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Cervical incomplete spinal cord injury

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https://www.readbyqxmd.com/read/28720987/management-of-post-traumatic-neglected-cervical-facet-dislocation
#1
Vinay Prabhat, Tankeshwar Boruah, Hitesh Lal, Ramesh Kumar, Ashish Dagar, Harekrushna Sahu
BACKGROUND: Post-traumatic unilateral or bilateral sub-axial cervical spine dislocations with locked facets are quite common. In developing countries like India, many patients with cervical injuries report late due to many reasons like rural backgrounds, lack of infrastructures and skilled surgeons, unawareness, poor socioeconomic status, lack of transportation to the specialized center with proper facility, etc. Early management is essential to maximize better neurological outcome. Delayed or neglected presentation makes treatment more challenging...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28705774/asia-a-sensory-and-motor-complete-is-not-different-than-asia-b-sensory-incomplete-motor-complete-in-gunshot-related-spinal-cord-injury
#2
Eric McCoy, Nima Eftekhary, Kenneth Nwosu, Dudley Fukunaga, Charles Liu, Kevin Rolfe
Background Context We receive a large number of spinal cord injury (SCI) patients due to penetrating gunshot wounds (GSW) at our national rehabilitation center. Though many patients are labeled American Spinal Injury Association (ASIA) B sensory incomplete due to sensory sparing, especially deep anal pressure, with purported prognostic value, we have not observed a clinical difference from ASIA A completes. We hypothesized that sensory sparing, if meaningful, should reduce the occurrence of pressure ulcers...
July 10, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28673831/risk-factors-for-laryngeal-penetration-aspiration-in-patients-with-acute-traumatic-cervical-spinal-cord-injury
#3
Tiina Ihalainen, Irina Rinta-Kiikka, Teemu M Luoto, Tuomo Thesleff, Mika Helminen, Anna-Maija Korpijaakko-Huuhka, Antti Ronkainen
BACKGROUND CONTEXT: Laryngeal penetration-aspiration, entry of material into the airways, is considered the most severe subtype of dysphagia and common among patients with acute cervical spinal cord injury. PURPOSE: The aim of this study was to investigate risk factors for penetration-aspiration in patients with acute traumatic cervical spinal cord injury (TCSCI). STUDY DESIGN: A prospective cohort study. PATIENT SAMPLE: Thirty-seven patients with TCSCI...
June 30, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28659464/impact-of-glutamatergic-and-serotonergic-neurotransmission-on-diaphragm-muscle-activity-after-cervical-spinal-hemisection
#4
Carlos B Mantilla, Heather M Gransee, Wen-Zhi Zhan, Gary C Sieck
Incomplete cervical spinal cord hemisection at C2 (SH) disrupts descending excitatory drive to phrenic motoneurons, paralyzing the ipsilateral diaphragm muscle. Spontaneous recovery over time is associated with increased phrenic motoneuron expression of glutamatergic N-methyl-D-aspartate (NMDA) and serotonergic 5-HT2A receptors. We hypothesized that NMDA and 5-HT2A receptor-mediated neurotransmission play a role in ipsilateral diaphragm muscle activity post-SH. Adult male Sprague-Dawley rats were implanted with bilateral diaphragm EMG electrodes for chronic EMG recordings up to 28 days post-SH (SH 28D)...
