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traumatic spinal cord injury

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https://www.readbyqxmd.com/read/28816874/does-surgical-intervention-or-timing-of-surgery-have-an-effect-on-neurological-recovery-in-the-setting-of-a-thoracolumbar-burst-fracture
#1
So Kato, Jean-Christophe Murray, Brian K Kwon, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic thoracolumbar burst fractures are one of the most common forms of spinal trauma with the majority occurring at the junctional area where mechanical load is maximal (AOSpine Thoracolumbar Spine Injury Classification System Subtype A3 or A4). Burst fractures entail the involvement of the middle column, and therefore, they are typically associated with bone fragment in the spinal canal, which may cause compression of the spinal cord, conus medullaris, cauda equina, or a combination of these. Fortunately, approximately half of the patients with thoracolumbar burst fractures are neurologically intact due to the wide canal diameter...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816870/spinal-cord-injury-what-are-the-controversies
#2
Christopher S Ahuja, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article reviews spinal cord injury (SCI) management followed by a discussion of the salient controversies in the field. Current care practices modeled on the American Association of Neurological Surgeons/Congress of Neurological Surgeons joint section guidelines are highlighted including key recommendations regarding immobilization, avoidance of hypotension, early International Standards for Neurological Classification of SCI examination and intensive care unit treatment...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816089/medusa-s-head-the-complement-system-in-traumatic-brain-and-spinal-cord-injury
#3
Francesco Roselli, Ebru Karasu, Clara Volpe, Markus Huber-Lang
Traumatic brain injury (TBI) and Spinal cord injury (SCI) are critical medical conditions and public health problem for which limited therapeutic options are available. Complement cascade is activated after TBI and SCI and the resulting effects have been investigated in gene-knockout and pharmacological models. Multiple experimental studies support a net detrimental role of C3 and C5 activation in the early stages of TBI and SCI. Less firm experimental evidence suggests that, downstream of C3/C5, effector mechanisms including the generation of MAC and direct damage to membranes and neutrophils infiltration may bring about the direct damage of CNS tissue and the enhancement of neuroinflammation...
August 17, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#4
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28808585/spinal-cord-injury-during-the-second-trimester-of-pregnancy
#5
Ahmad Zaheer Qureshi, Sami Ullah, Anas Jehad AlSaleh, Rubina' Ullah
INTRODUCTION: Pregnancies in women with spinal cord injury (SCI) are at greater risk of morbidity and mortality. Although pregnancy after SCI is well elaborated in the literature, SCI occurring during pregnancy is rarely reported. Abrupt changes in the body physiology because of SCI and the resulting disability add a risk to maternal and fetal well-being. Not only is the burden of care increased but there is also a higher risk of developing pressure ulcers, urinary tract infections, autonomic instability, intrauterine growth retardation and venous thromboembolism...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28807778/cervical-cord-canal-mismatch-a-new-method-for-identifying-predisposition-to-spinal-cord-injury
#6
REVIEW
Aria Nouri, Julio Montejo, Xin Sun, Justin Virojanapa, Luis E Kolb, Khalid M Abbed, Joseph Cheng
The risk for spinal cord injuries (SCIs) ranging from devastating traumatic injuries, compression due to degenerative pathology, and neurapraxia is increased in patients with congenital spinal stenosis. Classical diagnostic criteria include an absolute anteroposterior diameter of <12-13mm or a Torg-Pavlov Ratio of <0.80-0.82; however, these factors do not take into account the size of the spinal cord, which varies across patients independent of canal size. Recent large MRI studies of population cohorts have allowed newer methods to emerge that account for both cord and canal size by measuring a spinal cord occupation ratio (SCOR)...
