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Cervical incomplete spinal cord injury

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
Sameer H Halani, Jonathan P Riley, Gustavo Pradilla, Faiz U Ahmad
Traumatic neurologic injury in contact sports is a rare but serious consequence for its players. These injuries are most commonly associated with high-impact collisions, for example in football, but are found in a wide variety of sports. In an attempt to minimize these injuries, sports are trying to increase safety by adding protection for participants. Most recently is the seemingly 'safe' sport of Bubble Soccer, which attempts to protect its players with inflatable plastic bubbles. We report a case of a 16-year-old male sustaining a cervical spine burst fracture with incomplete spinal cord injury while playing Bubble Soccer...
September 10, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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
Nuray Yozbatiran, Zafer Keser, Matthew Davis, Argyrios Stampas, Marcia K O'Malley, Catherine Cooper-Hay, Joel Frontera, Felipe Fregni, Gerard E Francisco
BACKGROUND: After cervical spinal cord injury, current options for treatment of upper extremity motor functions have been limited to traditional approaches. However, there is a substantial need to explore more rigorous alternative treatments to facilitate motor recovery. OBJECTIVE: To demonstrate whether anodal-primary motor cortex (M1) excitability enhancement (with cathodal-supra orbital area) (atDCS) combined with robot-assisted arm training (R-AAT) will provide greater improvement in contralateral arm and hand motor functions compared to sham stimulation (stDCS) and R-AAT in patients with chronic, incomplete cervical spinal cord injury (iCSCI)...
July 15, 2016: NeuroRehabilitation
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
E O Uche, O E Nwankwo, E Okorie, A Muobike
BACKGROUND: Treatment of cervical spine injury is the most challenging of all the injuries of the spine, and there is yet no agreement on the best method of care. OBJECTIVE: We studied the complications and outcome of two skull traction devices used to treat cases of cervical spine injury in three centers in Enugu, South East Nigeria. PATIENTS AND METHODS: A retrospective analysis of patients with cervical spine injury managed with skull traction as the definitive treatment using either Crutchfield or Gardner-Wells tongs over a 5-year period (April 2008-March 2013)...
September 2016: Nigerian Journal of Clinical Practice
Jayme A Bertelli, Marcos F Ghizoni
OBJECTIVE The purpose of this paper was to report the authors' results with finger flexion restoration by nerve transfer in patients with tetraplegia. METHODS Surgery was performed for restoration of finger flexion in 17 upper limbs of 9 patients (8 male and 1 female) at a mean of 7.6 months (SD 4 months) after cervical spinal cord injury. The patients' mean age at the time of surgery was 28 years (SD 15 years). The motor level according to the ASIA (American Spinal Injury Association) classification was C-5 in 4 upper limbs, C-6 in 10, and C-7 in 3...
August 5, 2016: Journal of Neurosurgery. Spine
Paolo Federico, Monica A Perez
KEY POINTS: In uninjured humans, transmission in the corticospinal pathway changes in a task-dependent manner during movement preparation. We investigated whether this ability is preserved in humans with incomplete chronic cervical spinal cord injury (SCI). Our results show that corticospinal excitability is altered in the preparatory phase of an upcoming movement when there is a need to suppress but not to execute rapid index finger voluntary contractions in individuals with SCI compared with controls...
August 3, 2016: Journal of Physiology
Hatice Kumru, Jesus Benito-Penalva, Josep Valls-Sole, Narda Murillo, Josep M Tormos, Cecilia Flores, Joan Vidal
High-frequency rTMS combined with gait training improves lower extremity motor score (LEMS) and gait velocity in SCI subjects who are able to walk over ground. The aim of this study was to optimize the functional outcome in early phases of gait rehabilitation in SCI using rTMS as an additional treatment to physical therapy. The present study included 31 motor incomplete SCI subjects randomized to receive real or sham rTMS, just before Lokomat gait training (15 subjects for real, 16 for sham rTMS). rTMS consisted of one daily session for 20 days over vertex (at 20 Hz)...