June 28, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28631744/traumatic-cervical-spinal-cord-injury-a-prospective-clinical-study-of-laryngeal-penetration-and-aspiration
#5
T Ihalainen, I Rinta-Kiikka, T M Luoto, E A Koskinen, A-M Korpijaakko-Huuhka, A Ronkainen
STUDY DESIGN: Prospective cohort study. OBJECTIVES: Dysphagia is a relatively common secondary complication in patients with traumatic cervical spinal cord injuries (TCSCI). The purpose of this study was to determine the incidence of aspiration and penetration in patients with acute TCSCI. SETTING: Tampere University Hospital, Tampere, Finland. METHODS: A total of 46 patients with TCSCI were evaluated with a videofluoroscopic swallowing study (VFSS)...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28615341/high-frequency-epidural-stimulation-across-the-respiratory-cycle-evokes-phrenic-short-term-potentiation-after-incomplete-cervical-spinal-cord-injury
#6
Elisa J Gonzalez-Rothi, Kristi A Streeter, Marie H Hanna, Anna C Stamas, Paul J Reier, David M Baekey, David D Fuller
C2 spinal hemilesion (C2Hx) paralyzes the ipsilateral diaphragm, but recovery is possible through activation of "crossed spinal" synaptic inputs to ipsilateral phrenic motoneurons. We tested the hypothesis that high frequency epidural stimulation (HF-ES) would potentiate ipsilateral phrenic output after subacute and chronic C2Hx. HF-ES (300 Hz) was applied to the ventrolateral C4 or T2 spinal cord ipsilateral to C2Hx in anesthetized and mechanically ventilated adult rats. Stimulus duration was 60-sec and currents ranged from 100-1000 µA...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28598858/effects-of-intermittent-theta-burst-stimulation-on-spasticity-after-spinal-cord-injury
#7
Raffaele Nardone, Patrick B Langthaler, Andrea Orioli, Peter Höller, Yvonne Höller, Vanessa N Frey, Francesco Brigo, Eugen Trinka
PURPOSE: Spasticity is a common disorder in patients with spinal cord injury (SCI). The aim of this study was to investigate whether intermittent theta burst stimulation (iTBS), a safe, non-invasive and well-tolerated protocol of excitatory repetitive transcranial magnetic stimulation (rTMS), is effective in modulating spasticity in SCI patients. METHODS: In this randomized, double-blind, crossover, sham-controlled study, ten subjects with incomplete cervical or thoracic SCI received 10 days of daily sessions of real or sham iTBS...
2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28578003/generating-level-dependent-models-of-cervical-and-thoracic-spinal-cord-injury-exploring-the-interplay-of-neuroanatomy-physiology-and-function
#8
Jared T Wilcox, Kajana Satkunendrarajah, Yasmin Nasirzadeh, Alex M Laliberte, Alyssa Lip, David W Cadotte, Warren D Foltz, Michael G Fehlings
The majority of spinal cord injuries (SCI) occur at the cervical level, which results in significant impairment. Neurologic level and severity of injury are primary endpoints in clinical trials; however, how level-specific damages relate to behavioural performance in cervical injury is incompletely understood. We hypothesized that ascending level of injury leads to worsening forelimb performance, and correlates with loss of neural tissue and muscle-specific neuron pools. A direct comparison of multiple models was made with injury realized at the C5, C6, C7 and T7 vertebral levels using clip compression with sham-operated controls...
September 2017: Neurobiology of Disease
https://www.readbyqxmd.com/read/28549131/a-novel-cortical-target-to-enhance-hand-motor-output-in-humans-with-spinal-cord-injury
#9
Jinyi Long, Paolo Federico, Monica A Perez
A main goal of rehabilitation strategies in humans with spinal cord injury is to strengthen transmission in spared neural networks. Although neuromodulatory strategies have targeted different sites within the central nervous system to restore motor function following spinal cord injury, the role of cortical targets remain poorly understood. Here, we use 180 pairs of transcranial magnetic stimulation for ∼30 min over the hand representation of the motor cortex at an interstimulus interval mimicking the rhythmicity of descending late indirect (I) waves in corticospinal neurons (4...
June 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28541431/emerging-safety-of-intramedullary-transplantation-of-human-neural-stem-cells-in-chronic-cervical-and-thoracic-spinal-cord-injury
#10
Allan D Levi, David O Okonkwo, Paul Park, Arthur L Jenkins, Shekar N Kurpad, Ann M Parr, Aruna Ganju, Bizhan Aarabi, Dong Kim, Steven Casha, Michael G Fehlings, James S Harrop, Kim D Anderson, Allyson Gage, Jane Hsieh, Stephen Huhn, Armin Curt, Raphael Guzman
BACKGROUND: Human central nervous system stem cells (HuCNS-SC) are multipotent adult stem cells with successful engraftment, migration, and region-appropriate differentiation after spinal cord injury (SCI). OBJECTIVE: To present data on the surgical safety profile and feasibility of multiple intramedullary perilesional injections of HuCNS-SC after SCI. METHODS: Intramedullary free-hand (manual) transplantation of HuCNS-SC cells was performed in subjects with thoracic (n = 12) and cervical (n = 17) complete and sensory incomplete chronic traumatic SCI...