August 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28794901/a-randomized-controlled-trial-to-test-the-efficacy-of-the-sci-get-fit-toolkit-on-leisure-time-physical-activity-behaviour-and-social-cognitive-processes-in-adults-with-spinal-cord-injury
#7
Kelly P Arbour-Nicitopoulos, Shane N Sweet, Marie-Eve Lamontagne, Kathleen A Martin Ginis, Samantha Jeske, François Routhier, Amy E Latimer-Cheung
STUDY DESIGN: Single blind, two-group randomized controlled trial. OBJECTIVES: To evaluate the efficacy of the SCI Get Fit Toolkit delivered online on theoretical constructs and moderate-to-vigorous physical activity (MVPA) among adults with SCI. SETTING: Ontario and Quebec, Canada. ELIGIBILITY: Inactive, English- and French-speaking Canadian adults with traumatic SCI with Internet access, and no self-reported cognitive or memory impairments...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28791891/the-economic-burden-of-urinary-tract-infection-and-pressure-ulceration-in-acute-traumatic-spinal-cord-injury-admissions-evidence-for-comparative-economics-and-decision-analytics-from-a-matched-case-control-study
#8
Barry White, Nicolas Dea, John Street, Christiana L Cheng, Carly S Rivers, Najmedden Attabib, Brian K Kwon, Charles G Fisher, Marcel F Dvorak
Secondary complications of spinal cord injury (SCI) are a burden to afflicted individuals and the rest of society. However, there is limited evidence of the economic burden or cost of complications in SCI populations in Canada, which is necessary for comparative economic analyses and decision analytic modeling of possible solutions to these common health problems. Comparative economic analyses can inform resource allocation decisions, but the outputs are only as good as the inputs. In this article, new evidence of the excess or incremental costs of urinary tract infection (UTI) and pressure ulceration (PU) in acute traumatic SCI from an exploratory case series analysis of admissions to a Level I specialized Canadian spine facility (2008-2013) is presented...
August 9, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28790970/structural-and-functional-substitution-of-deleted-primary-sensory-neurons-by-new-growth-from-intrinsic-spinal-cord-nerve-cells-an-alternative-concept-in-reconstruction-of-spinal-cord-circuits
#9
Nicholas D James, Maria Angéria, Elizabeth J Bradbury, Peter Damberg, Stephen B McMahon, Mårten Risling, Thomas Carlstedt
In a recent clinical report, return of the tendon stretch reflex was demonstrated after spinal cord surgery in a case of total traumatic brachial plexus avulsion injury. Peripheral nerve grafts had been implanted into the spinal cord to reconnect to the peripheral nerves for motor and sensory function. The dorsal root ganglia (DRG) containing the primary sensory nerve cells had been surgically removed in order for secondary or spinal cord sensory neurons to extend into the periphery and replace the deleted DRG neurons...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28789779/management-of-blunt-cerebrovascular-injury-bcvi-in-the-multisystem-injury-patient-with-contraindications-to-immediate-anti-thrombotic-therapy
#10
Michelle K McNutt, A Cozette Kale, Ryan S Kitagawa, Ali H Turkmani, David W Fields, Sarah Baraniuk, Brijesh S Gill, Bryan A Cotton, Laura J Moore, Charles E Wade, Arthur Day, John B Holcomb
INTRODUCTION: Practice management guidelines for screening and treatment of patients with blunt cerebrovascular injury (BCVI) have been associated with a decreased risk of ischemic stroke. TREATMENT: of patients with BCVI and multisystem injuries that delays immediate antithrombotic therapy remains controversial. The purpose of this study was to determine the timing of BCVI treatment initiation, the incidence of stroke, and bleeding complications as a result of antithrombotic therapy in patients with isolated BCVI in comparison to those with BCVI complicated by multisystem injuries...
July 31, 2017: Injury
https://www.readbyqxmd.com/read/28781306/cervical-flexion-myelopathy-eleven-years-after-a-cervical-spinal-cord-injury
#11
Hiroto Nakano, Kenji Sakai, Kazuo Iwasa, Masahito Yamada
We herein describe a 37-year-old man who developed cervical flexion myelopathy 11 years after suffering a cervical spinal cord injury. Cervical magnetic resonance imaging 11 years after the accident demonstrated atrophy and hyperintense lesions at the C6 and C7 levels in the cervical cord with an abnormal alignment of the vertebrae. In the neck flexion position, an anterior shift of the cervical cord was evident. Our patient's condition suggests that an abnormal alignment of the cervical spine and spinal cord injury due to a traumatic accident could be risk factors in the subsequent development of cervical flexion myelopathy...