July 28, 2016: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Yann Thibaudier, Marie-France Hurteau, Charline Dambreville, Anass Chraibi, Laurent Goetz, Alain Frigon
Coordination between the arms/forelimbs and legs/hindlimbs is often impaired in humans and quadrupedal mammals after incomplete spinal cord injury. In quadrupeds, the forelimbs often take more steps than the hindlimb, producing a two-to-one forelimb-hindlimb (2-1 FL-HL) coordination. In locomotor performance scales, this is generally considered a loss of FL-HL coordination. Here, FL-HL coordination was quantified before and 8 weeks after a lateral spinal hemisection at the sixth thoracic segment in six adult cats...
May 24, 2016: Journal of Neurotrauma
Richard Macklin, Jihye Bae, Melanie Orell, Kimberly Anderson, Peter Ellaway, Monica Perez
We recently demonstrated that the electrical perceptual threshold (EPT) reveals spared sensory function at lower spinal segments compared with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) exam in humans with chronic incomplete cervical spinal cord injury (SCI). Here, we investigated whether discrepancies in sensory function detected by both sensory exams change over time following SCI. Forty eight participants with acute (< 1 year), chronic (> 1 to 10 years), and extended-chronic (> 10 years) incomplete cervical SCI and 30 control subjects were tested on dermatomes C2 to T4 bilaterally...
May 20, 2016: Journal of Neurotrauma
Ehsan Ali Alibai, Fahim Baghban, Majid Reza Farrokhi, Navideh Mohebali, Mohammad Hossein Ashraf
OBJECTIVE: To determine the effects of recombinant human erythropoietin (rhEPO) on functional outcome and disability of patients with traumatic cervical spinal cord injury (SCI). METHODS: This was a randomized, double blind, placebo controlled clinical trial being performed in Nemazee and Shahid Rajaei hospitals of Shiraz during a 3-year period from 2011 to 2014. A total number of 20 patients with acute traumatic cervical SCI less than 8 hours after injury were included...
July 2015: Bulletin of Emergency and Trauma
Yuying Chen, Yin He, Michael J DeVivo
OBJECTIVE: To document trends in the demographic and injury profile of new spinal cord injury (SCI) over time. DESIGN: Cross-sectional analysis of longitudinal data by injury years (1972-1979, 1980-1989, 1990-1999, 2000-2009, 2010-2014). SETTING: Twenty-eight Spinal Cord Injury Model Systems centers throughout the United States. PARTICIPANTS: Persons with traumatic SCI (N=30,881) enrolled in the National Spinal Cord Injury Database...
October 2016: Archives of Physical Medicine and Rehabilitation
Camila R Battistuzzo, Karen Smith, Peta Skeers, Alex Armstrong, Jillian Clark, Jacqui Agostinello, Shelley Cox, Stephen Bernard, Brian J C Freeman, Sarah A Dunlop, Peter E Batchelor
Clinical trials evaluating early therapies after spinal cord injury (SCI) are challenging because of the absence of a rapid assessment. The aim of this study was to determine whether the severity and level of SCI could be established from a brief neurological assessment capable of being used in an emergency setting. A brief assessment called the SPinal Emergency Evaluation of Deficits (SPEED) was developed and retrospectively evaluated in a cohort of 118 patients with SCI. Foot motor and sensory function was used to indicate injury severity...