May 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28527225/clinical-feasibility-of-gait-training-with-a%C3%A2-robotic-exoskeleton-wpal-in-an-individual-with-both-incomplete-cervical-and-complete-thoracic-spinal-cord-injury-a%C3%A2-case-study
#11
Shigeo Tanabe, Soichiro Koyama, Eiichi Saitoh, Satoshi Hirano, Kanan Yatsuya, Tetsuya Tsunoda, Masaki Katoh, Takeshi Gotoh, Ayako Furumoto
BACKGROUND: Patients with tetraplegia can achieve independent gait with lateral-type powered exoskeletons; it is unclear whether medial-type powered exoskeletons allow for this. OBJECTIVE: To investigate gait training with a medial-type powered exoskeleton wearable power-assist locomotor (WPAL) in an individual with incomplete cervical (C5) and complete thoracic (T12) spinal cord injury (SCI). METHODS: The 60-session program was investigated retrospectively using medical records...
May 19, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28505987/improved-grasp-function-with-transcranial-direct-current-stimulation-in-chronic-spinal-cord-injury
#12
Mar Cortes, Ana Heloisa Medeiros, Aasta Gandhi, Peter Lee, Hermano Igo Krebs, Gary Thickbroom, Dylan Edwards
BACKGROUND: Recovering hand function has important implications for improving independence of patients with tetraplegia after traumatic spinal cord injury (SCI). Transcranial direct current stimulation (tDCS) is a noninvasive rehabilitation technique that has potential to improve motor function. OBJECTIVE: To investigate the effects of one session of 1 mA, 2 mA, and sham anodal tDCS (a-tDCS) in the upper extremity (hand) motor performance (grasp and lease) in patients with chronic cervical SCI...
May 10, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28501121/validation-of-a-field-spinal-motion-restriction-protocol-in-a-level-i-trauma-center
#13
James M Tatum, Nicolas Melo, Ara Ko, Navpreet K Dhillon, Eric J T Smith, Dorothy A Yim, Galinos Barmparas, Eric J Ley
BACKGROUND: Spinal motion restriction (SMR) after traumatic injury has been a mainstay of prehospital trauma care for more than 3 decades. Recent guidelines recommend a selective approach with cervical spine clearance in the field when criteria are met. MATERIALS AND METHODS: In January 2014, the Department of Health Services of the City of Los Angeles, California, implemented revised guidelines for cervical SMR after blunt mechanism trauma. Adult patients (aged ≥18 y) with an initial Glasgow Coma Scale (GCS) score of ≥13 presented to a single level I trauma center after blunt mechanism trauma over the following 1-y period were retrospectively reviewed...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28488262/estimating-the-incidence-of-traumatic-spinal-cord-injuries-in-switzerland-using-administrative-data-to-identify-potential-coverage-error-in-a-cohort-study
#14
Jonviea D Chamberlain, Elias Ronca, Martin Wg Brinkhof
INTRODUCTION: Inferences from population-based cohort studies may be inaccurate as a result of biased coverage of the target population. We investigated the presence of absolute coverage error and selection bias in the Swiss Spinal Cord Injury (SwiSCI) cohort study, using a secondary, nationally representative data source. The proposed methodology is applicable to future Swiss cohort studies aiming to assess their cover-age error. METHODS: ICD-10 codes relating to traumatic spinal cord injuries (TSI) (S14...