August 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28780539/integrating-the-perspectives-of-individuals-with-spinal-cord-injuries-their-family-caregivers-and-healthcare-professionals-from-the-time-of-rehabilitation-admission-to-community-reintegration-protocol-for-a-scoping-study-on-sci-needs
#12
Alexander Moreno, Diana Zidarov, Chandhana Raju, Jill Boruff, Sara Ahmed
INTRODUCTION: There is fragmented information about the different needs following a spinal cord injury (SCI). Expressed SCI needs can be met or unmet, they change along the rehabilitation continuum (eg, acute, rehabilitation and reintegration into the community) and can be different for traumatic and non traumatic SCI. The general objective of this scoping study is to evaluate and integrate the needs of individuals with traumatic and non-traumatic SCI, their family caregivers and those reported by rehabilitation professionals from the time of rehabilitation admission to community reintegration...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28777128/spinal-cord-injury-following-a-mild-trauma-in-homocystinuria-related-bone-frailty-neurorehabilitation-and-education-on-bone-health-management
#13
Ginny Varghese, Wafa Al Yazeedi, Mohammed Al Hamawi, Mohammed N Awad, Giorgio Ferriero, Elena Giovanazzi
Homocystinuria (HCU) is a rare autosomal recessive disease characterized by the deficiency of cystathionine β-synthetase, presenting with variable clinical features including micronutrient deficiency-related osteoporosis. Early-onset osteoporosis results in increased bone fragility, which is associated with low-impact fractures. To date, no traumatic myelopathy has ever been described in patients with HCU. This case report describes a 30-year-old male patient with HCU who was not aware that he was at high risk of sustaining debilitating bone fractures...
August 2, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28771534/neural-stem-cell-mediated-recovery-is-enhanced-by-chondroitinase-abc-pretreatment-in-chronic-cervical-spinal-cord-injury
#14
Hidenori Suzuki, Christopher S Ahuja, Ryan P Salewski, Lijun Li, Kajana Satkunendrarajah, Narihito Nagoshi, Shinsuke Shibata, Michael G Fehlings
Traumatic spinal cord injuries (SCIs) affect millions of people worldwide; the majority of whom are in the chronic phase of their injury. Unfortunately, most current treatments target the acute/subacute injury phase as the microenvironment of chronically injured cord consists of a well-established glial scar with inhibitory chondroitin sulfate proteoglycans (CSPGs) which acts as a potent barrier to regeneration. It has been shown that CSPGs can be degraded in vivo by intrathecal Chondroitinase ABC (ChABC) to produce a more permissive environment for regeneration by endogenous cells or transplanted neural stem cells (NSCs) in the subacute phase of injury...
2017: PloS One
https://www.readbyqxmd.com/read/28767631/neuroprotective-effects-of-c-terminal-domain-of-tetanus-toxin-on-rat-brain-against-motorneuron-damages-after-experimental-spinal-cord-injury
#15
Murat Celal Sozbilen, Murat Oztürk, Gizem Kaftan, Taner Dagci, Halit Ozyalcin, Güliz Armagan
STUDY DESIGN: Experimental animal study investigating the efficacy of C-terminal domain of tetanus toxin application as neuroprotective effects on rat brain in a model of spinal cord injury. OBJECTIVE: The aim of the present study was to investigate the possible role of C-terminal domain of tetanus toxin (Hc-TeTx) on cell death mechanisms including apoptosis and autophagy following SCI. SUMMARY OF BACKGROUND DATA: Traumatic spinal cord injury (SCI) can lead to post-traumatic inflammation, oxidative stress, motor neuron apoptosis, necrosis and autophagy of tissue...
