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Acute spinal injury

Thomas Guiho, Christine Azevedo-Coste, David Guiraud, Claire Delleci, Grégoire Capon, Natalia Delgado-Piccoli, Luc Bauchet, Jean-Rodolphe Vignes
OBJECTIVESpinal cord injuries (SCIs) result in loss of movement and sensory feedback, but also organ dysfunction. Nearly all patients with complete SCI lose bladder control and are prone to kidney failure if intermittent catheterization is not performed. Electrical stimulation of sacral spinal roots was initially considered to be a promising approach for restoring continence and micturition control, but many patients are discouraged by the need for surgical deafferentation as it could lead to a loss of sensory functions and reflexes...
February 15, 2019: Journal of Neurosurgery. Spine
Jason Gandhi, Min Yea Lee, Gunjan Joshi, Sardar Ali Khan
CONTEXT: Surfer's myelopathy (SM) is an acute syndrome identified by nontraumatic paraparesis or paraplegia. Though traditionally tied to first-time surfers, the condition encompasses any activity involving hyperextension of the back such as gymnastics, yoga, and Pilates. METHODS: MEDLINE® and Google Scholar literature searches were gathered to identify relevant case reports for determining the etiology, pathogenesis, evaluation, and management of SM. RESULTS: While the rare nature of SM limits its full understanding, studies have pinpointed that hyperextension in the back leads to vasculature insufficiency secondary to dynamic compression of the artery of Adamkiewicz...
February 15, 2019: Journal of Spinal Cord Medicine
Michael Seth Smith, Jairo Olivas, Kristy Smith
Manipulative therapies include osteopathic manipulative treatment and many other forms of manual therapies used to manage a variety of conditions in adults and children. Spinal manipulative therapy may provide short-term improvement in patients with acute or chronic low back pain, comparable with other standard treatments. When compared with oral analgesics, cervical manipulation and/or mobilization appears to provide better short-term pain relief and improved function in patients with neck pain. Manipulative therapies may be as effective as amitriptyline for treating migraine headaches and can reduce the frequency and intensity of pain...
February 15, 2019: American Family Physician
Ronak H Jani, Arpan V Prabhu, James J Zhou, Nima Alan, Nitin Agarwal
OBJECTIVE: We conducted a citation analysis in order to catalog and pay tribute to the 100 most influential clinical research articles in traumatic spinal cord injury. DESIGN: The Thomson Reuters Web of Science was searched in a two-step process without time period limitations. Review articles were excluded. In the first stage of data extraction, a Boolean query was used to identify the top 100 most cited clinical papers on traumatic spinal cord injury. One hundred and seven keywords were manually chosen and extracted from titles and abstracts...
February 14, 2019: Journal of Spinal Cord Medicine
Elisa García, Roxana Rodríguez-Barrera, Vinnitsa Buzoianu-Anguiano, Adrian Flores-Romero, Emanuel Malagón-Axotla, Marco Guerrero-Godinez, Estefanía De la Cruz-Castillo, Laura Castillo-Carvajal, Monserrat Rivas-Gonzalez, Paola Santiago-Tovar, Ivis Morales, Cesar Borlongan, Antonio Ibarra
Spinal cord injury is a very common pathological event that has devastating functional consequences in patients. In recent years, several research groups are trying to find an effective therapy that could be applied in clinical practice. In this study, we analyzed the combination of different strategies as a potential therapy for spinal cord injury. Immunization with neural derived peptides (INDP), inhibition of glial scar formation (dipyridyl: DPY), as well as the use of biocompatible matrix (fibrin glue: FG) impregnated with bone marrow mesenchymal stem cells (MSCs) were combined and then its beneficial effects were evaluated in the induction of neuroprotection and neuroregeneration after acute SCI...
June 2019: Neural Regeneration Research
Nirupama S Wijesuriya, Danny J Eckert, Amy S Jordan, Rachel Schembri, Chaminda Lewis, Hailey Meaklim, Lauren Booker, Doug Brown, Marnie Graco, David J Berlowitz
STUDY DESIGN: Prospective, double-blind, randomised, placebo-controlled, cross-over trial of nasal decongestion in tetraplegia. OBJECTIVES: Tetraplegia is complicated by severe, predominantly obstructive, sleep apnoea. First-line therapy for obstructive sleep apnoea is nasal continuous positive airway pressure, but this is poorly tolerated. High nasal resistance associated with unopposed parasympathetic activation of the upper airway contributes to poor adherence...
February 13, 2019: Spinal Cord
Stephen Sprigle, Sharon Eve Sonenblum, Chen Feng
Pressure ulcers, by definition, are caused by external forces on the tissues, often in the regions of bony prominences. Wheelchair users are at risk to develop sitting-acquired pressure ulcers, which occur in the regions of the ischial tuberosities, sacrum/coccyx or greater trochanters. As a means to prevent pressure ulcers, instruction on performing pressure reliefs or weight shifts are a part of the rehabilitation process. The objective of this study was to monitor the weight shift activity of full-time wheelchair users with acute spinal cord injury over multiple epochs of time in order to determine consistency or routine within and across epochs...
