Spinal Cord Series and Cases

STUDY DESIGN: Qualitative exploratory study. OBJECTIVES: To understand the lived experiences of individuals with spinal cord injuries or disorders (SCI/D) who use wheelchairs during air travel in the United States (US), with a focus on the challenges and barriers to accessing this form of transportation. SETTING: Wheelchair users with SCI/D living in the community in the US. METHODS: Semi-structured interviews were used to collect data from six wheelchair users with SCI/D...

INTRODUCTION: Although multimodal intraoperative neuromonitoring (IONM), which has high sensitivity and specificity, is typically performed during spinal deformity surgery, neurological status may deteriorate with delay after surgical maneuvers. Here, we report a rare case of delayed postoperative neurological deficit (DPND) that was not detected by IONM during posterior spinal fusion (PSF) for congenital scoliosis. CASE PRESENTATION: A 14-year-old male presented with congenital scoliosis associated with T3 and T10 hemivertebrae...

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INTRODUCTION: Powered robotic exoskeleton (PRE) physiotherapy programmes are a relatively novel frontier which allow patients with reduced mobility to engage in supported walking. Research is ongoing regarding their utility, risks, and benefits. This article describes the case of two fractures occurring in one patient using a PRE. CASE: We report the case of a 54 year old man who sustained bilateral tibial fractures while using a PRE, on a background of T10 AIS A SCI...

STUDY DESIGN: Scoping systematic review. OBJECTIVES: To summarize the available experimental clinical and animal studies for the identification of all CSF and serum-derived biochemical markers in human and rat SCI models. SETTING: Tehran, Iran. METHODS: In this scoping article, we systematically reviewed the electronic databases of PubMed, Scopus, WOS, and CENTRAL to retrieve current literature assessing the levels of different biomarkers in human and rat SCI models...

STUDY DESIGN: Cross-Sectional Study. OBJECTIVES: To investigate the changes in the characteristics of cervical spinal cord injuries (CSCI) before and after the coronavirus disease 2019 (COVID-19) pandemic among patients transported to our hospital in Japan. SETTING: Hospital with an emergency center in Chiba, Japan. METHODS: Patients eligible for the study were those transported within 24 h of injury and diagnosed with cervical spinal cord injury between January 2018 and December 2021 at our hospital...

STUDY DESIGN: Feasibility study. OBJECTIVE: To determine the feasibility of conducting a large trial designed to determine whether the ROBERT® can be used to increase the strength of the hip flexor muscles after spinal cord injury (SCI). The ROBERT® is a robotic device that provides assisted active movement while supporting the weight of the leg. Focus was on recruitment capability, suitability, and acceptability of the intervention and outcome measure...

INTRODUCTION: Pneumorrachis is presence of air in the epidural space. It could be the result of trauma, barotrauma, iatrogenic or spontaneous. The pneumorrachis per se is an underdiagnosed entity as most of the patients are asymptomatic or have subclinical symptoms. The spontaneous occurrence of pneumorrachis has been reported in literature but giant spontaneous occurrence causing cauda equina syndrome has not been reported so far. CASE PRESENTATION: We report a case of 56-year-old male patient who came to our OPD on wheelchair with complains of difficulty in walking for 6 months with dribbling of urine for 2 months with on and off back pain...

INTRODUCTION: Historically, bladder washouts were used to instil therapeutic reagents directly into the bladder. This practice has expanded to include instillation of solutions that deal with catheter issues such as encrustation or formation of bio-film. They appear to provide a promising strategy for people with long term catheters. These products are readily available to purchase, but there is concern that people are using these solutions without a complete understanding of the purpose for the rinse and without clinical guidance to monitor response to treatment...

INTRODUCTION: NeuroAiD (MLC601 & MLC901)'s neuroprotective capabilities include limiting exaggerated calcium influx, decreasing excitotoxicity, reducing oxidative stress, and preventing glutamate-induced cell death. It has also been shown to facilitate synaptogenesis, neurogenesis, and neuroplasticity. However, its clinical efficacy has primarily been studied in the context of brain injuries, particularly stroke. NeuroAiD's potential application in SCI remains largely untapped. CASE PRESENTATION: A 34-year-old male presented with C4 complete tetraplegia...

STUDY DESIGN: Qualitative exploratory OBJECTIVES: Rehabilitation following spinal cord injury (SCI) is a life-long process involving healthcare in a variety of settings, including facilities lacking SCI-specific services (i.e., non-SCI-specialized centers). Activity-based therapy (ABT) is a neurorestorative approach involving intensive, task-specific movement practice below the injury level. This study explored the existing knowledge, perceptions, and implementation of ABT among physical and occupational therapists working in non-SCI-specialized centers...

