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Last update: November 12, 2013.
1

Spinal Cord Injury Map  

MedlinePLUS

Spinal Cord Injury Map Loss of function depends on what part of the spinal cord is damaged, ... control. Learn more about spinal cord injuries. A spinal cord injury affects the entire family FacingDisability is ...

2

Spinal Cord Injuries  

MedlinePLUS

Your spinal cord is a bundle of nerves that runs down the middle of your back. It carries signals ... forth between your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries ...

3

Spinal injury  

MedlinePLUS

... Pa: Mosby Elsevier; 2009:chap 40. Torg JS. Cervical Spine Injuries: 1. Cervical Spine Injuries in the Adult. In: DeLee JC, Drez ... chap 16, section A. Pizzutillo PD, Herman MJ. Cervical Spine Injuries: 2. Cervical Spine Injuries in the Child. ...

4

Spinal injury in sports  

Microsoft Academic Search

Nowadays, the scene of sports has changed as it involves not only money but prestige for self and country. Hence, sports has become aggressive. Any sport which involves movement and momentum can cause spinal injury, like football, water sports, wrestling, rugby, transpoling and ice hockey.Spinal injury can be simple to serious leading to paralysis or death.The team physician should: Identify

R C Mishra

2010-01-01

5

Spinal injuries in sports.  

PubMed

Athletic competition has long been a known source of spinal injuries. Approximately 8.7% of all new cases of spinal cord injuries in the United States are related to sports activities. The sports activities that have the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing, snowboarding, rugby, and cheerleading. Axial compression forces to the top of the head can lead to cervical fracture and quadriplegia in any sport. It is critical for any medical personnel responsible for athletes in team sports to have a plan for stabilization and transfer of an athlete who sustains a cervical spine injury. PMID:19084763

Boden, Barry P; Jarvis, Christopher G

2009-02-01

6

Spinal injuries in sports.  

PubMed

Athletic competition has long been a known source of spinal injuries. Approximately 8.7% of all new cases of spinal cord injuries in the United States are related to sports activities. The sports activities that have the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing, snowboarding, rugby, and cheerleading. Axial compression forces to the top of the head can lead to cervical fracture and quadriplegia in any sport. It is critical for any medical personnel responsible for athletes in team sports to have a plan for stabilization and transfer of an athlete who sustains a cervical spine injury. PMID:18295084

Boden, Barry P; Jarvis, Christopher G

2008-02-01

7

Pediatric Spinal Cord Injury 101  

MedlinePLUS Videos and Cool Tools

Experts \\ Pediatric Spinal Cord Injury 101 Topics Adult Injuries Spinal Cord Injury 101 The Basics of SCI Rehabilitation Preventing Pressure Sores Transition from Hospital to Home Spasticity, Physical Therapy- ...

8

Spinal Injuries in Children  

PubMed Central

About 5% of spinal injuries occur in children – however the consequences to the society are devastating, all the more so because the cervical spine is more commonly affected. Anatomical differences with adults along with the inherent elasticity of the pediatric spine, makes these injuries a biomechanically separate entity. Hence clinical manifestations are unique, one of which is the Spinal Cord Injury Without Radiological Abnormality. With the advent of high quality MRI and CT scan along with digital X-ray, it is now possible to exactly delineate the anatomical location, geometrical configuration, and the pathological extent of the injury. This has improved the management strategies of these unfortunate children and the role of surgical stabilization in unstable injuries can be more sharply defined. However these patients should be followed up diligently because of the recognized long term complications of spinal deformity and syringomyelia.

Basu, Saumyajit

2012-01-01

9

What Is Spinal Cord Injury?  

MedlinePLUS

... NICHD Research Information Clinical Trials Resources and Publications Spinal Cord Injury (SCI): Condition Information Page Content What ... back. Generally speaking, SCI is damage to the spinal nerves, the body's central and most important nerve ...

10

Living with Spinal Cord Injury  

MedlinePLUS

... available through spinal injury centers, most rehabilitation hospitals, medical centers, and clinics. Occupational therapists and occupational therapy assistants are trained in helping both adults and children ...

11

Vehicle related factors that influence injury outcome in head-on collisions.  

PubMed

This study specifically investigated a range of vehicle-related factors that are associated with a lower risk of serious or fatal injury to a belted driver in a head-on collision. This analysis investigated a range of structural characteristics, quantities that describes the physical features of a passenger vehicle, e.g., stiffness or frontal geometry. The study used a data-mining approach (classification tree algorithm) to find the most significant relationships between injury outcome and the structural variables. The algorithm was applied to 120,000 real-world, head-on collisions, from the National Highway Traffic Safety Administration's (NHTSA's) State Crash data files, that were linked to structural attributes derived from frontal crash tests performed as part of the USA New Car Assessment Program. As with previous literature, the analysis found that the heavier vehicles were correlated with lower injury risk to their drivers. This analysis also found a new and significant correlation between the vehicle's stiffness and injury risk. When an airbag deployed, the vehicle's stiffness has the most statistically significant correlation with injury risk. These results suggest that in severe collisions, lower intrusion in the occupant cabin associated with higher stiffness is at least as important to occupant protection as vehicle weight for self-protection of the occupant. Consequently, the safety community might better improve self-protection by a renewed focus on increasing vehicle stiffness in order to improve crashworthiness in head-on collisions. PMID:19026230

Blum, Jeremy J; Scullion, Paul; Morgan, Richard M; Digges, Kennerly; Kan, Cing-Dao; Park, Shinhee; Bae, Hanil

2008-10-01

12

Vehicle Related Factors that Influence Injury Outcome in Head-On Collisions  

PubMed Central

This study specifically investigated a range of vehicle-related factors that are associated with a lower risk of serious or fatal injury to a belted driver in a head-on collision. This analysis investigated a range of structural characteristics, quantities that describes the physical features of a passenger vehicle, e.g., stiffness or frontal geometry. The study used a data-mining approach (classification tree algorithm) to find the most significant relationships between injury outcome and the structural variables. The algorithm was applied to 120,000 real-world, head-on collisions, from the National Highway Traffic Safety Administration’s (NHTSA’s) State Crash data files, that were linked to structural attributes derived from frontal crash tests performed as part of the USA New Car Assessment Program. As with previous literature, the analysis found that the heavier vehicles were correlated with lower injury risk to their drivers. This analysis also found a new and significant correlation between the vehicle’s stiffness and injury risk. When an airbag deployed, the vehicle’s stiffness has the most statistically significant correlation with injury risk. These results suggest that in severe collisions, lower intrusion in the occupant cabin associated with higher stiffness is at least as important to occupant protection as vehicle weight for self-protection of the occupant. Consequently, the safety community might better improve self-protection by a renewed focus on increasing vehicle stiffness in order to improve crashworthiness in head-on collisions.

Blum, Jeremy J.; Scullion, Paul; Morgan, Richard M.; Digges, Kennerly; Kan, Cing-Dao; Park, Shinhee; Bae, Hanil

2008-01-01

13

Depression following spinal cord injury  

Microsoft Academic Search

Although depression has been widely studied among persons with spinal cord injury, the ubiquitous and unsophisticated use of the term and presumtions about its manifestations in the rehabilitation setting have needlessly encumbered the understanding and treatment of depression. Major themes and issues in the study, measurement, and treatment of depression among persons with spinal cord injury are reviewed. Greater precision

Timothy R. Elliott; Robert G. Frank

1996-01-01

14

Sexuality and spinal cord injury.  

PubMed

Spinal cord injury may have a profound effect on the patient's sexuality. In order to maximize the patient's potential, concern and support from health care professionals is needed. This article reviews normal sexual function and changes occurring following spinal cord injury. The PLISSIT model is described and is used to describe nursing interventions designed to deal with the sexual concerns of spinal cord-injured patients. PMID:2973501

Goddard, L R

1988-08-01

15

Spinal Cord Injury  

MedlinePLUS

... which then crush and destroy axons -- extensions of nerve cells that carry signals up and down the spinal ... drug methylprednisolone appears to reduce the damage to nerve cells if it is given within the first 8 ...

16

Pregnancy following spinal cord injury.  

PubMed Central

Each year about 2,000 women of childbearing age in the United States have a spinal cord injury. Only a few mostly anecdotal reports describe pregnancy after such an injury. In a retrospective study of 16 women with a spinal cord injury, half of whom have a complete injury and about half quadriplegia, 25 pregnancies occurred, with 21 carried to full term. The women delayed pregnancy an average of 6.5 years after their injury, with an average age at first pregnancy of 26.8 years. Cesarean section was necessary in 4 patients because of inadequate progress of labor. In 5 deliveries an episiotomy and local anesthesia were required, 7 required epidural anesthesia, including all cesarean sections, and 10 did not require anesthesia. Several complications have been identified in the antepartum, intrapartum, and postpartum periods including autonomic hyperreflexia, premature labor, pressure sores, urinary tract infections, abnormal presentation, and failure to progress. Ultrasonography and amniocentesis were used selectively. Women with spinal cord injuries can have healthy children, although there are significant risks and these women have special needs.

Cross, L. L.; Meythaler, J. M.; Tuel, S. M.; Cross, A. L.

1991-01-01

17

Hyperpyrexia in spinal injury patients  

Microsoft Academic Search

We studied 13 spinal injury patients who had hyperpyrexia during an 18 month period (September 1984—March 1986) to discover if differences existed in the core temperature of patients with tetraplegia and those with paraplegia, and the contribution of these differences to the final outcome. Children were excluded from this study as well as patients with any sign of infection on

A Essiet; O Onuba

1992-01-01

18

SPINAL CORD INJURY (SCI) DATABASE  

EPA Science Inventory

The National Spinal Cord Injury Database has been in existence since 1973 and captures data from SCI cases in the United States. Since its inception, 24 federally funded Model SCI Care Systems have contributed data to the National SCI Database. Statistics are derived from this da...

19

Motor vehicle related injuries among American Indian and Alaskan Native youth, 1981-92: analysis of a national hospital discharge database  

PubMed Central

Objective—To describe national trends in hospitalizations for motor vehicle related injuries among children and youth (0–24 years) of the United States Indian Health Service (IHS) from 1981–92. Design—Descriptive epidemiologic study of the E coded national hospital discharge database of the IHS. Results—From 1981 to 1992, the age standardized annual incidence of motor vehicle related injury hospitalizations (per 100 000 population) among American Indian and Alaskan Native (AI/AN) youth decreased more than 65% from 269 to 93. Substantial declines in hospitalization rates for all age and sex groups, all IHS areas, and most injury types were seen over this time. Injuries to vehicle occupants accounted for 78% of all motor vehicle related injury hospitalizations. The annual incidence of hospitalization (per 100 000 population) ranged from 291 in the Billings (Wyoming/Montana) and Aberdeen (the Dakotas) areas to 38 in the Portland area (Pacific Northwest). Conclusions—National motor vehicle related injury hospitalization rates of AI/AN children and youth decreased significantly from 1981–92. This may be due to a reduction in the incidence of severe motor vehicle related trauma, changing patterns of medical practice, and changes in the use of services. Additional measures, such as passage and enforcement of tribal laws requiring the use of occupant restraints and stronger laws to prevent alcohol impaired driving, might further reduce the incidence of serious motor vehicle related injuries in this high risk population.

Quinlan, K.; Wallace, L; Furner, S.; Brewer, R.; Bolen, J.; Schieber, R.

1998-01-01

20

Missed injuries of the spinal cord.  

PubMed Central

Damage to the spinal cord had not been recognised initially in 15 patients out of a consecutive series of 353 admitted over a decade to the National Spinal Injuries Centre with paralysis due to trauma to the cord. In some patients the missed diagnosis led to mismanagement and a greater neurological deficit. Missed injuries of the spinal cord are seen in patients with multiple injuries and head injuries and in those without any paralysis. Various radiological errors contribute to the failure to recognise the vertebral injury. In addition to causing severe disability to the victim these missed and mismanaged injuries of the spinal cord cost the National Health Service large sums in compensation. A careful evaluation of the history of each accident, with greater awareness of the potential of certain types of accidents to cause spinal cord injury, should reduce the incidence of missed injuries of the spinal cord. Images p955-a

Ravichandran, G; Silver, J R

1982-01-01

21

Cardiovascular Control After Spinal Cord Injury  

Microsoft Academic Search

Spinal cord injury (SCI) leads to profound haemodynamic changes. Constant outflows from the central autonomic pattern generators modulate the activity of the spinal sympathetic neurons. Sudden loss of communication between these centers and the sympathetic neurons in the intermediolateral thoracic and lumbar spinal cord leads to spinal shock. After high SCI, experimental data demonstrated a brief hypertensive peak followed by

F. A. A. Gondim; A. C. A. Lopes Jr.; G. R. Oliveira; C. L. Rodrigues; P. R. L. Leal; A. A. Santos; F. H. Rola

2004-01-01

22

The effect of counting principal and secondary injuries on national estimates of motor vehicle-related trauma: a NEISS–AIP special study  

Microsoft Academic Search

Objective:To demonstrate the effect of including both principal and secondary injuries in the calculation of national estimates of non-fatal motor vehicle-related injury, using the National Electronic Injury Surveillance System–All Injury Program (NEISS–AIP).Methods:The setting was a stratified sample of 15 US hospital emergency departments selected among 50 NEISS–AIP hospitals which agreed to participate in the study. Non-fatal injury data from a

J Halpin; A I Greenspan; T Haileyesus; J L Annest

2009-01-01

23

Spinal Cord Injury Medicine. 4. Community Reintegration After Spinal Cord Injury  

Microsoft Academic Search

Scelza WM, Kirshblum SC, Wuermser LA, Ho CH, Priebe MM, Chiodo AE. Spinal cord injury medicine. 4. Community reintegration after spinal cord injury.This self-directed learning module highlights community reintegration after spinal cord injury (SCI). It is part of the study guide on spinal cord injury medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and

William M. Scelza; Steven C. Kirshblum; Lisa-Ann Wuermser; Chester H. Ho; Michael M. Priebe; Anthony E. Chiodo

2007-01-01

24

Therapeutic approaches for spinal cord injury  

PubMed Central

This study reviews the literature concerning possible therapeutic approaches for spinal cord injury. Spinal cord injury is a disabling and irreversible condition that has high economic and social costs. There are both primary and secondary mechanisms of damage to the spinal cord. The primary lesion is the mechanical injury itself. The secondary lesion results from one or more biochemical and cellular processes that are triggered by the primary lesion. The frustration of health professionals in treating a severe spinal cord injury was described in 1700 BC in an Egyptian surgical papyrus that was translated by Edwin Smith; the papyrus reported spinal fractures as a “disease that should not be treated.” Over the last two decades, several studies have been performed to obtain more effective treatments for spinal cord injury. Most of these studies approach a patient with acute spinal cord injury in one of four manners: corrective surgery or a physical, biological or pharmacological treatment method. Science is unraveling the mechanisms of cell protection and neuroregeneration, but clinically, we only provide supportive care for patients with spinal cord injuries. By combining these treatments, researchers attempt to enhance the functional recovery of patients with spinal cord injuries. Advances in the last decade have allowed us to encourage the development of experimental studies in the field of spinal cord regeneration. The combination of several therapeutic strategies should, at minimum, allow for partial functional recoveries for these patients, which could improve their quality of life.