August 1, 2017: Spine
https://www.readbyqxmd.com/read/28762380/rasch-measurement-properties-of-the-pain-medication-questionnaire-in-persons-with-spinal-cord-injury
#16
B N Hand, C A Velozo, J S Krause
STUDY DESIGN: Secondary analysis of cross-sectional population-based self-report data. OBJECTIVE: To determine how well the Pain Medication Questionnaire (PMQ) measures risk of pain medication misuse and its precision in separating individuals with spinal cord injury (SCI) into meaningful classification categories. SETTING: Academic medical center in Southeastern United States. METHODS: Data were collected from a population-based registry of SCI (n=971)...
August 1, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28761411/the-crossed-phrenic-phenomenon
#17
REVIEW
Michael George Zaki Ghali
The cervical spine is the most common site of traumatic vertebral column injuries. Respiratory insufficiency constitutes a significant proportion of the morbidity burden and is the most common cause of mortality in these patients. In seeking to enhance our capacity to treat specifically the respiratory dysfunction following spinal cord injury, investigators have studied the "crossed phrenic phenomenon", wherein contraction of a hemidiaphragm paralyzed by a complete hemisection of the ipsilateral cervical spinal cord above the phrenic nucleus can be induced by respiratory stressors and recovers spontaneously over time...
June 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28760352/image-guided-percutaneous-intralesional-administration-of-mesenchymal-stromal-cells-in-subjects-with-chronic-complete-spinal-cord-injury-a-pilot-study
#18
Ticiana Ferreira Larocca, Carolina Thé Macêdo, Bruno Solano de Freitas Souza, Yuri M Andrade-Souza, Cristiane Flora Villarreal, André Costa Matos, Daniela Nascimento Silva, Kátia Nunes da Silva, Clarissa Lima E Moura de Souza, Daniela da Silva Paixão, Milena da Rocha Bezerra, Rodrigo Leal Alves, Milena Botelho Pereira Soares, Ricardo Ribeiro Dos Santos
BACKGROUND AIMS: The potential of cell therapies to improve neurological function in subjects with spinal cord injury (SCI) is currently under investigation. In this context, the choice of cell type, dose, route and administration regimen are key factors. Mesenchymal stromal cells (MSCs) can be easily obtained, expanded and are suitable for autologous transplantation. Here we conducted a pilot study that evaluated safety, feasibility and potential efficacy of intralesional MSCs transplantation performed through image-guided percutaneous injection, in subjects with chronic complete SCI...
July 28, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28758543/inconsistencies-with-screening-for-traumatic-brain-injury-in-spinal-cord-injury-across-the-continuum-of-care
#19
Seema Sikka, Angela Vrooman, Librada Callender, David Salisbury, Monica Bennett, Rita Hamilton, Simon Driver
OBJECTIVE: Explore how traumatic brain injury (TBI) is screened among spinal cord injury (SCI) patients across the continuum of care. DESIGN: Retrospective chart review Setting: Emergency department, trauma, inpatient rehabilitation Participants: 325 patients with SCI from inpatient rehabilitation facility (IRF) between March 1, 2011 and December 31, 2014 were screened. 49 eligible subjects had traumatic SCI and received care in adjoining acute care (AC) hospital...
July 31, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28754163/choroid-plexus-cerebrospinal-fluid-route-for-monocyte-derived-macrophages-after-stroke
#20
Ruimin Ge, Daniel Tornero, Masao Hirota, Emanuela Monni, Cecilia Laterza, Olle Lindvall, Zaal Kokaia
BACKGROUND: Choroid plexus (CP) supports the entry of monocyte-derived macrophages (MDMs) to the central nervous system in animal models of traumatic brain injury, spinal cord injury, and Alzheimer's disease. Whether the CP is involved in the recruitment of MDMs to the injured brain after ischemic stroke is unknown. METHODS: Adult male C57BL/6 mice were subjected to focal cortical ischemia by permanent occlusion of the distal branch of the right middle cerebral artery...
July 28, 2017: Journal of Neuroinflammation
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