STUDY DESIGN: Anonymous online survey OBJECTIVES: To investigate the priorities, needs and willingness to adopt nerve stimulation devices for managing neurogenic bladder and bowel function in people with spinal cord injury (SCI) living in Australia. SETTING: Online survey of people living with SCI in Australia. METHODS: This anonymous online survey used Qualtrics and was advertised via standard communication channels, such as advocacy groups representing the SCI community in Australia, social media, attending SCI sporting events and by word-of-mouth...

INTRODUCTION: Acute transverse myelitis (ATM) refers to a rare severe acquired spinal cord inflammation, with a challenging diagnostic work-up and treatment. CASE PRESENTATION: We report the case of a 42-year-old patient who presented with loss of temperature and pain sensation beneath the C5 dermatome in her left side and reported a history of a possible respiratory tract illness 10 days ago. Within 2 days, clinical worsening was noted, compatible with Brown-Sequard syndrome...

STUDY DESIGN: Observational study. OBJECTIVES: To evaluate the perceptions of patients requiring a tracheostomy tube and to identify possible different perceptions in critically ill patients with tracheostomy tubes who have acute (ASCI) or chronic spinal cord injuries (CSCI). SETTING: Medical and surgical intensive care units (ICU) and intermediate care unit of the BG University Hospital Bergmannsheil Bochum, Germany. METHODS: Patients who met the inclusion criteria completed a 25-item questionnaire on two consecutive days regarding their experiences and perceptions in breathing, coughing, pain, speaking, swallowing, and comfort of the tracheostomy tube...

INTRODUCTION: Due to activity limitations and physical environmental barriers, low remunerative employment is a challenging issue for people with spinal cord injury (SCI) and relevant rehabilitation personnel. Since work opportunities in digital fields have continued to emerge, this study aims to report and discuss the possibility of using digital working as a strategy for increasing remunerative employment in people with SCI. CASE PRESENTATION: We report live experiences of four people with SCI in Thailand who have digital works with different types of jobs (image segmentation and identification for artificial intelligence development, online merchant, online streamer, cryptocurrency investor), different required digital skills (basic or intermediate digital skills), different employment statuses (employee or owner), and different incomes (from 50 to 200 USD/month)...

STUDY DESIGN: A prospective randomized controlled trial (RCT) in persons with spinal cord injury (SCI) and ongoing pressure injury (PI). OBJECTIVES: The main aim was to perform a cost-utility analysis (CUA) alongside the RCT comparing regular care to regular care with additional videoconference consultations. Secondary aims were to assess costs and greenhouse gas emission related to transportation in the two study groups. SETTING: Two spinal cord units in Norway...

STUDY DESIGN: Cross-sectional, analytical study design using a conveneient sampling strategy. OBJECTIVES: To examine the interrelationship between pain, life satisfaction and indices of negative mental well-being amongst the traumatic spinal cord injury (TSCI) population. SETTING: Western Cape Rehabilitation Center in Cape Town, South Africa. METHODS: Participants (n = 70) were adults (mean age of 36.3, SD = 9...

INTRODUCTION: Patients with spinal cord injuries/disorders (SCI/D) often suffer from bladder dysfunction, commonly referred to as neurogenic bladder or neurogenic lower urinary tract dysfunction (NLUTD). Standard urologic evaluation and management help to minimize complications such as vesicoureteral reflux, urinary tract infection, and nephrolithiasis. However, we have further encountered patients with more complex issues, such as chronic kidney disease (CKD), end-stage renal disease (ESRD), bilateral nephrectomies, and urinary diversion/augmentation surgeries...

STUDY DESIGN: Cross-sectional study. OBJECTIVES: A spinal cord injury (SCI) can compromise the ability to maintain sufficient balance control during activities in an upraised position. The objective of the study was to explore the relationship between balance control and muscle strength and muscle activation in the lower extremities in persons with incomplete SCI (iSCI). SETTING: Sunnaas Rehabilitation Hospital, Norway. METHODS: Thirteen men and two women with iSCI and 15 healthy, matched controls were included...

INTRODUCTION: Intramedullary spinal cord abscesses (ISCA) are rare and caused by central nervous system infections. Although polymicrobial infections are rarely seen in ISCAs, isolation of the causative pathogen is important for treatment. Here, we describe a very rare case of ISCA resulting from a mixed Streptococcus and Actinomyces infection. CASE PRESENTATION: An 82-year-old man presented with acute posterior cervical pain and progressive quadriplegia. Radiological investigations revealed a mass lesion showing marginal enhancement at the level of the C3-4 vertebrae...