Cristante, Alexandre Fogaca; de Barros Filho, Tarcisio Eloy Pessoa; Marcon, Raphael Martus; Letaif, Olavo Biraghi; da Rocha, Ivan Dias

2012-01-01

25

Acute management of spinal cord injury.  

PubMed

Demographic trends in the occurrence of injury and improvements in the early management of spinal trauma are changing the long-term profile of patients with spinal cord injuries. More patients are surviving the initial injury, and proportionately fewer patients are sustaining complete injuries. While preventive efforts to reduce the overall incidence of spinal cord injury are important, a number of steps can be taken to minimize secondary injury once the initial trauma has occurred. Recent efforts have focused on understanding the biochemical basis of secondary injury and developing pharmacologic agents to intervene in the progression of neurologic deterioration. The Third National Acute Spinal Cord Injury Study investigators concluded that methylprednisolone improves neurologic recovery after acute spinal cord injury and recommended that patients who receive methylprednisolone within 3 hours of injury should be maintained on the treatment regimen for 24 hours. When methylprednisolone therapy is initiated 3 to 8 hours after injury, it should continue for 48 hours. In addition to the adoption of the guidelines of that study, rapid reduction and stabilization of injuries causing spinal cord compression are critical steps in optimizing patients' long-term neurologic and functional outcomes. PMID:10346825

Delamarter, R B; Coyle, J

26

Depression Following a Spinal Cord Injury  

Microsoft Academic Search

Elliott TR, Frank RG. Depression following spinal cord injury. Arch Phys Med Rehabil 1996;77:816-23. Although depression has been widely studied among persons with spinal cord injury, the ubiquitous and unsophisticated use of the term and presumtions about its manifestations in the rehabilitation setting have needlessly encumbered the under- standing and treatment of depression. Major themes and issues in the study,

Robert G. Frank

1996-01-01

27

Neural Plasticity After Spinal Cord Injury  

Microsoft Academic Search

Spinal cord injury (SCI) has devastating physical and socioeconomical impact. However, some degree of functional recovery is frequently observed in patients after SCI. There is considerable evidence that functional plasticity occurs in cerebral cortical maps of the body, which may account for functional recovery after injury. Additionally, these plasticity changes also occur at multiple levels including the brainstem, spinal cord,

Yuemin Ding; Abba J. Kastin; Weihong Pan

2005-01-01

28

Regenerative treatment in spinal cord injury.  

PubMed

Spinal cord injury is a devastating, traumatic event, and experienced mainly among young people. Until the modern era, spinal cord injury was so rapidly fatal that no seriously injured persons would survive long enough for regeneration to occur. Treatment of spinal cord injury can be summarized as follows: prevent further cord injury, maintain blood flow, relieve spinal cord compression, and provide secure vertebral stabilization so as to allow mobilization and rehabilitation, none of which achieves functional recovery. Previous studies have focused on analyzing the pathogenesis of secondary injury that extends from the injury epicenter to the periphery, as well as the tissue damage and neural cell death associated with secondary injury. Now, there are hundreds of current experimental and clinical regenerative treatment studies. One of the most popular treatment method is cell transplantation in injured spinal cord. For this purpose bone marrow stromal cells, mononuclear stem cells, mesenchymal stem cells, embryonic stem cells, neural stem cells, and olfactory ensheathing cells can be used. As a result, cell transplantation has become a promising therapeutic option for spinal cord injury patients. In this paper we discuss the effectiveness of stem cell therapy in spinal cord injury. PMID:22849699

Ozdemir, Mevci; Attar, Ayhan; Kuzu, Isinsu

2012-09-01

29

Therapeutic approaches for spinal cord injury.  

PubMed

This study reviews the literature concerning possible therapeutic approaches for spinal cord injury. Spinal cord injury is a disabling and irreversible condition that has high economic and social costs. There are both primary and secondary mechanisms of damage to the spinal cord. The primary lesion is the mechanical injury itself. The secondary lesion results from one or more biochemical and cellular processes that are triggered by the primary lesion. The frustration of health professionals in treating a severe spinal cord injury was described in 1700 BC in an Egyptian surgical papyrus that was translated by Edwin Smith; the papyrus reported spinal fractures as a "disease that should not be treated." Over the last biological or pharmacological treatment method. Science is unraveling the mechanisms of cell protection and neuroregeneration, but clinically, we only provide supportive care for patients with spinal cord injuries. By combining these treatments, researchers attempt to enhance the functional recovery of patients with spinal cord injuries. Advances in the last decade have allowed us to encourage the development of experimental studies in the field of spinal cord regeneration. The combination of several therapeutic strategies should, at minimum, allow for partial functional recoveries for these patients, which could improve their quality of life. PMID:23070351

Cristante, Alexandre Fogaça; Barros Filho, Tarcísio Eloy Pessoa de; Marcon, Raphael Martus; Letaif, Olavo Biraghi; Rocha, Ivan Dias da

2012-10-01

30

Nutrition in acute spinal cord injury.  

PubMed

Nutrition in acute spinal cord injury is complicated. Not every aspect of nutrition as it relates to the acutely injured spinal cord patient is known. The stress response to injury, fever, infection, sepsis, and surgery alter nutritional needs, as does the spinal cord injury itself. The sequelae of spinal cord injury, including denervation atrophy and paralysis, glucose intolerance, skin and wound breakdown, poikilothermy, anemia, respiratory paralysis, pneumonia, paralytic ileus, gastrointestinal ulcers and hemorrhage, neurogenic bowel and bladder, and depression, all affect the nutritional needs of the patient. Orthopedic appliances, pharmacologic agents, and other injuries can also alter nutritional requirements. Nutritional assessment in acute spinal cord injury is also complex. It should include medical and diet history, physical examination, intake and output measurements, prediction of energy expenditure and protein requirements, or--even better--measurements of energy expenditure with indirect methodology, using the metabolic cart or pulmonary artery catheter. Application of computerized tomography and radioisotope studies may prove valuable in the future. Finally, the direct relationship between nutrition and physiologic alterations of acute spinal cord injury necessitates that the critical care nurse incorporate nutrition-focused thinking into many aspects of the acute spinal cord--injured patient's care. PMID:2264960

Blissitt, P A

1990-09-01

31

Hyperpyrexia in spinal injury patients.  

PubMed

We studied 13 spinal injury patients who had hyperpyrexia during an 18 month period (September 1984-March 1986) to discover if differences existed in the core temperature of patients with tetraplegia and those with paraplegia, and the contribution of these differences to the final outcome. Children were excluded from this study as well as patients with any sign of infection on first admission, patients with multiple injuries, and those referred from peripheral hospitals more than one week after injury. Patients with tetraplegia (C3-C7) had persistently high and uncontrollable core temperatures (average 39.5 degrees C) while those with paraplegia (T4-L5) showed lower core temperatures which were still high (average 38.1 degrees C). The difference in the average high core temperature (1.4 degrees C) is statistically significant. The lowest average core temperatures were about the same in tetraplegics and paraplegics (just over 35 degrees C). Four patients died: 3 tetraplegics and one paraplegic. Antipyretic analgesics were ineffective in reducing the high core temperatures. PMID:1598174

Essiet, A; Onuba, O

1992-05-01

32

Nanomedicine for treating spinal cord injury  

NASA Astrophysics Data System (ADS)

Spinal cord injury results in significant mortality and morbidity, lifestyle changes, and difficult rehabilitation. Treatment of spinal cord injury is challenging because the spinal cord is both complex to treat acutely and difficult to regenerate. Nanomaterials can be used to provide effective treatments; their unique properties can facilitate drug delivery to the injury site, enact as neuroprotective agents, or provide platforms to stimulate regrowth of damaged tissues. We review recent uses of nanomaterials including nanowires, micelles, nanoparticles, liposomes, and carbon-based nanomaterials for neuroprotection in the acute phase. We also review the design and neural regenerative application of electrospun scaffolds, conduits, and self-assembling peptide scaffolds.

Tyler, Jacqueline Y.; Xu, Xiao-Ming; Cheng, Ji-Xin

2013-09-01

33

Nanomedicine for treating spinal cord injury.  

PubMed

Spinal cord injury results in significant mortality and morbidity, lifestyle changes, and difficult rehabilitation. Treatment of spinal cord injury is challenging because the spinal cord is both complex to treat acutely and difficult to regenerate. Nanomaterials can be used to provide effective treatments; their unique properties can facilitate drug delivery to the injury site, enact as neuroprotective agents, or provide platforms to stimulate regrowth of damaged tissues. We review recent uses of nanomaterials including nanowires, micelles, nanoparticles, liposomes, and carbon-based nanomaterials for neuroprotection in the acute phase. We also review the design and neural regenerative application of electrospun scaffolds, conduits, and self-assembling peptide scaffolds. PMID:23945984

Tyler, Jacqueline Y; Xu, Xiao-Ming; Cheng, Ji-Xin

2013-08-14

34

Obesity after spinal cord injury.  

PubMed

America is in the midst of an obesity epidemic, and individuals who have spinal cord injury (SCI) are perhaps at greater risk than any other segment of the population. Recent changes in the way obesity has been defined have lulled SCI practitioners into a false sense of security about the health of their patients regarding the dangers of obesity and its sequelae. This article defines and uses a definition of obesity that is more relevant to persons who have SCI, reviews the physiology of adipose tissue, and discusses aspects of heredity and environment that contribute to obesity in SCI. The pathophysiology of obesity is discussed relative to health risks for persons who have SCI, particularly those contributing to cardiovascular disease. Prevalence of obesity and its comorbidities are discussed and management options reviewed. PMID:17543776

Gater, David R

2007-05-01

35

Construction equipment and motor vehicle related injuries on construction sites in Turkey.  

PubMed

Research on occupational accidents on construction sites in Turkey is very few. Moreover, research on motor vehicle and equipment accidents also do not exist. Investigation in the scope of this study shows that after falls and contact with electricity, accidents involving heavy equipment and motor vehicles rank third and fourth, respectively. This study aims to reveal the characteristics of these types of accidents, deduct the prominent causes that lead to fatalities as well as permanent disabilities using the present data. With the aid of obtained results, recommendations are made for safety experts on how to derive data from insufficient sources in Turkey and to evaluate these data for prevention and mitigation of the risks that construction workers are exposed to. 168 fatal and 38 non-fatal traffic accident-caused incidents as well as 206 fatal and 97 non-fatal construction equipment accidents, which were selected from official statistics and expert reports, were taken into consideration. Analysis and classification of these accidents were done according to the way they happened, the type of construction site and the occupation of the victims. Moreover, the leading causes of fatal and non-fatal injuries, to which drivers, operators and co-operators are exposed, are presented. Critical findings concerning prominent ways of occurrence, type of construction work and occupation are presented; and a number of measures for reducing the present risks are suggested. Some approaches for analysing relevant data are proposed for further research. PMID:18716386

Gürcanli, G Emre; Müngen, Ugur; Akad, Murat

2008-08-01

36

Spinal Cord Injury Medicine. 3. Rehabilitation Phase After Acute Spinal Cord Injury  

Microsoft Academic Search

Kirshblum SC, Priebe MM, Ho CH, Scelza WM, Chiodo AE, Wuermser LA. Spinal cord injury medicine. 3. Rehabilitation phase after acute spinal cord injury.This self-directed learning module highlights the rehabilitation aspects of care for people with traumatic spinal cord injury (SCI). It is part of the chapter on SCI medicine in the Self-Directed Physiatric Education Program for practitioners and trainees

Steven C. Kirshblum; Michael M. Priebe; Chester H. Ho; William M. Scelza; Anthony E. Chiodo; Lisa-Ann Wuermser

2007-01-01

37

Spinal Cord Injury Medicine. 6. Economic and Societal Issues in Spinal Cord Injury  

Microsoft Academic Search

Priebe MM, Chiodo AE, Scelza WM, Kirshblum SC, Wuermser LA, Ho CH. Spinal cord injury medicine. 6. Economic and societal issues in spinal cord injury.This self-directed learning module presents a variety of social and economic issues facing people with spinal cord injury (SCI). It is part of the study guide on SCI medicine in the Self-Directed Physiatric Education Program for

Michael M. Priebe; Anthony E. Chiodo; William M. Scelza; Steven C. Kirshblum; Lisa-Ann Wuermser; Chester H. Ho

2007-01-01

38

Pharmacological approaches to chronic spinal cord injury.  