May 10, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28435743/effects-of-overground-locomotor-training-on-the-ventilatory-response-to-volitional-treadmill-walking-in-individuals-with-incomplete-spinal-cord-injury-a-pilot-study
#15
Gino S Panza, Andrew A Guccione, Lisa M Chin, Jared M Gollie, Jeffery E Herrick, John P Collins
INTRODUCTION: Although there has been substantial emphasis on the neuromuscular and cardiovascular adaptations following rehabilitation, pulmonary adaptations in individuals with incomplete SCI (iSCI) in response to locomotor training have been less frequently studied. In healthy individuals, effective transition from rest to work is accomplished by a hyperpneic response, which exhibits an exponential curve with three phases. However, the degree to which our current understanding of exercise hyperpnea can be applied to individuals with iSCI is unknown...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28433644/supraspinal-respiratory-plasticity-following-acute-cervical-spinal-cord-injury
#16
Tatiana Bezdudnaya, Vitaliy Marchenko, Lyandysha V Zholudeva, Victoria M Spruance, Michael A Lane
Impaired breathing is a devastating result of high cervical spinal cord injuries (SCI) due to partial or full denervation of phrenic motoneurons, which innervate the diaphragm - a primary muscle of respiration. Consequently, people with cervical level injuries often become dependent on assisted ventilation and are susceptible to secondary complications. However, there is mounting evidence for limited spontaneous recovery of respiratory function following injury, demonstrating the neuroplastic potential of respiratory networks...
July 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28290466/incidence-of-acute-spinal-cord-injury-in-the-czech-republic-a-prospective-epidemiological-study-2006-2015
#17
J Kriz, M Kulakovska, H Davidova, M Silova, A Kobesova
STUDY DESIGN: A prospective study. OBJECTIVES: Analysis of epidemiological data about acute spinal cord injury (SCI) in the Czech Republic over a period of 10 years (2006-2015). METHODS: A data collection system was implemented in the rehabilitation centres which provides care to patients with acute SCI in the Czech Republic. The recorded variables are as follows: age at time of SCI; gender; cause of injury; neurological level of injury (NLI); and its severity (ASIA Impairment Scale (AIS))...
March 14, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28269106/using-surface-electromyography-to-detect-changes-in-innervation-zones-pattern-after-human-cervical-spinal-cord-injury
#18
Babak Afsharipour, Milap S Sandhu, Ghulam Rasool, Nina L Suresh, William Z Rymer
Human spinal cord injuries (SCI) disrupt the pathways between brain and spinal cord, resulting in substantial impairment and loss of function. Currently, we do not have the ability to precisely quantify the "functional" level of motor injury. The aim of this study is to determine if high-density surface electromyography imaging (SEI) can be used to characterize the location and extent of the spinal lesion. SEI is a safe and non-invasive technique, which uses several electrodes to provide a map of muscle activity...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268623/closed-loop-afferent-electrical-stimulation-for-recovery-of-hand-function-in-individuals-with-motor-incomplete-spinal-injury-early-clinical-results
#19
Christopher J Schildt, Sarah H Thomas, Elizabeth S Powell, Lumy Sawaki, Sridhar Sunderam
Afferent electrical stimulation is known to augment the effect of rehabilitative therapy through use-dependent cortical plasticity. Experiments pairing transcranial magnetic stimulation (TMS) with peripheral nerve stimulation (PNS) have shown a timing-dependent effect on motor evoked potential (MEP) amplitude suggesting that PNS applied in closed-loop (CL) mode could augment this effect through positive reinforcement. We present early results from a clinical trial in which an EEG brain-machine interface (BMI) was used to apply PNS to two subjects in response to motor intent detected from sensorimotor cortex in a cue-driven hand grip task...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28265259/remodeling-brain-activity-by-repetitive-cervicothoracic-transspinal-stimulation-after-human-spinal-cord-injury
#20
Lynda M Murray, Maria Knikou
Interventions that can produce targeted brain plasticity after human spinal cord injury (SCI) are needed for restoration of impaired movement in these patients. In this study, we tested the effects of repetitive cervicothoracic transspinal stimulation in one person with cervical motor incomplete SCI on cortical and corticospinal excitability, which were assessed via transcranial magnetic stimulation with paired and single pulses, respectively. We found that repetitive cervicothoracic transspinal stimulation potentiated intracortical facilitation in flexor and extensor wrist muscles, recovered intracortical inhibition in the more impaired wrist flexor muscle, increased corticospinal excitability bilaterally, and improved voluntary muscle strength...
2017: Frontiers in Neurology
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