2019: PloS One
Boressa Adugna Horsa, Yohanes Ayele, Mohammed Biset Ayalew
Background: Critically ill patients with moderate-to-severe physiologically stressful event are at high risk of developing stress ulcers. The use of pharmacological prophylaxis significantly reduces the incidence of stress ulcer in high-risk patients. Objective: The aim of this study was to assess the use of pharmacological prophylaxis for stress ulcer in the medical wards of University of Gondar Hospital. Methods: A cross-sectional study design was used...
2019: SAGE Open Medicine
Siavash Piran, Sam Schulman
Patients with acute spinal cord injury (SCI) have the highest risk of venous thromboembolism (VTE) among hospitalized patients. The incidence of total deep vein thrombosis ranges from 50 to 100% in untreated patients and pulmonary embolism is the third most common cause of mortality in these patients. The pathophysiology of the increased risk of VTE is explained by venous stasis after injury, endothelial vessel wall injury from surgery, and a hypercoagulable state associated with trauma. The current thromboprophylaxis options are limited, with low-molecular-weight heparin (LMWH) being the current standard of care...
February 11, 2019: Seminars in Thrombosis and Hemostasis
Tsuyoshi Kato, Hiroyuki Inose, Shoichi Ichimura, Yasuaki Tokuhashi, Hiroaki Nakamura, Masatoshi Hoshino, Daisuke Togawa, Toru Hirano, Hirotaka Haro, Tetsuro Ohba, Takashi Tsuji, Kimiaki Sato, Yutaka Sasao, Masahiko Takahata, Koji Otani, Suketaka Momoshima, Ukihide Tateishi, Makoto Tomita, Ryuichi Takemasa, Masato Yuasa, Takashi Hirai, Toshitaka Yoshii, Atsushi Okawa
While bracing is the standard conservative treatment for acute osteoporotic compression fracture, the efficacy of different brace treatments has not been extensively studied. We aimed to clarify and compare the preventive effect of the different brace treatments on the deformity of the vertebral body and other clinical results in this patient cohort. This multicenter nationwide prospective randomized study included female patients aged 65⁻85 years with acute one-level osteoporotic compression fractures. We assigned patients within four weeks of injury to either a rigid-brace treatment or a soft-brace treatment...
February 6, 2019: Journal of Clinical Medicine
Caroline Der-Nigoghossian, Kimberly Levasseur-Franklin, Jason Makii
Optimal blood pressure management is controversial in neurocritically ill patients due to conflicting concerns of worsening ischemia with decreased blood pressure versus cerebral edema and increased intracranial pressure with elevated blood pressure. In addition, there is a lack of high-quality evidence regarding optimal blood pressure goals in patients with most of these conditions. This review summarizes guideline recommendations and examines the literature for blood pressure management in patients with ischemic stroke, intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, traumatic brain injury, and spinal cord injury...
February 7, 2019: Pharmacotherapy
Daisuke Kudo, Naohisa Miyakoshi, Michio Hongo, Yuji Kasukawa, Yoshinori Ishikawa, Noriyuki Ishikawa, Yoichi Shimada
STUDY DESIGN: Retrospective epidemiological study. OBJECTIVE: To investigate the epidemiology of traumatic spinal cord injury (TSCI) in the fastest aging area in Japan. SETTING: Hospitals in Akita Prefecture, Japan. Akita Prefecture has the highest ratio of people aged 65 or older in Japan (30.4% in 2012 and 34.6% in 2016). METHODS: Patients with acute TSCI who required hospital treatment between 2012 and 2016 were included...
February 7, 2019: Spinal Cord
Jacquelyn J Cragg, Bobo Tong, Catherine R Jutzeler, Freda M Warner, Neil Cashman, Fred Geisler, John L K Kramer
The objective of our study was to determine whether treatment with baclofen is neurologically safe with respect to exposure during recovery from spinal cord injury. We performed a secondary longitudinal analysis of a cohort of adult patients with traumatic acute spinal cord injury. Cumulative baclofen dose was computed over the first 4 weeks following injury from concomitant medication information from a completed clinical trial. The main outcome measure was neurologic status, which was assessed over 52 weeks with "marked recovery" defined as the conversion to higher sensory and motor function...