PubMed

Although research on neural tissue repair has made enormous progress in recent years, spinal cord injury remains a devastating condition for which there is still no cure. In fact, recent estimates of prevalence in the United States reveal that spinal cord injury has undergone a five-fold increase in the last decades. Though, it has become the second most common neurological problem in North America after Alzheimer's disease. Despite modern trauma units and intensive care treatments, spinal cord injury remains associated with several comorbid conditions and unbearable health care costs. Regular administration of a plethora of symptomatic drug treatments aimed at controlling related-secondary complications and life-threatening problems in chronic spinal cord-injured patients has recently been reported. This article provides a thorough overview of the main drug classes and products currently used or in development for chronic spinal cord injury. Special attention is paid to a novel class of drug treatment designed to provide a holistic solution for several chronic complications and diseases related with spinal cord injury. There is clear evidence showing that new class can elicit 'on-demand' episodes of rhythmic and stereotyped walking activity in previously completely paraplegic animals and may consequently constitute a simple therapy against several physical inactivity-related comorbid problems. Understanding further pharmacological approaches to chronic spinal cord injury may improve both life expectancy and overall quality of life while reducing unsustainable cost increases associated with this debilitation condition. PMID:23360274

Steuer, Inge; Rouleau, Pascal; Guertin, Pierre A

2013-01-01

39

Antioxidant Therapies for Acute Spinal Cord Injury  

Microsoft Academic Search

Summary  One of the most investigated molecular mechanisms involved in the secondary pathophysiology of acute spinal cord injury (SCI)\\u000a is free radical-induced, iron-catalyzed lipid peroxidation (LP) and protein oxidative\\/nitrative damage to spinal neurons,\\u000a glia, and microvascular cells. The reactive nitrogen species peroxynitrite and its highly reactive free radicals are key initiators\\u000a of LP and protein nitration in the injured spinal cord,

Edward D. Hall

2011-01-01

40

Cervical spinal cord injury in sapho syndrome.  

PubMed

Cervical spinal fracture and pseudarthrosis are previously described causes of spinal cord injury (SCI) in patients with spondylarthropathy. SAPHO (Synovitis Acne Pustulosis Hyperostosis Osteitis) syndrome is a recently recognized rheumatic condition characterized by hyperostosis and arthro-osteitis of the upper anterior chest wall, spinal involvement similar to spondylarthropathies and skin manifestations including palmoplantar pustulosis and pustular psoriasis. We report the first case of SAPHO syndrome disclosed by SCI related to cervical spine ankylosis. PMID:10338354

Deltombe, T; Nisolle, J F; Boutsen, Y; Gustin, T; Gilliard, C; Hanson, P

1999-04-01

41

Muscle after spinal cord injury.  

PubMed

The morphological and contractile changes of muscles below the level of the lesion after spinal cord injury (SCI) are dramatic. In humans with SCI, a fiber-type transformation away from type I begins 4-7 months post-SCI and reaches a new steady state with predominantly fast glycolytic IIX fibers years after the injury. There is a progressive drop in the proportion of slow myosin heavy chain (MHC) isoform fibers and a rise in the proportion of fibers that coexpress both the fast and slow MHC isoforms. The oxidative enzymatic activity starts to decline after the first few months post-SCI. Muscles from individuals with chronic SCI show less resistance to fatigue, and the speed-related contractile properties change, becoming faster. These findings are also present in animals. Future studies should longitudinally examine changes in muscles from early SCI until steady state is reached in order to determine optimal training protocols for maintaining skeletal muscle after paralysis. PMID:19705475

Biering-Sørensen, Bo; Kristensen, Ida Bruun; Kjaer, Michael; Biering-Sørensen, Fin

2009-10-01

42

CHRONIC PAIN FOLLOWING SPINAL CORD INJURY  

PubMed Central

Most patients with insults to the spinal cord or central nervous system suffer from excruciating, unrelenting, chronic pain that is largely resistant to treatment. This condition affects a large percentage of spinal cord injury patients, and numerous patients with multiple sclerosis, stroke and other conditions. Despite the recent advances in basic science and clinical research the pathophysiological mechanisms of pain following spinal cord injury remain unknown. Here we describe a novel mechanism of loss of inhibition within the thalamus that may predispose for the development of this chronic pain and discuss a potential treatment that may restore inhibition and ameliorate pain.

Masri, Radi; Keller, Asaf

2013-01-01

43

Epidemiology of spinal injuries in Romania  

Microsoft Academic Search

Retrospective and prospective epidemiological studies in Bucharest indicated a high rate of spinal injuries (about 28.5 per million population per year) in Romania. Most patients were poor, male, manual workers. Half of them were aged less than 40. Falls, particularly from horse-drawn carts, and road traffic accidents were the most frequent causes of injury. In summer, diving accidents were a

A Soopramanien

1994-01-01

44

Intractable Pruritus After Traumatic Spinal Cord Injury  

PubMed Central

Background: This report describes a young woman with incomplete traumatic cervical spinal cord injury and intractable pruritus involving her dorsal forearm. Method: Case report. Findings: Anatomic distribution of the pruritus corresponded to the dermatomal distribution of her level of spinal cord injury and vertebral fusion. Symptoms were attributed to the spinal cord injury and possible cervical root injury. Pruritus was refractory to all treatments, including topical lidocaine, gabapentin, transcutaneous electrical nerve stimulation, intravenous Bier block, stellate ganglion block, and acupuncture. Conclusions: Further understanding of neuropathic pruritus is needed. Diagnostic workup of intractable pruritus should include advanced imaging to detect ongoing nerve root compression. If diagnostic studies suggest radiculopathy, epidural steroid injection should be considered. Because the autonomic nervous system may be involved in complex chronic pain or pruritic syndromes, sympatholysis via such techniques as stellate ganglion block might be effective.

Crane, Deborah A; Jaffee, Kenneth M; Kundu, Anjana

2009-01-01

45

Rugby injuries to the cervical spinal cord.  

PubMed

An analysis of the orthopaedic injuries in 20 patients who sustained injury to the cervical spinal cord while playing rugby has been made. Eight (40%) of the players were injured during scrums and the remainder were injured during tackling. The incidence of and mortality due to spinal cord injuries sustained during rugby are discussed. Analysis of the scrum injuries shows a specific type of orthopaedic injury indicating a flexion-rotation mechanism. No specific mechanism of injury in the group injured during tackling could by demonstrated. It is concluded that the rugby scrum provides an ideal occasion for dislocation of the cervical spine and is potentially the most hazardous facet of the game. PMID:870992

Scher, A T

1977-04-01

46

Neuronal dysfunction in chronic spinal cord injury.  

PubMed

This review describes the changes of spinal neuronal function that occur after a motor complete spinal cord injury (cSCI) in humans. In healthy subjects, polysynaptic spinal reflex (SR) evoked by non-noxious tibial nerve stimulation consists of an early SR component and rarely a late SR component. Soon after a cSCI, SR and locomotor activity are absent. After spinal shock; however, an early SR component re-appears associated with the recovery of locomotor activity in response to appropriate peripheral afferent input. Clinical signs of spasticity take place in the following months, largely as a result of non-neuronal changes. After around 1 year, the locomotor and SR activity undergo fundamental changes, that is, the electromyographic amplitude in the leg muscles during assisted locomotion exhaust rapidly, accompanied by a shift from early to dominant late SR components. The exhaustion of locomotor activity is also observed in non-ambulatory patients with an incomplete spinal cord injury (SCI). At about 1 year after injury, in most cSCI subjects the neuronal dysfunction is fully established and remains more or less stable in the following years. It is assumed that in chronic SCI, the patient's immobility resulting in a reduced input from supraspinal and peripheral sources leads to a predominance of inhibitory drive within spinal neuronal circuitries underlying locomotor pattern and SR generation. Training of spinal interneuronal circuits including the enhancement of an appropriate afferent input might serve as an intervention to prevent neuronal dysfunction after an SCI. PMID:21060314

Hubli, M; Bolliger, M; Dietz, V

2010-11-09

47

Cell Cycle Activation and Spinal Cord Injury  

Microsoft Academic Search

Summary  Traumatic spinal cord injury (SCI) evokes a complex cascade of events with initial mechanical damage leading to secondary\\u000a injury processes that contribute to further tissue loss and functional impairment. Growing evidence suggests that the cell\\u000a cycle is activated following SCI. Up-regulation of cell cycle proteins after injury appears to contribute not only to apoptotic\\u000a cell death of postmitotic cells, including

Junfang Wu; Bogdan A. Stoica; Alan I. Faden

2011-01-01

48

Spinal cord injuries due to diving accidents  

Microsoft Academic Search

Study design:Retrospective study and data analysis.Objective:To investigate and analyse the main features of spinal cord injuries due to diving accidents accepted in our Centre from June 1978 to December 2002.Setting:Regional Spinal Unit of Florence, Italy.Introduction:Diving accidents mostly occur in a young and healthy population and most of the patients develop tetraplegia with a severe lifelong disability. From 1978 to 2002,

S Aito; M D'Andrea; L Werhagen

2005-01-01

49

Worklife After Traumatic Spinal Cord Injury  

PubMed Central

Objective: To develop predictive models to estimate worklife expectancy after spinal cord injury (SCI). Design: Inception cohort study. Setting: Model SCI Care Systems throughout the United States. Participants: 20,143 persons enrolled in the National Spinal Cord Injury Statistical Center database since 1973. Intervention: Not applicable. Main Outcome Measure: Postinjury employment rates and worklife expectancy. Results: Using logistic regression, we found a greater likelihood of being employed in any given year to be significantly associated with younger age, white race, higher education level, being married, having a nonviolent cause of injury, paraplegia, ASIA D injury, longer time postinjury, being employed at injury and during the previous postinjury year, higher general population employment rate, lower level of Social Security Disability Insurance benefits, and calendar years after the passage of the Americans with Disabilities Act. Conclusions: The likelihood of postinjury employment varies substantially among persons with SCI. Given favorable patient characteristics, worklife should be considerably higher than previous estimates.

Pflaum, Christopher; McCollister, George; Strauss, David J; Shavelle, Robert M; DeVivo, Michael J

2006-01-01

50

Interrater Reliability of the International Standards for Neurological Classification of Spinal Cord Injury in Youths With Chronic Spinal Cord Injury  

Microsoft Academic Search

Mulcahey MJ, Gaughan JP, Chafetz RS, Vogel LC, Samdani AF, Betz RR. Interrater reliability of the International Standards for Neurological Classification of Spinal Cord Injury in youths with chronic spinal cord injury.

Mary Jane Mulcahey; John P. Gaughan; Ross S. Chafetz; Larry C. Vogel; Amer F. Samdani; Randal R. Betz

2011-01-01

51

Maladaptive spinal plasticity opposes spinal learning and recovery in spinal cord injury  

PubMed Central

Synaptic plasticity within the spinal cord has great potential to facilitate recovery of function after spinal cord injury (SCI). Spinal plasticity can be induced in an activity-dependent manner even without input from the brain after complete SCI. A mechanistic basis for these effects is provided by research demonstrating that spinal synapses have many of the same plasticity mechanisms that are known to underlie learning and memory in the brain. In addition, the lumbar spinal cord can sustain several forms of learning and memory, including limb-position training. However, not all spinal plasticity promotes recovery of function. Central sensitization of nociceptive (pain) pathways in the spinal cord may emerge in response to various noxious inputs, demonstrating that plasticity within the spinal cord may contribute to maladaptive pain states. In this review we discuss interactions between adaptive and maladaptive forms of activity-dependent plasticity in the spinal cord below the level of SCI. The literature demonstrates that activity-dependent plasticity within the spinal cord must be carefully tuned to promote adaptive spinal training. Prior work from our group has shown that stimulation that is delivered in a limb position-dependent manner or on a fixed interval can induce adaptive plasticity that promotes future spinal cord learning and reduces nociceptive hyper-reactivity. On the other hand, stimulation that is delivered in an unsynchronized fashion, such as randomized electrical stimulation or peripheral skin injuries, can generate maladaptive spinal plasticity that undermines future spinal cord learning, reduces recovery of locomotor function, and promotes nociceptive hyper-reactivity after SCI. We review these basic phenomena, how these findings relate to the broader spinal plasticity literature, discuss the cellular and molecular mechanisms, and finally discuss implications of these and other findings for improved rehabilitative therapies after SCI.

Ferguson, Adam R.; Huie, J. Russell; Crown, Eric D.; Baumbauer, Kyle M.; Hook, Michelle A.; Garraway, Sandra M.; Lee, Kuan H.; Hoy, Kevin C.; Grau, James W.

