTRODUCTION: Central Cord Syndrome (CCS) is the most common of the spinal cord injury syndromes. Few cases have been presented with gunshot wound (GSW) as a cause of a central cord syndrome, and none, to our knowledge, has been presented without any evidence of central canal bullet/bone fragments. CASE PRESENTATION: A 27-year-old male suffered two close-range gunshot wounds, one to the left neck and one to the left shoulder. CT scan showed C5 spinous process fracture and paraspinal muscle hemorrhage without evidence of central canal stenosis or bullet/bone fragments...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28244500/social-activity-and-relationship-changes-experienced-by-people-with-bowel-and-bladder-dysfunction-following-spinal-cord-injury
#16
S Braaf, A Lennox, A Nunn, B Gabbe
STUDY DESIGN: Exploratory qualitative. OBJECTIVES: The aim of this study was to describe the experiences of bowel and bladder dysfunction on social activities and relationships in people with spinal cord injury living in the community. SETTING: People living with spinal cord injury experiencing bowel and bladder dysfunction. METHODS: Participants were recruited through the Australian Quadriplegic Association Victoria...
July 2017: Spinal Cord
https://www.readbyqxmd.com/read/28120049/update-on-mechanism-and-therapeutic-implications-of-spinal-cord-stimulation-and-cerebral-hemodynamics-a-narrative-review
#17
REVIEW
Elisabetta Peppucci, Rina Di Bonaventura, Vincenzo Esposito, Jun Zhong, Gerardo Iacopino, Giuseppe Barbagallo, Massimiliano Visocchi
Spinal cord stimulation (SCS) is well known for its early role in the management of chronic pain, mainly failed back surgery syndrome (FBSS), spasticity, and bowel and bladder dysfunction. In more recent years, SCS has been proposed for patients suffering from refractory angina or peripheral vasculopathies in order to gain symptom relief, thus indicating some hemodynamic effect on the peripheral circulation. Taking into account this scientific observation, since the late1980s, researchers have started to investigate the potential effect of SCS on cerebral blood flow (CBF) regulation and its possible application in certain pathological settings dealing with vascular pattern dysfunction, such as ischemia, subarachnoid hemorrhage, head trauma, and brain tumors...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/27984226/intraperitoneal-instillation-of-lidocaine-improves-postoperative-analgesia-at-cesarean-delivery-a-randomized-double-blind-placebo-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
Ruchira Patel, Jose C A Carvalho, Kristi Downey, Marcelo Kanczuk, Paul Bernstein, Naveed Siddiqui
BACKGROUND: Cesarean delivery is a commonly performed procedure worldwide. Despite improvements in balanced multimodal analgesia, there remains a proportion of women for whom postoperative pain relief and patient satisfaction are still inadequate. Intraperitoneal instillation of local anesthetic has been shown to be effective in reducing postoperative pain after abdominal surgery. We sought to investigate the effect of intraperitoneal instillation of lidocaine on postcesarean delivery pain as part of a multimodal analgesia regimen...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27931505/phase-iii-clinical-trial-assessing-safety-and-efficacy-of-umbilical-cord-blood-mononuclear-cell-transplant-therapy-of-chronic-complete-spinal-cord-injury
#19
Hui Zhu, Waisang Poon, Yansheng Liu, Gilberto Ka-Kit Leung, Yatwa Wong, Yaping Feng, Stephanie C P Ng, Kam Sze Tsang, David T F Sun, David K Yeung, Caihong Shen, Fang Niu, Zhexi Xu, Pengju Tan, Shaofeng Tang, Hongkun Gao, Yun Cha, Kwok-Fai So, Robert Fleischaker, Dongming Sun, John Chen, Jan Lai, Wendy Cheng, Wise Young
Umbilical cord blood-derived mononuclear cell (UCB-MNC) transplants improve recovery in animal spinal cord injury (SCI) models. We transplanted UCB-MNCs into 28 patients with chronic complete SCI in Hong Kong (HK) and Kunming (KM). Stemcyte Inc. donated UCB-MNCs isolated from human leukocyte antigen (HLA 4:6)-matched UCB units. In HK, four patients received four 4-l injections (1.6 million cells) into dorsal entry zones above and below the injury site, and another four received 8-l injections (3.2 million cells)...
November 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27676766/peer-supported-self-management-to-facilitate-community-re-entry-after-discharge-from-spinal-cord-injury-rehabilitation-engaging-peers-as-change-agents-and-research-partners
#20
Michael Jones, Julie Gassaway
OBJECTIVE: Peer support is an important adjunct to clinical care for people with disabilities, and may help address barriers to community reintegration. Peers offer positive role models and the benefit of learning from shared experiences of living with disability. Despite potential benefits, peer support is not consistently integrated in the rehabilitation process. This presentation describes three interventions recommended by patients, and directed by peer mentors, to promote successful community transition after rehabilitation for traumatic spinal cord injury (SCI)...
September 2016: Annals of Physical and Rehabilitation Medicine
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