February 6, 2019: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Ahmad Jabir Rahyussalim, Rizky Priambodo Wisnubaroto, Tri Kurniawati, Alfariq Senja Belantara Latsarizul, Nuryati Chairani
Hemorrhagic schwannoma in the medulla spinalis is a rare occurrence. It is a variant of the slow-growing nerve sheath tumor that usually has subtle clinical symptoms. Injury to the spinal schwannoma that was previously suspected by spinal manipulations may accelerate the progression of symptoms and cause an acute presentation of paraplegia. We report a case of a patient that was suspected of an intradural tumor with paraparesis that initially refused treatment. Spinal manipulation procedures were performed outside of the hospital setting with subsequent advancement of paraparesis...
2019: Case Reports in Medicine
Sami AlEissa, Suhail Saad AlAssiri, Rayed Meshal AlJehani, Faisal Mohammedsaleh Konbaz, Mohammed Jassim AlSalman, Majed Abaalkhail, Mohammed Hassan AlShehri, Ibrahim Alfaris, Suliman Abdulah Alghnam
BACKGROUND: A traumatic spinal fracture (TSF) is a serious condition that has a tremendous impact on patients and their families. Understanding the causes and patterns of TSF is critical in developing prevention programs. OBJECTIVES: Identify causes and patterns of TSF and explore predictors of neurological disability in Saudi Arabia. DESIGN: A retrospective medical record review. SETTING: Level 1 trauma center in Riyadh...
January 2019: Annals of Saudi Medicine
Jason F Talbott, John Russell Huie, Adam R Ferguson, Jacqueline C Bresnahan, Michael S Beattie, Sanjay S Dhall
T2-weighted (T2W) imaging is the most important sequence for detection of acute traumatic spinal cord pathology in clinical practice. Intramedullary hemorrhage on T2W imaging is associated with some component of irreversible injury and arguably the most robust MR imaging predictor of injury severity. The MR imaging appearance of the injured spinal cord in the early stages of injury is highly dynamic, and the time delay from injury to imaging must be considered in image interpretation. Diffusion imaging offers promise as specific tool for interrogating spinal cord integrity, although well-designed, prospective clinical studies validating its application remain limited...
March 2019: Radiologic Clinics of North America
Sergio Ricardo Thomaz, Gerson Cipriano, Magno Ferreira Formiga, Emerson Fachin-Martins, Graziella França Bernardelli Cipriano, Wagner Rodrigues Martins, Lawrence Patrick Cahalin
STUDY DESIGN: This work is a systematic review with meta-analysis OBJECTIVE: Evaluate the effect of electrical stimulation (ES) on skeletal muscle volume and spasticity in individuals with spinal cord injury (SCI). SETTING: University of Brasilia, Brazil METHODS: Searches were conducted of the Cochrane Library, MEDLINE, CINAHL, PEDro, PsycINFO and EMBASE electronic databases for relevant articles published up to June 2018. No restrictions were imposed regarding the year of publication...
January 29, 2019: Spinal Cord
Laurelie R Wall, Rebecca L Nund, Elizabeth C Ward, Petrea L Cornwell, Delena I Amsters
PURPOSE: Voice and communication changes can occur following cervical spinal cord injury due to dysfunction of the respiratory and phonatory subsystems. Few studies have explored the "lived experience" of communication changes post cervical spinal cord injury. Furthermore, the impacts of these changes on community activity/participation and requirements for psychosocial adjustment have not been well-elucidated. The current study explored the experience of communication changes in non-ventilated individuals following cervical spinal cord injury, using a biopsychosocial framework...
January 29, 2019: Disability and Rehabilitation
Marian H Hettiaratchi, Matthew J O'Meara, Carter J Teal, Samantha L Payne, Andrew J Pickering, Molly S Shoichet
Central nervous system (CNS) injuries, such as stroke and spinal cord injuries, result in the formation of a proteoglycan-rich glial scar, which acts as a barrier to axonal regrowth and limits the regenerative capacity of the CNS. Chondroitinase ABC (ChABC) is a potent bacterial enzyme that degrades the chondroitin sulfate proteoglycan (CSPG) component of the glial scar and promotes tissue recovery; however, its use is significantly limited by its inherent instability at physiological temperatures. Here, we demonstrate that ChABC can be stabilized using site-directed mutagenesis and covalent modification with poly(ethylene glycol) chains (i...
January 25, 2019: Journal of Controlled Release: Official Journal of the Controlled Release Society
Ying Tang, Hong-Liang Liu, Ling-Xia Min, Hao-Shi Yuan, Lei Guo, Peng-Bo Han, Yu-Xin Lu, Jian-Feng Zhong, Dong-Lin Wang
Tau protein, a microtubule-associated protein, has a high specific expression in neurons and axons. Because traumatic spinal cord injury mainly affects neurons and axons, we speculated that tau protein may be a promising biomarker to reflect the degree of spinal cord injury and prognosis of motor function. In this study, 160 female Sprague-Dawley rats were randomly divided into a sham group, and mild, moderate, and severe spinal cord injury groups. A laminectomy was performed at the T8 level to expose the spinal cord in all groups...
May 2019: Neural Regeneration Research
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