May 16, 2016: Journal of Neurotrauma
Edmund R Hollis, Nao Ishiko, Ting Yu, Chin-Chun Lu, Ariela Haimovich, Kristine Tolentino, Alisha Richman, Anna Tury, Shih-Hsiu Wang, Maysam Pessian, Euna Jo, Alex Kolodkin, Yimin Zou
Limited functional recovery can be achieved through rehabilitation after incomplete spinal cord injury. Eliminating the function of a repulsive Wnt receptor, Ryk, in mice and rats by either conditional knockout in the motor cortex or monoclonal antibody infusion resulted in increased corticospinal axon collateral branches with presynaptic puncta in the spinal cord and enhanced recovery of forelimb reaching and grasping function following a cervical dorsal column lesion. Using optical stimulation, we observed that motor cortical output maps underwent massive changes after injury and that hindlimb cortical areas were recruited to control the forelimb over time...
May 2016: Nature Neuroscience
Brett J Hilton, Eitan Anenberg, Thomas C Harrison, Jamie D Boyd, Timothy H Murphy, Wolfram Tetzlaff
UNLABELLED: Motor cortical plasticity contributes to spontaneous recovery after incomplete spinal cord injury (SCI), but the pathways underlying this remain poorly understood. We performed optogenetic mapping of motor cortex in channelrhodopsin-2 expressing mice to assess the capacity of the cortex to re-establish motor output longitudinally after a C3/C4 dorsal column SCI that bilaterally ablated the dorsal corticospinal tract (CST) containing ∼96% of corticospinal fibers but spared ∼3% of CST fibers that project via the dorsolateral funiculus...
April 6, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Steven C Kirshblum, Amanda L Botticello, Trevor A Dyson-Hudson, Rachel Byrne, Ralph J Marino, Daniel P Lammertse
OBJECTIVE: To assess the patterns of sacral sparing and recovery in newly injured persons with traumatic spinal cord injury (SCI). DESIGN: Retrospective analysis of data from the national Spinal Cord Injury Model Systems (SCIMS) database for patients enrolled from January 2011 to February 2015. SETTING: SCIMS centers. PARTICIPANTS: Individuals (N=1738; age ≥16y) with traumatic SCI admitted to rehabilitation within 30 days after injury with follow-up at discharge, at 1 year, or both...
October 2016: Archives of Physical Medicine and Rehabilitation
J C Furlan, F Verocai, X Palmares, M G Fehlings
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Although cardiac arrhythmias are relatively well recognized in the chronic stage after spinal cord injury (SCI), little is known regarding its occurrence during the early stage. The objective of this study was to examine electrocardiogram changes within the first 72 h after acute traumatic SCI. SETTING: Acute spine trauma center, Toronto, Ontario, CanadaMethods:This study included all consecutive patients with spine trauma admitted to our institution from January 1998 to June 2007 who had an electrocardiogram within the first 72 h post trauma...
February 16, 2016: Spinal Cord
N Derakhshanrad, M S Yekaninejad, F Vosoughi, F Sadeghi Fazel, H Saberi
STUDY DESIGN: A cross-sectional study. OBJECTIVES: This study was performed for epidemiological assessment of Iranian Traumatic Spinal Cord Injuries (TSCI), referred to a specialized spine center. SETTING: Patient recruitment and evaluations were conducted at the Brain and Spinal Injury Research Center, Tehran, Iran. METHODS: This study was performed from September 2011 to March 2015 on 1137 consecutive TSCIs. History, clinicoradiological findings as well as chronic complications and social integration were recorded...
February 16, 2016: Spinal Cord
Roisin T Dolan, Joseph S Butler, John M O'Byrne, Ashley R Poynton
Cervical myelopathy is a well-described clinical syndrome that may evolve from a combination of etiological mechanisms. It is traditionally classified by cervical spinal cord and/or nerve root compression which varies in severity and number of levels involved. The vast array of clinical manifestations of cervical myelopathy cannot fully be explained by the simple concept that a narrowed spinal canal causes compression of the cord, local tissue ischemia, injury and neurological impairment. Despite advances in surgical technology and treatment innovations, there are limited neuro-protective treatments for cervical myelopathy, which reflects an incomplete understanding of the pathophysiological processes involved in this disease...
January 18, 2016: World Journal of Orthopedics
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