2012-01-01

52

Supernumerary phantom limbs in spinal cord injury  

Microsoft Academic Search

Study design and objectives:Case report and review of supernumerary phantom limbs in patients suffering from spinal cord injury (SCI).Setting:SCI rehabilitation centre.Case report:After a ski accident, a 71-year-old man suffered an incomplete SCI (level C3; AIS C, central cord syndrome), with a C3\\/C4 dislocation fracture. From the first week after injury, he experienced a phantom duplication of both upper limbs that

A Curt; C Ngo Yengue; L M Hilti; P Brugger

2011-01-01

53

Spinal cord injuries due to diving  

Microsoft Academic Search

One hundred and fifty patients with spinal cord lesions due to diving accidents were admitted to Stoke Mandeville Hospital between 1944-77. Most of the patients were young men, 65 had dived into the sea, 48 into swimming pools, 21 into rivers and 3 into lakes. Injuries due to diving into the deep end of swimming pools appear to have been

H L Frankel; F A Montero; P T Penny

1980-01-01

54

Sleep disordered breathing following spinal cord injury  

Microsoft Academic Search

Individuals with spinal cord injury (SCI) commonly complain about difficulty in sleeping. Although various sleep disordered breathing definitions and indices are used that make comparisons between studies difficult, it seems evident that the frequency of sleep disorders is higher in individuals with SCI, especially with regard to obstructive sleep apnea. In addition, there is a correlation between the incidence of

Fin Biering-Sørensen; Poul Jennum; Michael Laub

2009-01-01

55

Sexuality and Women with Spinal Cord Injury  

Microsoft Academic Search

Women with spinal cord injury (SCI) have unique concerns and problems related to their sexuality. The purpose of this study is to assess sexual issues in women with SCI, for \\u000abetter management and rehabilitation of such patients. Consequently, 40 such women were interviewed based on a standardized questionnaire. Evaluation of sexual activity, medical problems most significantly interfering with sexual activity,

Roop Singh; Sansar C. Sharma

2005-01-01

56

Psychological investigation of spinal cord injury patients  

Microsoft Academic Search

Spinal cord injuries (SCI) often have psychological consequences, primarily anxiety and depression, which may interfere with rehabilitation possibilities, with adjustment to the impairment and therefore with the possibility of returning to previous familiar social life and work. To assess the degree of anxiety and depression in SCI patients, and to study the factors contributing to their genesis, 100 SCI in-

Giorgio Scivoletto; Annelisa Petrelli; Lina Di Lucente; Vincenzo Castellano; Dott. G Scivoletto

1997-01-01

57

Spinal cord injury (SCI)—Prehospital management  

Microsoft Academic Search

Up to 20,000 patients annually suffer from spinal cord injury (SCI) and 20% of these die before being admitted to the hospital in the United States as well as in the European Union. Prehospital management of SCI is of critical importance since 25% of SCI damage may occur or be aggravated after the initial event. Prehospital management includes examination of

Michael Bernhard; Andr ´ e Gries; Paul Kremer

2005-01-01

58

Adult spinal cord injury without radiological abnormality  

Microsoft Academic Search

Spinal cord injury without radiological abnormality is rare in adults. A case is described of a 61 year old man who fell 15 feet from a ladder striking his head on a wall who presented with neck pain and with motor and sensory neurological abnormalities in his limbs. Plain radiographs of the neck revealed no fractures or dislocations. Further imaging

Sarah Crawford; Tony Bleetman

2000-01-01

59

Brain and Spinal Cord Interaction: Protective Effects of Exercise Prior to Spinal Cord Injury  

PubMed Central

We have investigated the effects of a spinal cord injury on the brain and spinal cord, and whether exercise provided before the injury could organize a protective reaction across the neuroaxis. Animals were exposed to 21 days of voluntary exercise, followed by a full spinal transection (T7–T9) and sacrificed two days later. Here we show that the effects of spinal cord injury go beyond the spinal cord itself and influence the molecular substrates of synaptic plasticity and learning in the brain. The injury reduced BDNF levels in the hippocampus in conjunction with the activated forms of p-synapsin I, p-CREB and p-CaMK II, while exercise prior to injury prevented these reductions. Similar effects of the injury were observed in the lumbar enlargement region of the spinal cord, where exercise prevented the reductions in BDNF, and p-CREB. Furthermore, the response of the hippocampus to the spinal lesion appeared to be coordinated to that of the spinal cord, as evidenced by corresponding injury-related changes in BDNF levels in the brain and spinal cord. These results provide an indication for the increased vulnerability of brain centers after spinal cord injury. These findings also imply that the level of chronic activity prior to a spinal cord injury could determine the level of sensory-motor and cognitive recovery following the injury. In particular, exercise prior to the injury onset appears to foster protective mechanisms in the brain and spinal cord.

Gomez-Pinilla, Fernando; Ying, Zhe; Zhuang, Yumei

2012-01-01

60

Brachial plexus injury mimicking a spinal-cord injury  

PubMed Central

Objective:?High-energy impact to the head, neck, and shoulder can result in cervical spine as well as brachial plexus injuries. Because cervical spine injuries are more common, this tends to be the initial focus for management. We present a case in which the initial magnetic resonance imaging (MRI) was somewhat misleading and a detailed neurological exam lead to the correct diagnosis. Clinical presentation:?A 19-year-old man presented to the hospital following a shoulder injury during football practice. The patient immediately complained of significant pain in his neck, shoulder, and right arm and the inability to move his right arm. He was stabilized in the field for a presumed cervical-spine injury and transported to the emergency department. Intervention:?Initial radiographic assessment (C-spine CT, right shoulder x-ray) showed no bony abnormality. MRI of the cervical-spine showed T2 signal change and cord swelling thought to be consistent with a cord contusion. With adequate pain control, a detailed neurological examination was possible and was consistent with an upper brachial plexus avulsion injury that was confirmed by CT myelogram. The patient failed to make significant neurological recovery and he underwent spinal accessory nerve grafting to the suprascapular nerve to restore shoulder abduction and external rotation, while the phrenic nerve was grafted to the musculocutaneous nerve to restore elbow flexion. Conclusion:?Cervical spinal-cord injuries and brachial plexus injuries can occur by the same high energy mechanisms and can occur simultaneously. As in this case, MRI findings can be misleading and a detailed physical examination is the key to diagnosis. However, this can be difficult in polytrauma patients with upper extremity injuries, head injuries or concomitant spinal-cord injury. Finally, prompt diagnosis and early surgical renerveration have been associated with better long-term recovery with certain types of injury.

Macyszyn, Luke J.; Gonzalez-Giraldo, Ernesto; Aversano, Michael; Heuer, Gregory G.; Zager, Eric L.; Schuster, James M.

2010-01-01

61

Olfactory ensheathing cells — another miracle cure for spinal cord injury?  

Microsoft Academic Search

Several recent publications describe remarkably promising effects of transplanting olfactory ensheathing cells as a potential future method to repair human spinal cord injuries. But why were cells from the nose transplanted into the spinal cord? What are olfactory ensheathing cells, and how might they produce these beneficial effects? And more generally, what do we mean by spinal cord injury? To

Geoff Raisman

2001-01-01

62

Five-level noncontiguous spinal injuries of cervical region: report of a case and literature review.  

PubMed

The incidence of multiple noncontiguous spinal injuries (MNSI) in the cervical spine is rare but has catastrophic consequences. The patient in this report was a 34-year-old woman with five-level cervical MNSI. CT and MRI showed that injuries included atlantoaxial instability, burst fracture of C6, dislocation of C6/7, rupture of the intervertebal disc or ligamentous complex, and irreversible cord damage. The mechanism for this case was a combined pattern of hyperflexion, compression, and hyperextension injuries. A review of the literature revealed that this case is the first report in the literature of a vehicle related accident causing five-level noncontiguous injuries of the cervical spine. PMID:22931993

Guo, Hong-Gang; Ma, Xin-Long; Li, Feng-Tan; Feng, Shi-Qing

2012-08-01

63

[Spinal and spinal cord injuries. Therapeutic approach in Gabon].  

PubMed

The authors present their experience with 81 cases (66.4%) of acute cervical spine injuries (C.S.I.) and 41 cases (33.6%) of acute thoracolumbar spine injuries (T.L.S.I.) treated by a multidisciplinary approach, at Jeanne Ebori Hospital (Libreville, Gabon) between the years 1981 and 1987. Traffic accidents were the leading cause of injury. The largest group consisted of patients in their third decade. The anatomic localizations were: upper cervical spine: 22 cases (27%); lower cervical spine: 56 (69%); upper thoracic spine: 11 (26.8%); lower thoracic spine or thoracolumbar area: 19 (46.3%); lumbar spine: 7 (17%). There were osteoligamental lesions in 3 cases (3.7%) of C.S.I. and 4 (9.7%) of T.L.S.I. Clinically, 44 patients (54.3%) with C.S.I. and 37 (90.2%) with T.L.S.I. had neurological deficits. Surgical indications depended upon the osseous as well as neurologic lesions. There were five important steps in the treatment of spinal injuries associated with neurological deficit: (1) immobilization, (2) medical stabilization, (3) spinal alignment (skeletal traction), (4) operative decompression if there was proven cord compression, and (5) spinal stabilization. Twenty patients (24.6%) with cervical injuries were treated conservatively (traction, collar, kinesitherapy); 53 (65.4%) underwent a surgical intervention (anterior approach - 21, posterior fusion - 30, combined approach - 2); and in 8 patients (9.8%) refraining from surgery seemed the best alternative. After lengthy multidisciplinary discussion, the authors elected not to operate on tetraplegic patients with respiratory problems that necessitated assisted ventilation, because of its fatal outcome. Of injuries to the thoracolumbar spine, 13 (31.7%) were treated conservatively (bedrest, orthopedic treatment). Twenty-eight patients (68.2%) with unstable thoracic and lumbar fractures associated with neurologic deficit required acute surgical intervention (stabilization with or without decompression of the neural elements). Laminectomy alone was performed in 5 cases, laminectomy with graft in 2, stabilization by Roy-Camille plates in 16 and by Harrington rods in 5. Most upper thoracic spine fractures were treated conservatively. Surgical intervention was increasingly possible with the availability of more material and qualified staff. There were 17 patients (21%) who died from C.S.I. (15 were tetraplegic), and 6 (14.6%) from T.L.S.I. In general, osteoligamental consolidation was satisfactory. Neurological recovery was observed only in patients with partial deficits. Most cases posed socioeconomic problems. PMID:2038942

Loembe, P M; Bouger, D; Dukuly, L; Ndong-Launay, M

1991-01-01

64

Anesthetic Management of Chronic Spinal Cord Injury  

Microsoft Academic Search

\\u000a As longevity increases for patients with spinal cord injuries (SCI), operative procedures are often necessary to further rehabilitation,\\u000a control pain, evaluate urinary dysfunction, maintain skin integrity and reverse further neurologic degeneration. Increasingly,\\u000a SCI women are completing pregnancies. Considerations for anesthetic management of patients with chronic SCI include avoiding\\u000a autonomic hyperreflexia and hyperkalemia-related to succinylcholine, preventing exacerbations of pulmonary dysfunction and

Patricia H. Petrozza

65

Critical care of traumatic spinal cord injury.  

PubMed

Approximately 11 000 people suffer traumatic spinal cord injury (TSCI) in the United States, each year. TSCI incidences vary from 13.1 to 52.2 per million people and the mortality rates ranged from 3.1 to 17.5 per million people. This review examines the critical care of TSCI. The discussion will focus on primary and secondary mechanisms of injury, spine stabilization and immobilization, surgery, intensive care management, airway and respiratory management, cardiovascular complication management, venous thromboembolism, nutrition and glucose control, infection management, pressure ulcers and early rehabilitation, pharmacologic cord protection, and evolving treatment options including the use of pluripotent stem cells and hypothermia. PMID:21482574

Jia, Xiaofeng; Kowalski, Robert G; Sciubba, Daniel M; Geocadin, Romergryko G

2011-04-11

66

Prevention of spinal cord injuries that occur in swimming pools  

Microsoft Academic Search

The purpose of this study was to determine the usual circumstances surrounding spinal cord injuries that occur in swimming pools so that appropriate primary prevention programs targeted at high risk persons, activities, and environments could be developed and initiated. A sample of 341 persons enrolled in the National Spinal Cord Injury Statistical Center database since 1973 whose injury was the

Michael J DeVivo; Padmini Sekar

1997-01-01

67

Adult Stem Cell Application in Spinal Cord Injury  

Microsoft Academic Search

The mechanical force incurred by spinal cord injury results in degenerative neural tissue damage beyond the site of initial injury. By nature, the central nervous system (CNS) does not regenerate itself. Cell therapy, in particular, stem cell implantation has become a possible solution for spinal cord injury. Embryonic stem cells and fetal stem cells are the forefathers of the field

Sherri S. Schultz

2005-01-01

68

Skimboarding: a new cause of water sport spinal cord injury  

Microsoft Academic Search

Study design:Case series.Objective:To present three cases of spinal cord injuries associated with skimboarding and to suggest aspects of the sport that may be associated with spinal cord injury.Setting:Shepherd Center, Atlanta, GA, USA. Spinal cord injury rehabilitation facility.Methods:Three males, aged 17–23 years, sustained cervical spine fractures resulting in tetraplegia after skimboarding accidents.Results:The patients admitted from Florida hospitals presented with tetraplegia resulting

T R Collier; M L Jones; H H Murray

2010-01-01

69

Neural Plasticity After Spinal Cord Injury  

PubMed Central

Spinal cord injury (SCI) has devastating physical and socioeconomical impact. However, some degree of functional recovery is frequently observed in patients after SCI. There is considerable evidence that functional plasticity occurs in cerebral cortical maps of the body, which may account for functional recovery after injury. Additionally, these plasticity changes also occur at multiple levels including the brainstem, spinal cord, and peripheral nervous system. Although the interaction of plasticity changes at each level has been less well studied, it is likely that changes in subcortical levels contribute to cortical reorganization. Since the permeability of the blood-brain barrier (BBB) is changed, SCI-induced factors, such as cytokines and growth factors, can be involved in the plasticity events, thus affecting the final functional recovery after SCI. The mechanism of plasticity probably differs depending on the time frame. The reorganization that is rapidly induced by acute injury is likely based on unmasking of latent synapses resulting from modulation of neurotransmitters, while the long-term changes after chronic injury involve changes of synaptic efficacy modulated by long-term potentiation and axonal regeneration and sprouting. The functional significance of neural plasticity after SCI remains unclear. It indicates that in some situations plasticity changes can result in functional improvement, while in other situations they may have harmful consequences. Thus, further understanding of the mechanisms of plasticity could lead to better ways of promoting useful reorganization and preventing undesirable consequences.

Ding, Yuemin; Kastin, Abba J.; Pan, Weihong

2012-01-01

70

Corticospinal reorganization after spinal cord injury  

PubMed Central

The corticospinal tract (CST) is a major descending pathway contributing to the control of voluntary movement in mammals. During the last decades anatomical and electrophysiological studies have demonstrated significant reorganization in the CST after spinal cord injury (SCI) in animals and humans. In animal models of SCI, anatomical evidence showed corticospinal sprouts rostral and caudal to the lesion and their integration into intraspinal axonal circuits. Electrophysiological data suggested that indirect connections from the primary motor cortex to forelimb motoneurons, via brainstem nuclei and spinal cord interneurons, or direct connections from slow uninjured corticospinal axons, might contribute to the control of movement after a CST injury. In humans with SCI, post mortem spinal cord tissue revealed anatomical changes in the CST some of which were similar but others markedly different from those found in animal models of SCI. Human electrophysiological studies have provided ample evidence for corticospinal reorganization after SCI that may contribute to functional recovery. Together these studies have revealed a large plastic capacity of the CST after SCI. There is also a limited understanding of the relationship between anatomical and electrophysiological changes in the CST and control of movement after SCI. Increasing our knowledge of the role of CST plasticity in functional restoration after SCI may support the development of more effective repair strategies.

Oudega, Martin; Perez, Monica A

2012-01-01

71

Hydrogels in Spinal Cord Injury Repair Strategies  

PubMed Central

Nowadays there are at present no efficient therapies for spinal cord injury (SCI), and new approaches have to be proposed. Recently, a new regenerative medicine strategy has been suggested using smart biomaterials able to carry and deliver cells and/or drugs in the damaged spinal cord. Among the wide field of emerging materials, research has been focused on hydrogels, three-dimensional polymeric networks able to swell and absorb a large amount of water. The present paper intends to give an overview of a wide range of natural, synthetic, and composite hydrogels with particular efforts for the ones studied in the last five years. Here, different hydrogel applications are underlined, together with their different nature, in order to have a clearer view of what is happening in one of the most sparkling fields of regenerative medicine.

2011-01-01

72

Long-term urological outcomes in paediatric spinal cord injury  

Microsoft Academic Search

Study design:Retrospective review.Objective:This retrospective review observes the evolution of bladder management by time and reports adult urological outcomes and complications in paediatric onset spinal cord injury (SCI).Setting:Spinal Injuries Unit RNOH Stanmore.Method:In total, 10 traumatic SCI patients with mean age at injury of 13.6 years underwent treatment, for a mean period of 13.1 years. Characteristics of injury were noted. Two diagnostic

P Patki; R Hamid; S Somayaji; J Bycroft; P J R Shah; M Craggs

2006-01-01

73

Accelerating locomotor recovery after incomplete spinal injury.  

PubMed

A traumatic spinal injury can destroy cells, irreparably damage axons, and trigger a cascade of biochemical responses that increase the extent of injury. Although damaged central nervous system axons do not regrow well naturally, the distributed nature of the nervous system and its capacity to adapt provide opportunities for recovery of function. It is apparent that activity-dependent plasticity plays a role in this recovery and that the endogenous response to injury heightens the capacity for recovery for at least several weeks postinjury. To restore locomotor function, researchers have investigated the use of treadmill-based training, robots, and electrical stimulation to tap into adaptive activity-dependent processes. The current challenge is to maximize the degree of functional recovery. This manuscript reviews the endogenous neural system response to injury, and reviews data and presents novel analyses of these from a rat model of contusion injury that demonstrates how a targeted intervention can accelerate recovery, presumably by engaging processes that underlie activity-dependent plasticity. PMID:23531014

Hillen, Brian K; Abbas, James J; Jung, Ranu

2013-03-01

74

Stem cell-based therapies for spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) results in loss of nervous tissue and consequently loss of motor and sensory function. There is no treatment available that restores the injury-induced loss of function to a degree that an independent life can be guaranteed. Transplantation of stem cells or progenitors may support spinal cord repair. Stem cells are characterized by self-renewal and their ability

R. D. S. Nandoe Tewarie; A. Hurtado; R. H. M. A. Bartels; A. Grotenhuis; M. Oudega

2009-01-01

75

Classification of chronic pain associated with spinal cord injuries  

Microsoft Academic Search

Cardenas DD, Turner JA, Warms CA, Marshall HM. Classification of chronic pain associated with spinal cord injuries. Arch Phys Med Rehabil 2002;83:1708-14. Objectives: To determine interrater reliability of a classification system for chronic pain in persons with spinal cord injury (SCI) and to determine the frequency and characteristics of various pain types as categorized by this system. Design: Independent categorization

Diana D. Cardenas; Judith A. Turner; Catherine A. Warms; Helen M. Marshall

2002-01-01

76

Spinal Cord Injury. A Selected Bibliography Supplement, 1971-1975.  

National Technical Information Service (NTIS)

This bibliography is the third supplement to the Spinal Cord Injury, a Selected Bibliography, 1940-63, and encompasses the years 1971-1975. The subject of spinal cord injury has been divided into eleven subgroupings: (1) general aspects; (2) neurological ...

1977-01-01

77

Critical Rehabilitation of the Patient With Spinal Cord Injury  

Microsoft Academic Search

Most healthcare practitioners have worked with patients with spinal cord injury at some point in their career, for some it is a specialty. The critical care area usually only has patient with spinal cord injury for a brief time before they are transferred. More recently, there are longer intensive care unit stays due to multiple trauma and lack of insurance.

Joyce M. Fries

78

Health outcomes among American Indians with spinal cord injury  

Microsoft Academic Search

Krause JS, Coker JL, Charlifue S, Whiteneck GG. Health outcomes among American Indians with spinal cord injury. Arch Phys Med Rehabil 2000;81:924-31. Objective: To identify factors related to risk for poor health outcomes and secondary conditions in a sample of American Indians with spinal cord injury (SCI). Design: Interviews were conducted by telephone with most participants; those who did not

J. Stuart Krause; Jennifer L. Coker; Susan Charlifue; Gale G. Whiteneck

2000-01-01

79

Nonfatal All-Terrain Vehicle-Related Injuries to Youths Living on Farms in the United States, 2001  

ERIC Educational Resources Information Center

Use of all-terrain vehicles (ATVs) in agriculture appears to be growing. Purpose: To provide estimates of ATV ownership and exposure on US farms and an overview of injuries to youths as a result of ATV use on the farm in 2001. Methods: Analysis of the National Institute for Occupational Safety and Health and US Department of Agriculture 2001…

Goldcamp, E. Michael; Myers, John; Hendricks, Kitty; Layne, Larry; Helmkamp, Jim

2006-01-01

80

Nonfatal All-Terrain Vehicle-Related Injuries to Youths Living on Farms in the United States, 2001  

ERIC Educational Resources Information Center

|Use of all-terrain vehicles (ATVs) in agriculture appears to be growing. Purpose: To provide estimates of ATV ownership and exposure on US farms and an overview of injuries to youths as a result of ATV use on the farm in 2001. Methods: Analysis of the National Institute for Occupational Safety and Health and US Department of Agriculture 2001…

Goldcamp, E. Michael; Myers, John; Hendricks, Kitty; Layne, Larry; Helmkamp, Jim

2006-01-01

81

International spinal cord injury cardiovascular function basic data set  

Microsoft Academic Search

Objective:To create an International Spinal Cord Injury (SCI) Cardiovascular Function Basic Data Set within the framework of the International SCI Data Sets.Setting:An international working group.Methods:The draft of the data set was developed by a working group comprising members appointed by the American Spinal Injury Association (ASIA), the International Spinal Cord Society (ISCoS) and a representative of the executive committee of

A Krassioukov; M S Alexander; A-K Karlsson; W Donovan; C J Mathias; F Biering-Sørensen

2010-01-01

82

Peripheral Nerve Grafts Support Regeneration after Spinal Cord Injury  

Microsoft Academic Search

Summary  Traumatic insults to the spinal cord induce both immediate mechanical damage and subsequent tissue degeneration leading to\\u000a a substantial physiological, biochemical, and functional reorganization of the spinal cord. Various spinal cord injury (SCI)\\u000a models have shown the adaptive potential of the spinal cord and its limitations in the case of total or partial absence of\\u000a supraspinal influence. Meaningful recovery of

Marie-Pascale Côté; Arthi A. Amin; Veronica J. Tom; John D. Houle

2011-01-01

83

Intraspinal microstimulation generates functional movements after spinal-cord injury  

Microsoft Academic Search

Restoring locomotion after spinal-cord injury has been a difficult problem to solve with traditional functional electrical stimulation (FES) systems. Intraspinal microstimulation (ISMS) is a novel approach to FES that takes advantage of spinal-cord locomotor circuits by stimulating in the spinal cord directly. Previous studies in spinal-cord intact cats showed near normal recruitment order, reduced fatigue, and functional, synergistic movements induced

Rajiv Saigal; Costantino Renzi; Vivian K. Mushahwar

2004-01-01

84

Patterns of lower extremity innervation in pediatric spinal cord injury  

Microsoft Academic Search

Study design:Retrospective review.Objectives:To identify relationships between lower extremity innervation and level of injury, mechanism of injury, and age at injury in a pediatric population with spinal cord injury (SCI). Secondarily, relationships between innervation and completeness of injury, time since injury, race, and sex were evaluated.Setting:Pediatric orthopedic referral hospital, Philadelphia, Pennsylvania.Methods:Records of 190 subjects, ages 1–21 years, were reviewed. Data collected

T E Johnston; M N Greco; J P Gaughan; B T Smith; R R Betz

2005-01-01

85

Disordered cardiovascular control after spinal cord injury.  

PubMed

Damage to the spinal cord disrupts autonomic pathways, perturbing cardiovascular homeostasis. Cardiovascular dysfunction increases with higher levels of injury and greater severity. Disordered blood pressure control after spinal cord injury (SCI) has significant ramifications as cord-injured people have an increased risk of developing heart disease and stroke; cardiovascular dysfunction is currently a leading cause of death among those with SCI. Despite the clinical significance of abnormal cardiovascular control following SCI, this problem has been generally neglected by both the clinical and research community. Both autonomic dysreflexia and orthostatic hypotension are known to prevent and delay rehabilitation, and significantly impair the overall quality of life after SCI. Starting with neurogenic shock immediately after a higher SCI, ensuing cardiovascular dysfunctions include orthostatic hypotension, autonomic dysreflexia and cardiac arrhythmias. Disordered temperature regulation accompanies these autonomic dysfunctions. This chapter reviews the human and animal studies that have furthered our understanding of the pathophysiology and mechanisms of orthostatic hypotension, autonomic dysreflexia and cardiac arrhythmias. The cardiovascular dysfunction that occurs during sexual function and exercise is elaborated. New awareness of cardiovascular dysfunction after SCI has led to progress toward inclusion of this important autonomic problem in the overall assessment of the neurological condition of cord-injured people. PMID:23098715

Weaver, Lynne C; Fleming, Jennifer C; Mathias, Christopher J; Krassioukov, Andrei V

2012-01-01

86

Biological basis of exercise-based treatments: spinal cord injury.  

PubMed

Despite intensive neurorehabilitation, extensive functional recovery after spinal cord injury is unattainable for most individuals. Optimal recovery will likely depend on activity-based, task-specific training that personalizes the timing of intervention with the severity of injury. Exercise paradigms elicit both beneficial and deleterious biophysical effects after spinal cord injury. Modulating the type, intensity, complexity, and timing of training may minimize risk and induce greater recovery. This review discusses the following: (a) the biological underpinning of training paradigms that promote motor relearning and recovery, and (b) how exercise interacts with cellular cascades after spinal cord injury. Clinical implications are discussed throughout. PMID:21703584

Michele Basso, D; Hansen, Christopher N

2011-06-01

87

Limiting spinal cord injury by pharmacological intervention.  

PubMed

The direct primary mechanical trauma to neurons, glia and blood vessels that occurs with spinal cord injury (SCI) is followed by a complex cascade of biochemical and cellular changes which serve to increase the size of the injury site and the extent of cellular and axonal loss. The aim of neuroprotective strategies in SCI is to limit the extent of this secondary cell loss by inhibiting key components of the evolving injury cascade. In this review we will briefly outline the pathophysiological events that occur in SCI, and then review the wide range of neuroprotective agents that have been evaluated in preclinical SCI models. Agents will be considered under the following categories: antioxidants, erythropoietin and derivatives, lipids, riluzole, opioid antagonists, hormones, anti-inflammatory agents, statins, calpain inhibitors, hypothermia, and emerging strategies. Several clinical trials of neuroprotective agents have already taken place and have generally had disappointing results. In attempting to identify promising new treatments, we will therefore highlight agents with (1) low known risks or established clinical use, (2) behavioral data gained in clinically relevant animal models, (3) efficacy when administered after the injury, and (4) robust effects seen in more than one laboratory and/or more than one model of SCI. PMID:23098731

Priestley, John V; Michael-Titus, Adina T; Tetzlaff, Wolfram

2012-01-01

88

Hunting-related spinal cord injuries among Oklahoma residents.  

PubMed

While major causes of traumatic spinal cord injuries have been described as motor vehicle crashes, falls, sports-related events, and injuries related to violence, causes of serious consequence but of lesser magnitude have not been widely reported. This report, drawn from Oklahoma State Department of Health spinal cord injury surveillance data, describes the incidence and circumstances surrounding hunting-related spinal cord injuries. All of the injuries resulted from falls from trees or tree stands. The incidence rate of injury was less than one per 100,000 licensed hunters. Half of the injuries resulted in neurological damage severe enough to result in permanent paralysis or death. The circumstances of the injuries suggest a need for educating hunters concerning safe hunting practices and safe tree stand use, including inspection of trees for weak or dead branches, and use of a safety belt when ascending, descending, or sitting in a tree or tree stand. PMID:8051586

Price, C; Mallonee, S

1994-06-01

89

Neurophysiological characterization of motor recovery in acute spinal cord injury  

Microsoft Academic Search

Study design:Prospective cohort study.Objective:This study was designed to neurophysiologically characterize motor control recovery after spinal cord injury (SCI).Setting:University of Louisville, Louisville, Kentucky, USA.Material:Eleven acute SCI admissions and five non-injured subjects were recruited for this study.Methods:The American Spinal Injury Association Impairment Scale (AIS) was used to categorize injury level and severity at onset. Multimuscle surface electromyography (sEMG) recording protocol of reflex

W B McKay; A V Ovechkin; T W Vitaz; D G L Terson de Paleville; S J Harkema

2011-01-01

90

Work related spinal cord injury, Australia 1986–97  

Microsoft Academic Search

Objectives—Little has been published before on the epidemiology and prevention of work related spinal cord injury (SCI). This study is the first national population based epidemiological analysis of this type of injury. It presents that largest case series ever reported.Setting—The study utilises information from the Australian Spinal Cord Injury Register, which has full coverage of the population.Methods—All newly incident cases

P OConnor

2001-01-01

91

Epidemiology of spinal cord injuries in the 2005 Pakistan earthquake  

Microsoft Academic Search

Study design:Prospective observational study.Objectives:To identify the epidemiological features specific to spinal injuries as a result of an earthquake.Settings:Rawalpindi, Pakistan in the months after the 8 October 2005 earthquake.Methods:In the month after the earthquake, the one established rehabilitation center was augmented with two makeshift spinal cord centers. Information on mechanism of injury, mode of evacuation, associated injuries was gathered, and a

M F A Rathore; P Rashid; A W Butt; A A Malik; Z A Gill; A J Haig; MFA Rathore

2007-01-01

92

Functional outcome after incomplete spinal cord injuries due to blunt injury  

Microsoft Academic Search

During a 3-year period, 19 patients with incomplete spinal cord injuries caused by blunt trauma were admitted to a single rural referral centre. The mean age was 50 years. Injury mechanisms included falls in eight, road traffic accidents in five, diving mishaps in two, and miscellaneous in four. The level of spinal cord injury was cervical in 11, thoracic in

W. H. Merry; T. H. Cogbill; B. L. Annis; P. J. Lambert

1996-01-01

93

GABA and Central Neuropathic Pain following Spinal Cord Injury  

PubMed Central

Spinal cord injury induces maladaptive synaptic transmission in the somatosensory system that results in chronic central neuropathic pain. Recent literature suggests that glial-neuronal interactions are important modulators in synaptic transmission following spinal cord injury. Neuronal hyperexcitability is one of the predominant phenomenon caused by maladaptive synaptic transmission via altered glial-neuronal interactions after spinal cord injury. In the somatosensory system, spinal inhibitory neurons counter balance the enhanced synaptic transmission from peripheral input. For a decade, the literature suggests that hypofunction of GABAergic inhibitory tone is an important factor in the enhanced synaptic transmission that often results in neuronal hyperexcitability in dorsal horn neurons following spinal cord injury. Neurons and glial cells synergistically control intracellular chloride ion gradients via modulation of chloride transporters, extracellular glutamate and GABA concentrations via uptake mechanisms. Thus, the intracellular “GABA-glutamate-glutamine cycle” is maintained for normal physiological homeostasis. However, hyperexcitable neurons and glial activation after spinal cord injury disrupts the balance of chloride ions, glutamate and GABA distribution in the spinal dorsal horn and results in chronic neuropathic pain. In this review, we address spinal cord injury induced mechanisms in hypofunction of GABAergic tone that results in chronic central neuropathic pain.

Gwak, Young S.; Hulsebosch, Claire E.

2012-01-01

94

Sports-related spinal cord injury in Japan (From the nationwide spinal cord injury registry between 1990 and 1992)  

Microsoft Academic Search

The Injury Prevention Committee of the Japan Medical Society of Paraplegia (JMSoP) conducted a nationwide epidemiological survey on spinal cord injury (SCI) using postal questionnaires for 3 years periods from 1990 to 1992, and the annual incidence of the spinal cord injury was estimated as 40.2 per million. From this registry, we investigated SCI related to sports activities.In 3 years,

Shinsuke Katoh; Hikosuke Shingu; Takaaki Ikata; Eiji Iwatsubo

1996-01-01

95

Epidemiology, demographics, and pathophysiology of acute spinal cord injury.  

PubMed

Spinal cord injury occurs through various countries throughout the world with an annual incidence of 15 to 40 cases per million, with the causes of these injuries ranging from motor vehicle accidents and community violence to recreational activities and workplace-related injuries. Survival has improved along with a greater appreciation of patterns of presentation, survival, and complications. Despite much work having been done, the only treatment to date known to ameliorate neurologic dysfunction that occurs at or below the level of neurologic injury has been intravenous methylprednisolone therapy. Much research over the past 30 to 40 years has focused on elucidating the mechanisms of spinal cord injury, with the complex pathophysiologic processes slowly being unraveled. With a greater understanding of both primary and secondary mechanisms of injury, the roles of calcium, free radicals, sodium, excitatory amino acids, vascular mediators, and apoptosis have been elucidated. This review examines the epidemiology, demographics, and pathophysiology of acute spinal cord injury. PMID:11805601

Sekhon, L H; Fehlings, M G

2001-12-15

96

Outcome Measures in Spinal Cord Injury  

PubMed Central

Study Design review by the Spinal Cord Outcomes Partnership Endeavor (SCOPE), which is a broad-based international consortium of scientists and clinical researchers representing academic institutions, industry, government agencies, not-for-profit organizations and foundations. Objectives assessment of current and evolving tools for evaluating human spinal cord injury (SCI) outcomes for both clinical diagnosis and clinical research studies. Methods a framework for the appraisal of evidence of metric properties was used to examine outcome tools or tests for accuracy, sensitivity, reliability and validity for human SCI. Results imaging, neurological, functional, autonomic, sexual health, bladder/bowel, pain, and psycho-social tools were evaluated. Several specific tools for human SCI studies have or are being developed to allow the more accurate determination for a clinically meaningful benefit (improvement in functional outcome or quality of life) being achieved as a result of a therapeutic intervention. Conclusion significant progress has been made, but further validation studies are required to identify the most appropriate tools for specific targets in a human SCI study or clinical trial.

Alexander, Marcalee S.; Anderson, Kim; Biering-Sorensen, Fin; Blight, Andrew R.; Brannon, Ruth; Bryce, Thomas; Creasey, Graham; Catz, Amiram; Curt, Armin; Donovan, William; Ditunno, John; Ellaway, Peter; Finnerup, Nanna B.; Graves, Daniel E.; Haynes, Beth Ann; Heinemann, Allen W.; Jackson, Amie B.; Johnston, Mark; Kalpakjian, Claire Z.; Kleitman, Naomi; Krassioukov, Andrei; Krogh, Klaus; Lammertse, Daniel; Magasi, Susan; Mulcahey, MJ; Schurch, Brigitte; Sherwood, Arthur; Steeves, John D.; Stiens, Steven; Tulsky, David S.; van Hedel, Hubertus J.A.; Whiteneck, Gale

2009-01-01

97

An update on spinal cord injury research.  

PubMed

Spinal cord injury (SCI) can have a range of debilitating effects and permanently alter the capabilities and quality of life of survivors. The first specialized centers of care for SCI were established in 1944 and since then an increasing amount of research has been carried out in this area. Despite this, the present treatment and care levels for SCI are not comparable to those in other areas of medicine. In the clinic, the aim of SCI treatment is primarily to limit secondary damage by reducing compression in trauma spots and stabilizing the spinal column. Currently, no effective strategy for functional recovery is offered. In this review, we focus on research progress on the molecular mechanisms underlying SCI, and assess the treatment outcomes of SCI in animal models, i.e., neurotrophins and stem cells are discussed as pre-clinical therapies in animal models. We also assess the resources available and national research projects carried out on SCI in China in recent years, as well as making recommendations for the future allocation of funds in this area. PMID:23124646

Cao, He-Qi; Dong, Er-Dan

2012-11-03

98

Advances in Imaging of Vertebral and Spinal Cord Injury  

PubMed Central

Background/Objectives: Imaging technology is an important part of the diagnosis and management of spinal trauma. Indications and findings in post-traumatic imaging of the vertebral column and spinal cord are reviewed. Methods: An extensive literature review was performed on the imaging of vertebral and spinal cord injury. Relevant images from a Level I trauma center were included as examples. Results: Imaging plays an important role in the evaluation of acute and chronic spinal injury. Spinal cord and soft-tissue injuries are best evaluated by magnetic resonance imaging (MRI), whereas spinal fractures are better characterized by computed tomography (CT). Vascular injuries can be evaluated using CT or MR angiography. Conclusions: Imaging using CT and MRI is essential in the management of spinal cord injuries, both in the acute and in the chronic settings. MRI shows the status of ligamentous integrity and visualizes internal derangement of the spinal cord. Vascular compromise can be diagnosed by MR and CT angiography. Plain radiography now has a more limited, adjunctive role, and the need for higher risk myelography has been minimized.

Goldberg, Andrew L; Kershah, Sharif M

2010-01-01

99

The acute abdomen in spinal cord injury individuals  

Microsoft Academic Search

A review of 1300 patients with spinal cord injury (SCI), over a period of 14 years, revealed 12 patients with an 'acute abdomen'. Seven events occurred during the initial admission, ranging from 10 days to 9 months from injury, and five during readmission of 'chronic' SCI patients. Four were in the acute stage 10-30 days from injury, all with peptic

Z Bar-On; A Ohry

1995-01-01

100

Heart rate variability is altered following spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) patients are know to suffer from autonomic failure as a result of their injury. The magnitude of the dysautonomia resulting from such an injury is difficult to predict or characterize and, in varying degree, it impedes the recovery of physiological homeostasis. This study is intended to investigate the effectiveness of heart rate variability (HRV) analysis as

David C. Bunten; Alberta L. Warner; Sherry R. Brunnemann; Jack L. Segal

1998-01-01

101

Degenerative and regenerative mechanisms governing spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) is a major cause of disability, and at present, there is no universally accepted treatment. The functional decline following SCI is contributed to both direct mechanical injury and secondary pathophysiological mechanisms that are induced by the initial trauma. These mechanisms initially involve widespread haemorrhage at the site of injury and necrosis of central nervous system (CNS)

Christos Profyris; Surindar S Cheema; DaWei Zang; Michael F Azari; Kristy Boyle; Steven Petratos

2004-01-01

102

Rehabilitation of a child with a spinal cord injury  

Microsoft Academic Search

The incidence and sex distribution of spinal cord injury (SCI) changes with age. Motor vehicle accidents, bicycle accidents, sports accidents, and violence are major causes in the pediatric population. Pulmonary complications may be severe and life-threatening in the acute phase. Chronically, the degree of ventilatory support needed depends on the level of the injury, with high cervical injuries typically requiring

Kathryn Zidek; Rajashree Srinivasan

2003-01-01

103

Spinal cord missile injuries during the Lebanese civil war  

Microsoft Academic Search

BACKGROUNDSpinal cord injuries due to penetrating wounds are not uncommon. The management of these injuries remains controversial especially with regard to the effect of laminectomy on the neurological outcome.METHODSBetween 1980 and 1989, 64 patients injured by bullets and shell fragments to the spinal cord were reviewed. There were 58 males and 6 females: 24 injuries (37.5%) involved the cervical spine,

Maarouf A Hammoud; Fuad S Haddad; Nazih A Moufarrij

1995-01-01

104

Arylsulfatase B Improves Locomotor Function after Mouse Spinal Cord Injury  

PubMed Central

Bacterial chondroitinase ABC (ChaseABC) has been used to remove the inhibitory chondroitin sulfate chains from chondroitin sulfate proteoglycans to improve regeneration after rodent spinal cord injury. We hypothesized that the mammalian enzyme arylsulfatase B (ARSB) would also enhance recovery after mouse spinal cord injury. Application of the mammalian enzyme would be an attractive alternative to ChaseABC because of its more robust chemical stability and reduced immunogenicity. A one-time injection of human ARSB into injured mouse spinal cord eliminated immunoreactivity for chondroitin sulfates within five days, and up to 9 weeks after injury. After a moderate spinal cord injury, we observed improvements of locomotor recovery assessed by the Basso Mouse Scale (BMS) in ARSB treated mice, compared to the buffer-treated control group, at 6 weeks after injection. After a severe spinal cord injury, mice injected with equivalent units of ARSB or ChaseABC improved similarly and both groups achieved significantly more locomotor recovery than the buffer-treated control mice. Serotonin and tyrosine hydroxylase immunoreactive axons were more extensively present in mouse spinal cords treated with ARSB and ChaseABC, and the immunoreactive axons penetrated further beyond the injury site in ARSB or ChaseABC treated mice than in control mice. These results indicate that mammalian ARSB improves functional recovery after CNS injury. The structural/molecular mechanisms underlying the observed functional improvement remain to be elucidated.

Yoo, Myungsik; Khaled, Muntasir; Gibbs, Kurt M.; Kim, Jonghun; Kowalewski, Bjorn; Dierks, Thomas; Schachner, Melitta

2013-01-01

105

Psychiatric disorders in patients with spinal cord injuries.  

PubMed

Although previous studies have reported that all patients with spinal cord injuries experience depression, they have not distinguished between despondency and depressive disorder. Of 30 patients with spinal cord lesions and depressive disorders diagnosed using the Schedule for Affective Disorders and Schizophrenia and the Research Diagnostic Criteria (RDC). 15 patients had RDC diagnoses before or after their injury. A depressive disorder developed in nine after injury. Eight depressive disorders developed within a month of the injury. Postinjury depressive disorders were more common in patients with complete spinal cord lesions but were divided equally between paraplegics and quadriplegics. Only one patient received antidepressants. The remainder recovered without treatment other than the rehabilitation program. The accident causing the injury seemed related to a psychiatric disorder before injury in six patients (four alcoholics and two hypomanics) and to drinking before the accident in 15 patients. PMID:7316682

Fullerton, D T; Harvey, R F; Klein, M H; Howell, T

1981-12-01

106

VEGF 165 Therapy Exacerbates Secondary Damage Following Spinal Cord Injury  

Microsoft Academic Search

Vascular endothelial growth factor (VEGF) demonstrates potent and well-characterized effects on endothelial cytoprotection and angiogenesis. In an attempt to preserve spinal microvasculature and prolong the endogenous neovascular response observed transiently following experimental spinal cord injury (SCI), exogenous recombinant human VEGF (rhVEGF165) was injected into the injured rat spinal cord. Adult female Fischer 344 rats were subjected to moderate SCI (12.5

Richard L. Benton; Scott R. Whittemore

2003-01-01

107

Upper and Lower-Extremity Motor Recovery After Traumatic Cervical Spinal Cord Injury: An Update From the National Spinal Cord Injury Database  

Microsoft Academic Search

Marino RJ, Burns S, Graves DE, Leiby BE, Kirshblum S, Lammertse DP. Upper- and lower-extremity motor recovery after traumatic cervical spinal cord injury: an update from the National Spinal Cord Injury Database.

Ralph J. Marino; Stephen Burns; Daniel E. Graves; Benjamin E. Leiby; Steven Kirshblum; Daniel P. Lammertse

2011-01-01

108

Patterns, Predictors, and Associated Benefits of Driving a Modified Vehicle After Spinal Cord Injury: Findings From the National Spinal Cord Injury Model Systems  

Microsoft Academic Search

Norweg A, Jette AM, Houlihan B, Ni P, Boninger ML. Patterns, predictors, and associated benefits of driving a modified vehicle after spinal cord injury: findings from the National Spinal Cord Injury Model Systems.

Anna Norweg; Alan M. Jette; Bethlyn Houlihan; Pengsheng Ni; Michael L. Boninger

2011-01-01

109

Spinal cord injury I: A synopsis of the basic science  

PubMed Central

Substantial knowledge has been gained in the pathological findings following naturally occurring spinal cord injury (SCI) in dogs and cats. The molecular mechanisms involved in failure of neural regeneration within the central nervous system, potential therapeutics including cellular transplantation therapy, neural plasticity, and prognostic indicators of recovery from SCI have been studied. This 2-part review summarizes 1) basic science perspectives regarding treating and curing spinal cord injury, 2) recent studies that shed light on prognosis and recovery from SCI, 3) current thinking regarding standards of care for dogs with SCI, 4) experimental approaches in the laboratory setting, and 5) current clinical trials being conducted in veterinary medicine. Part I presents timely information on the pathophysiology of spinal cord injury, challenges associated with promoting regeneration of neurons of the central nervous system, and experimental approaches aimed at developing treatments for spinal cord injury.

Webb, Aubrey A.; Ngan, Sybil; Fowler, J. David

2010-01-01

110

Motor Cortex Stimulation Reverses Maladaptive Plasticity Following Spinal Cord Injury.  

National Technical Information Service (NTIS)

The majority of patients with spinal cord injury (SCI) develop intractable chronic neuropathic pain that is resistant to conventional pharmacologic treatments. An alternative and potentially effective modality of treatment motor cortex stimulation (MCS) o...

R. Masri

2012-01-01

111

Targeted Study of Catastrophic Illness Addressing Spinal Injury.  

National Technical Information Service (NTIS)

The purpose of the study was to perform a targeted analysis of spinal injury relating to enhancing the preparation of actuarial cost estimates of national catastrophic health insurance programs, and studying alternative public investments to prevent and t...

B. V. Shah D. C. Jones K. D. Nash K. R. McLeroy S. H. Spetz

1980-01-01

112

Self-injurious behavior in children and adolescents with spinal cord injuries  

Microsoft Academic Search

Study design: A case report of self-injurious behavior in four children and adolescents with spinal cord injuries (SCI).Objectives: To report a relatively unusual complication of pediatric-onset SCI, focusing on the potential role that dysesthesia may play in self-injurious behavior.Setting: A Spinal Cord Injury Program in a Children's Hospital in Chicago that serves children from midwestern and south-central United States of

LC Vogel; CJ Anderson

2002-01-01

113

Recovery of airway protective behaviors after spinal cord injury  

PubMed Central

Pulmonary morbidity is high following spinal cord injury and is due, in part, to impairment of airway protective behaviors. These airway protective behaviors include augmented breaths, the cough reflex, and expiration reflexes. Functional recovery of these behaviors has been reported after spinal cord injury. In humans, evidence for functional recovery is restricted to alterations in motor strategy and changes in the frequency of occurrence of these behaviors. In animal models, compensatory alterations in motor strategy have been identified. Crossed descending respiratory motor pathways at the thoracic spinal cord levels exist that are composed of crossed premotor axons, local circuit interneurons, and propriospinal neurons. These pathways can collectively form a substrate that supports maintenance and/or recovery of function, especially after asymmetric spinal cord injury. Local sprouting of premotor axons in the thoracic spinal cord also can occur following chronic spinal cord injury. These mechanisms may contribute to functional resiliency of the cough reflex that has been observed following chronic spinal cord injury in the cat.

Bolser, Donald C.; Jefferson, Stephanie C.; Rose, Melanie J.; Tester, Nicole J.; Reier, Paul J.; Fuller, David D.; Davenport, Paul W.; Howland, Dena R.

2009-01-01

114

Mechanisms of chronic central neuropathic pain after spinal cord injury  

Microsoft Academic Search

Not all spinal contusions result in mechanical allodynia, in which non-noxious stimuli become noxious. The studies presented use the NYU impactor at 12.5 mm drop or the Infinite Horizons Impactor (150 kdyn, 1 s dwell) devices to model spinal cord injury (SCI). Both of these devices and injury parameters, if done correctly, will result in animals with above level (forelimb), at level (trunk)

Claire E. Hulsebosch; Bryan C. Hains; Eric D. Crown; Susan M. Carlton

2009-01-01

115

Spinal cord injury, coping and psychological adjustment: a literature review  

Microsoft Academic Search

Objectives:This paper reviews the literature concerning psychological adjustment to spinal cord injury, focusing on the recent methodological developments and new directions in research.Method:Several literature reviews using the search terms Spinal Cord Injury, Paraplegia, Coping and Adjustment were undertaken using the databases in Pubmed, Medline and Embase. The papers that were published from 2001 onwards, written in English and used a

Z Chevalier; P Kennedy; O Sherlock

2009-01-01

116

The Spinal Cord Injury-Interventions Classification System  

Microsoft Academic Search

Title: The Spinal Cord Injury-Interventions Classification System: development and evaluation of a documentation tool to record therapy to improve mobility and self-care in people with spinal cord injury. Background: Many rehabilitation researchers have emphasized the need to examine the actual contents of rehabilitation programmes. One key component of these contents is the therapy provided. Mobility and self-care are the main

A. H. B. van Langeveld

2010-01-01

117

Cardiac pacing in patients with a cervical spinal cord injury  

Microsoft Academic Search

Study design:Retrospective medical record review.Objectives:To compare patients, admitted to an intensive care unit (ICU) with an acute cervical spinal cord injury (SCI) and documented motor deficit, who did, with those who did not, require a cardiac pacemaker.Setting:South Australian Tertiary Referral Intensive Care and Spinal Injury Unit.Methods:Retrospective medical record review and data set linkage.Results:From 1995 to 2007, 465 patients sustained a

P Rangappa; J Jeyadoss; A Flabouris; J M Clark; R Marshall

2010-01-01

118

The International Spinal Cord Injury Pain Basic Data Set  

Microsoft Academic Search

Objective:To develop a basic pain data set (International Spinal Cord Injury Basic Pain Data Set, ISCIPDS:B) within the framework of the International spinal cord injury (SCI) data sets that would facilitate consistent collection and reporting of pain in the SCI population.Setting:International.Methods:The ISCIPDS:B was developed by a working group consisting of individuals with published evidence of expertise in SCI-related pain regarding

E Widerström-Noga; F Biering-Sørensen; T Bryce; D D Cardenas; N B Finnerup; M P Jensen; J S Richards; P J Siddall

2008-01-01

119

Immunizing against depression and anxiety after spinal cord injury  

Microsoft Academic Search

Objective: To further report on the effectiveness of early psychological intervention in reducing anxiety and depressive mood in persons with spinal cord injury 2 years after injury.Design: A nonrandomized, longitudinal, controlled trial.Setting, Outcome Measures, and Intervention: Twenty-eight spinal cord injured persons participated in group cognitive behavior therapy during hospital rehabilitation. They were assessed for depressive mood and anxiety before, immediately

Ashley R. Craig; Karen Hancock; Esther Chang; Hugh Dickson

1998-01-01

120

Regaining health and wellbeing after traumatic spinal cord injury.  

PubMed

Objective: Traumatic spinal cord injury is typically a devastating event, leading to permanent physical disability. Despite the severity of the condition, many persons with traumatic spinal cord injury manage to lead both active and independent lives. The aim of this study was to investigate the experience of health and wellbeing of persons living with a traumatic spinal cord injury for at least 20 years. Design and methods: A qualitative design was used. Data was analysed using a phenomenological-hermeneutical method. Rich narratives were obtained from 14 persons with paraplegia due to traumatic spinal cord injury sustained at least 20 years ago. Results: The key finding was that health and wellbeing were attained when persons were able to perceive themselves as being "normal" in everyday relationships and circumstances. The normalization process involved learning to negotiate and/or prevent potentially embarrassing situations by acting in a "parallel world", covertly "behind the scenes". Conclusion: The subjective experience of wellbeing and health after traumatic spinal cord injury depends upon the ability to prevent or resolve potentially embarrassing situations without this being noticed by others. Performing this work "behind the scenes", enables persons with traumatic spinal cord injury to interact smoothly with others and thereby be perceived as normal, despite substantial disability. PMID:24048205

Suarez, Nivia Carballeira; Levi, Richard; Bullington, Jennifer

2013-10-23

121

A surgery protocol for adult zebrafish spinal cord injury.  

PubMed

Adult zebrafish has a remarkable capability to recover from spinal cord injury, providing an excellent model for studying neuroregeneration. Here we list equipment and reagents, and give a detailed protocol for complete transection of the adult zebrafish spinal cord. In this protocol, potential problems and their solutions are described so that the zebrafish spinal cord injury model can be more easily and reproducibly performed. In addition, two assessments are introduced to monitor the success of the surgery and functional recovery: one test to assess free swimming capability and the other test to assess extent of neuroregeneration by in vivo anterograde axonal tracing. In the swimming behavior test, successful complete spinal cord transection is monitored by the inability of zebrafish to swim freely for 1 week after spinal cord injury, followed by the gradual reacquisition of full locomotor ability within 6 weeks after injury. As a morphometric correlate, anterograde axonal tracing allows the investigator to monitor the ability of regenerated axons to cross the lesion site and increasingly extend into the gray and white matter with time after injury, confirming functional recovery. This zebrafish model provides a paradigm for recovery from spinal cord injury, enabling the identification of pathways and components of neuroregeneration. PMID:23021548

Fang, Ping; Lin, Jin-Fei; Pan, Hong-Chao; Shen, Yan-Qin; Schachner, Melitta

2012-08-25

122

Synaptic Plasticity, Neurogenesis, and Functional Recovery after Spinal Cord Injury  

PubMed Central

Spinal cord injury research has greatly expanded in recent years, but our understanding of the mechanisms that underlie the functional recovery that can occur over the weeks and months following the initial injury, is far from complete. To grasp the scope of the problem, it is important to begin by defining the sensorimotor pathways that might be involved by a spinal injury. This is done in the rodent and nonhuman primate, which are two of the most commonly used animal models in basic and translational spinal injury research. Many of the better known experimentally induced models are then reviewed in terms of the pathways they involve and the reorganization and recovery that have been shown to follow. The better understood neuronal mechanisms mediating such post-injury plasticity, including dendritic spine growth and axonal sprouting, are then examined.

Darian-Smith, Corinna

2010-01-01

123

Temporal modifications in bone following spinal cord injury in rats  

PubMed Central

Introduction The aim of this study was to investigate the temporal modifications in bone mass, bone biomechanical properties and bone morphology in spinal cord injured rats 2, 4 and 6 weeks after a transection. Material and methods Control animals were randomly distributed into four groups (n = 10 each group): control group (CG) – control animals sacrificed immediately after surgery; spinal cord-injured 2 weeks (2W) – spinal cord-injured animals sacrificed 2 weeks after surgery; spinal cord-injured 4 weeks (4W) – spinal cord-injured animals sacrificed 4 weeks after surgery; spinal cord-injured 6 weeks (6W) – spinal cord-injured animals sacrificed 6 weeks after surgery. Results Biomechanical properties of the right tibia were determined by a three-point bending test and injured animals showed a statistically significant decrease in maximal load compared to control animals. The right femur was used for densitometric analysis and bone mineral content of the animals sacrificed 4 and 6 weeks after surgery was significantly higher compared to the control animals and animals sacrificed 2 weeks after surgery. Histopathological and morphological analysis of tibiae revealed intense resorptive areas in the group 2 weeks after injury only. Conclusions The results of this study show that this rat model is a valuable tool to investigate bone remodeling processes specifically associated with SCI. Taken together, our results suggest that spinal cord injury induced bone loss within 2 weeks after injury in rats.

Amorim, Beatriz Oliveira; Fernandes, Kelly Rosseti; Pereira, Rosa Maria; Renno, Ana Claudia Muniz; Ribeiro, Daniel Araki

2012-01-01

124

Intermittent hypoxia induces functional recovery following cervical spinal injury  

PubMed Central

Respiratory-related complications are the leading cause of death in spinal cord injury (SCI) patients. Few effective SCI treatments are available after therapeutic interventions are performed in the period shortly after injury (e.g. spine stabilization and prevention of further spinal damage). In this review we explore the capacity to harness endogenous spinal plasticity induced by intermittent hypoxia to optimize function of surviving (spared) neural pathways associated with breathing. Two primary questions are addressed: 1) does intermittent hypoxia induce plasticity in spinal synaptic pathways to respiratory motor neurons following experimental SCI? and 2) can this plasticity improve respiratory function? In normal rats, intermittent hypoxia induces serotonin-dependent plasticity in spinal pathways to respiratory motor neurons. Early experiments suggest that intermittent hypoxia also enhances respiratory motor output in experimental models of cervical SCI, (cervical hemisection) and that the capacity to induce functional recovery is greater with longer durations post-injury. Available evidence suggests that intermittent hypoxia-induced spinal plasticity has considerable therapeutic potential to treat respiratory insufficiency following chronic cervical spinal injury.

Vinit, Stephane; Lovett-Barr, Mary Rachael; Mitchell, Gordon S.

2009-01-01

125

Spinal fractures in recreational bobsledders: an unexpected mechanism of injury  

PubMed Central

Study design:?Retrospective case series and literature review. Objective:?To report and discuss spinal fractures occurring in recreational bobsledders. Summary of background data:?Spinal fractures have been commonly described following traumatic injury during a number of recreational sports. Reports have focused on younger patients and typically involved high-impact sports or significant injuries. With an aging population and a wider array of recreational sports, spinal injuries may be seen after seemingly benign activities and without a high-impact injury. Methods:?A retrospective review of two patients and review of the literature was performed. Results:?Two patients with spinal fractures after recreational bobsledding were identified. Both patients, aged 57 and 54 years, noticed a simultaneous onset of severe back pain during a routine turn on a bobsled track. Neither was involved in a high-impact injury during the event. Both patients were treated conservatively with resolution of symptoms. An analysis of the bobsled track revealed that potential forces imparted to the rider may be greater than the yield strength of vertebral bone. Conclusions:?Older athletes may be at greater risk for spinal fracture associated with routine recreational activities. Bobsledding imparts large amounts of force during routine events and may result in spinal trauma. Older patients, notably those with osteoporosis or metabolic bone disease, should be educated about the risks associated with seemingly benign recreational sports.

Severson, Erik P.; Sofianos, Dmitri A.; Powell, Amy; Daubs, Michael; Patel, Rakesh; Patel, Alpesh A.

2012-01-01

126

Tracheostomy timing in traumatic spinal cord injury  

PubMed Central

The study conducted is the retrospective study and the main objective is to evaluate the benefits and safety of early versus late tracheostomy in traumatic spinal cord injury (SCI) patients requiring mechanical ventilation. Tracheostomy offers many advantages in critical patients who require prolonged mechanical ventilation. Despite the large amount of patients treated, there is still an open debate about advantages of early versus late tracheostomy. Early tracheostomy following the short orotracheal intubation is probably beneficial in appropriately selected patients. It is a retrospective clinical study and we evaluated clinical records of 152 consecutive trauma patients who required mechanical ventilation and who received tracheostomy. The results show that the early placement (before day 7 of mechanical ventilation) offers clear advantages for shortening of mechanical ventilation, reducing ICU stay and lowering rates of severe orotracheal intubation complication, such as tracheal granulomas and concentric tracheal stenosis. On the other hand, we could not demonstrate that early tracheostomy avoids neither risk of ventilator-associated pneumonia nor the mortality rate. In SCI patients, the early tracheostomy was associated with shorter duration of mechanical ventilation, shorter length of ICU stay and decreased laryngotracheal complications. We conclude by suggesting early tracheostomy in traumatic SCI patients who are likely to require prolonged mechanical ventilation.

Vari, Alessandra; Gambarrutta, Claudia; Oliviero, Antonio

2009-01-01

127

Pharmacological management of hemodynamic complications following spinal cord injury.  

PubMed

Damage from spinal cord injury (SCI) may be complicated by concomitant hemodynamic alterations within hours to months of the initial insult. Neurogenic shock, symptomatic bradycardia, autonomic dysreflexia, and orthostatic hypotension are specific conditions occurring commonly with SCI. Early recognition and appropriate management of each disorder may minimize secondary injury to the cord, avert systemic complications, and help alleviate patient discomfort. PMID:19472960

McMahon, Deanna; Tutt, Matthew; Cook, Aaron M

2009-05-01

128

Colorectal motility and defecation after spinal cord injury in humans  

Microsoft Academic Search

Following spinal cord injury, colorectal problems are a significant cause of morbidity, and chronic gastrointestinal problems remain common with increasing time after injury. Although many cord-injured patients achieve an adequate bowel frequency with drugs and manual stimulation, the risk and occurrence of fecal incontinence, difficulties with evacuation, and need for assistance remain significant problems. The underlying physiology of colorectal motility

A. C. Lynch; F. A. Frizelle

2006-01-01

129

Prevention of spinal injuries from diving in Slovenia  

Microsoft Academic Search

Injury of the cervical spine involving the spinal cord such as results from diving into shallow water causes very severe disability. In spite of progress in medical science, results of the treatment and rehabilitation of such patients are not satisfactory. Every effort should be undertaken to give young swimmers, the most frequent victims of diving injuries, proper instructions to prevent

H Damjan; P R Turk

1995-01-01

130

Sexual issues of women with spinal cord injuries  

Microsoft Academic Search

The need for research addressing problems unique to women with spinal cord injuries is well documented. Consequently, 231 such women, ages 18 to 45, were surveyed. Demographic characteristics and data relating to physician usage, female hygiene, pregnancy, contraception and sexuality were collected.Analysis revealed that 60% of the respondents had post injury amenorrhea; the average time until menses resumption was 5

S W Charlifue; K A Gerhart; R R Menter; G G Whiteneck; M Scott Manley

1992-01-01

131

Spinal cord injuries associated with vertebral fractures and dislocations  

Microsoft Academic Search

During the period 1968–1975, 11 patients with paraplegia and 19 with tetraplegia were treated at the Central Hospital of Tampere. The mean age of the patients was 33 years. The spinal cord injury was sustained in a traffic accident in 11 cases, at work in 6 and at home or during leisure hours in 13. The injury was due to

M. Härkönen; P. Lepistö; T. Paakkala; H. Pätiälä; P. Rokkanen

1979-01-01

132

Incidence of Secondary Complications in Spinal Cord Injury.  

ERIC Educational Resources Information Center

Data from 348 patients (mean age 37) with postacute spinal cord injury revealed that 95% reported at least 1 secondary problem, and 58% reported 3 or more. The number and severity of complications varied with time since the injury. Obesity, pain, spasticity, urinary tract infections, pressure sores, and lack of social integration were common…

Anson, C. A.; Shepherd, C.

1996-01-01

133

Spinal cord injury and plasticity: opportunities and challenges.  

PubMed

There is still no effective treatment to promote functional recovery following spinal cord injury. However, promoting injury-induced adaptive changes (plasticity) within the central nervous system, associated with repair, promise new treatment strategies. Recent contributions from our group and current challenges of this relatively young field are discussed in this review. PMID:20471456

Fouad, Karim; Krajacic, Aleksandra; Tetzlaff, Wolfram

2010-05-13

134

Myelin Gene Expression after Experimental Contusive Spinal Cord Injury  

Microsoft Academic Search

After incomplete traumatic spinal cord injury (SCI), the spared tissue exhibits abnormal myelination that is associated with reduced or blocked axonal conductance. To examine the mo- lecular basis of the abnormal myelination, we used a standard- ized rat model of incomplete SCI and compared normal unin- jured tissue with that after contusion injury. We evaluated expression of mRNA for myelin

Jean R. Wrathall; Wen Li; Lynn D. Hudson

1998-01-01

135

Spinal cord injuries and attempted suicide: a retrospective review  

Microsoft Academic Search

Study design: A retrospective review examining the cases of 137 individuals with spinal cord injury (SCI) as a result of a suicide attempt between 1951–1992. Objective: To ascertain demographic details of this participant sample, explore and identify the type of psychiatric condition evident around the time of injury, and to review outcome information of this sample with specific focus on

P Kennedy; B Rogers; S Speer; H Frankel

1999-01-01

136

Epidemiology of Spinal Cord Injury in New Zealand  

Microsoft Academic Search

Spinal cord injury (SCI) is a catastrophic and costly result of both intentional and unintentional injury. We present data from the Health Statistics Services files of New Zealand for the year 1988 on the epidemiology of SCI resulting in morbidity. New Zealand has one of the highest rates of SCI in the western world and since 1979 this has been

Graeme S. Dixon; John N. Danesh; Tudor H. Caradoc-Davies

1993-01-01

137

Incidence of Secondary Complications in Spinal Cord Injury.  

ERIC Educational Resources Information Center

|Data from 348 patients (mean age 37) with postacute spinal cord injury revealed that 95% reported at least 1 secondary problem, and 58% reported 3 or more. The number and severity of complications varied with time since the injury. Obesity, pain, spasticity, urinary tract infections, pressure sores, and lack of social integration were common…

Anson, C. A.; Shepherd, C.

1996-01-01

138

The puerperium alters spinal cord plasticity following peripheral nerve injury.  

PubMed

Tissue and nerve damage can result in chronic pain. Yet, chronic pain after cesarean delivery is remarkably rare in women and hypersensitivity from peripheral nerve injury in rats resolves rapidly if the injury occurs in the puerperium. Little is known regarding the mechanisms of this protection except for a reliance on central nervous system oxytocin signaling. Here we show that the density of inhibitory noradrenergic fibers in the spinal cord is greater when nerve injury is performed in rats during the puerperium, whereas the expression of the excitatory regulators dynorphin A and neuregulin-1 in the spinal cord is reduced. The puerperium did not alter spinal cord microgial and astrocyte activation. Astrocyte activation, as measured by glial fibrillary acidic protein (GFAP) expression, was not evident in female rats with injury, regardless of delivery status suggesting sex differences in spinal astrocyte activation after injury. These results suggest a change in the descending inhibitory/facilitating balance on spinal nociception neurotransmission during the puerperium, as mechanisms for its protective effect against injury-induced hypersensitivity. PMID:23103215

Gutierrez, S; Hayashida, K; Eisenach, J C

2012-10-25

139

International Campaign for Cures of Spinal Cord Injury Paralysis (ICCP): another step forward for spinal cord injury research.  

PubMed

For over 20 years, charitable organizations have worked to promote research that will cure the paralysis associated with spinal cord injury (SCI). When they began this quest, the consequences of SCI were thought to be permanent; that once damaged, the spinal cord could not be repaired. Today, the same organizations are credited with funding research that has realized many significant advances, brought new optimism and changed the outlook of researchers, clinicians and injured individuals alike. Progress in understanding the basic biology of spinal cord repair means that it is now a case of how soon useful treatments will be available, rather than if there will ever be anything to offer. With this in mind, many of the organizations that promote spinal cord research have formed an alliance to determine the ways in which their collaboration can hasten progress. The mission and objectives of this alliance, termed the International Campaign for Cures of Spinal Cord Injury Paralysis (ICCP), are described here. PMID:14968108

Adams, M; Cavanagh, J F R

2004-05-01

140

Spinal Injuries in the 2012 Twin Earthquakes, Northwest Iran  

PubMed Central

On 11 August 2012, twin earthquakes measured 6.3 and 6.4 on the Richter scale hit three towns (Ahar, Varzaqan, and Heris) in East Azerbaijan Province, Iran resulting in tragic loss of three hundred lives and leaving thousands of injured. The aim of the present study was to report the spinal injuries during recent earthquake in northwest Iran, its consequences and management. