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Cervical incomplete 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
Feng Yang, Ming-Sheng Tan, Ping Yi, Xiang-Sheng Tang, Qing-Ying Hao, Ying-Na Qi
OBJECTIVE: To compare the clinical effect between spinal card decompression combined with traditional Chinese medicine and simple spinal card decompression for cervical spondylotic myelopathy. METHODS: From June 2012 to June 2015, 73 patients with cervical spondylotic myelopathy were treated, including 42 males and 31 females, aged from 29 to 73 years old with a mean of 50.9 years old. The patients were divided into the simple operation group (34 cases) and the operation combined with traditional Chinese medicine group(39 cases) according to the idea of themselves...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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
Kimberly Hamilton, Brandon Rocque, Nathaniel Brooks
BACKGROUND: Deer hunting is popular in much of the United States. In Wisconsin, use of tree stands for hunting is common. Spine surgeons at a Level 1 Trauma Center observed a high incidence of spine and spinal cord injury due to falls from tree stands while hunting. This study's purpose is to systematically characterize and classify those injuries. METHODS: We reviewed the University of Wisconsin Hospital and Clinics' trauma database for tree stand-related injuries from 1999 to 2013...
November 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
Hai-Liang Li, Hong Xu, Yu-Lin Li, Shi-Wei Sun, Wen-Ye Song, Qiang Wu, Jie Ai, Jing-Cheng Sun, Guang-Zhi Ning, Shi-Qing Feng
STUDY DESIGN: Hospital-based retrospective study Objectives: To evaluate the pathogenetic features of traumatic spinal cord injury (TSCI) during 1999-2016 according to changed injury etiology with time, explore different characteristics of patients suffered a TSCI during 1999-2007 and 2008-2016 in Tianjin, China. SETTING: Tianjin Medical University General Hospital Methods: In this study, the medical records of TSCI patients were obtained from Tianjin Medical University General Hospital (TMUGH) from 1st January 1999 to 31th December 2016...
January 11, 2018: Journal of Spinal Cord Medicine
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
Christian Iorio-Morin, Vanessa K Noonan, Barry White, Luc Noreau, Jean Leblond, Frédéric S Dumont, Brian K Kwon, Marcel F Dvorak, Nicolas Dea
STUDY DESIGN: National, multicenter, cross-sectional study. OBJECTIVE: The goal of this study was to provide overall quality of life (QOL) and health utility (HU) values for patients with traumatic spinal cord injury (SCI) stratified by injury level and neurological status. SUMMARY OF BACKGROUND DATA: Traumatic SCI is a leading cause of disability. Varying injury level and severity generate a spectrum of neurological dysfunction and reduction in long-term QOL...
November 17, 2017: Spine
De-Chao Miao, Bao-Yang Zhang, Tao Lei, Yong Shen
BACKGROUND The aim of this study was to analyze the clinical features and to evaluate the efficacy of anterior partial corpectomy and titanium mesh fusion and internal fixation of old fracture dislocation of the lower cervical spine. MATERIAL AND METHODS We retrospectively analyzed the clinical data of 52 patients with old lower cervical fracture and dislocation treated with anterior partial corpectomy and titanium mesh fusion fixation between January 2008 and December 2013, with a mean follow-up period of 4...
November 29, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Ioana Goganau, Beatrice Sandner, Norbert Weidner, Karim Fouad, Armin Blesch
Activity dependent plasticity is a key mechanism for the central nervous system (CNS) to adapt to its environment. Whether neuronal activity also influences axonal regeneration in the injured CNS, and whether electrical stimulation (ES) can activate regenerative programs in the injured CNS remains incompletely understood. Using KCl-induced depolarization, in vivo ES followed by ex-vivo neurite growth assays and ES after spinal cord lesions and cell grafting, we aimed to identify parameters important for ES-enhanced neurite growth and axonal regeneration...
February 2018: Experimental Neurology
Andrew C Smith, Kenneth A Weber, Denise R O'Dell, Todd B Parrish, Marie Wasielewski, James M Elliott
OBJECTIVE: To investigate the relationship between spinal cord damage and specific motor function in participants with incomplete spinal cord injury (iSCI). DESIGN: single-blinded cross-sectional study design SETTING: University setting research laboratory. PARTICIPANTS: Fourteen individuals with chronic cervical iSCI (1 female and 13 males, average age = 43 ± 12 years old). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Axial T2 MRI of spinal cord damage was performed in 14 participants with iSCI...
October 26, 2017: Archives of Physical Medicine and Rehabilitation
Le Li, Henry Shin, Argyrios Stampas, Xiaoyan Li, Ping Zhou
OBJECTIVE: This study was to apply the newly developed electrical impedance myography (EIM) technique to examine hand muscles in patients with an incomplete cervical spinal cord injury (SCI). METHODS: EIM was performed on the thenar, hypothenar, and first dorsal interosseous (FDI) muscles of SCI (n=16) and age-matched healthy control (n=18) subjects. By sending low intensity and high frequency current through the skin and measuring the consequent voltage, EIM estimates the major impedance parameters, which include resistance (R), reactance (X) and phase angle (θ)...
November 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Muhammad Faheem Khan, Rashid Jooma, Fauzan Alam Hashmi, Muhammad Faraz Raghib
Anterior cervical discectomy and fusion (ACDF) for cord compression is a safe and effective procedure with good outcomes. However, worsening of myelopathy is the most feared adverse event of the surgery. We report the case of a 36-year-old male patient who presented with an acute non-traumatic C5-6 cervical disc herniation causing incomplete quadriparesis. He underwent an uncomplicated ACDF at C5-6, and after an initial period of improvement, he developed a delayed onset of an anterior cord syndrome on day 3, without any discerning cause...
October 9, 2017: BMJ Case Reports
Y Ronzi, B Perrouin-Verbe, O Hamel, R Gross
OBJECTIVES: To specify outcomes and identify prognostic factors of neurologic and functional recovery in patients with an acute traumatic spinal cord injury (SCI) associated with cervical spinal canal stenosis (SCS), without spinal instability. METHODS: A retrospective study was conducted using data from a Regional Department for SCI rehabilitation in France. A description of the population characteristics, clinical data and neurological and functional outcomes of all patients treated for acute SCI due to cervical trauma associated with SCS was performed...
October 6, 2017: Annals of Physical and Rehabilitation Medicine
Randy D Trumbower, Heather B Hayes, Gordon S Mitchell, Steven L Wolf, Victoria A Stahl
OBJECTIVE: To test the hypothesis that daily acute intermittent hypoxia (AIH) combined with hand opening practice improves hand dexterity, function, and maximum hand opening in persons with chronic, motor-incomplete, cervical spinal cord injury. METHODS: Six participants completed the double-blind, crossover study. Participants received daily (5 consecutive days) AIH (15 episodes per day: 1.5 minutes of fraction of inspired oxygen [FIo2 ] = 0.09, 1-minute normoxic intervals) followed by 20 repetitions of hand opening practice and normoxia (sham, FIo2 = 0...
October 31, 2017: Neurology
Di Wu, Michelle C Klaw, Theresa Connors, Nikolai Kholodilov, Robert E Burke, Marie-Pascale Côté, Veronica J Tom
After spinal cord injury (SCI), severed axons in the adult mammalian CNS are unable to mount a robust regenerative response. In addition, the glial scar at the lesion site further restricts the regenerative potential of axons. We hypothesized that a combinatorial approach coincidentally targeting these obstacles would promote axonal regeneration. We combined (1) transplantation of a growth-permissive peripheral nerve graft (PNG) into an incomplete, cervical lesion cavity; (2) transduction of neurons rostral to the SCI site to express constitutively active Rheb (caRheb; a Ras homolog enriched in brain), a GTPase that directly activates the growth-promoting pathway mammalian target of rapamycin (mTOR) via AAV-caRheb injection; and (3) digestion of growth-inhibitory chondroitin sulfate proteoglycans within the glial scar at the distal PNG interface using the bacterial enzyme chondroitinase ABC (ChABC)...
December 6, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
Nuray Yozbatiran, Zafer Keser, Khader Hasan, Argyrios Stampas, Radha Korupolu, Sam Kim, Marcia K O'Malley, Felipe Fregni, Gerard E Francisco
INTRODUCTION: This is a prospective clinical pilot case series. Improvement of arm and hand functions after spinal cord injury (SCI) is one of the major rehabilitation goals. Electrical stimulation of the primary motor cortex via transcranial direct current stimulation (tDCS) coupled with high-intensity repetitive motor training may have potential to facilitate improvement in motor function in chronic, incomplete cervical SCI. We investigated the relationship between motor recovery and changes in white matter integrity in response to treatment intervention...
2017: Spinal Cord Series and Cases
Yuming Lei, Monica A Perez
Most cervical spinal cord injuries result in asymmetrical functional impairments in hand and arm function. However, the extent to which reach-to-grasp movements are affected in humans with incomplete cervical spinal cord injury (SCI) remains poorly understood. Using kinematics and electromyographic (EMG) recordings in hand and arm muscles we studied the different phases of unilateral self-paced reach-to-grasp movements (arm acceleration, hand opening and closing) to a small cylinder in the more and less affected arms of individuals with cervical SCI and age-matched controls...
September 20, 2017: Journal of Neurophysiology
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
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
Stuart N Baker, Monica A Perez
Multiple descending motor pathways likely contribute to the recovery of hand motor function following spinal cord injury (SCI). Reticulospinal neurons project to spinal motor neurons controlling hand muscles and extensively sprout into gray matter structures after SCI; therefore, it has been proposed that the reticulospinal tract is one of the descending motor pathways involved in recovery of hand function after injury. To test this hypothesis, we examined the StartReact response, an involuntary release of a planned movement via a startling stimulus that engages the reticulospinal tract, by measuring reaction times from electromyographic activity in an intrinsic finger muscle during three motor tasks requiring different degrees of hand dexterity: index finger abduction, a precision grip, and a power grip...
October 4, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
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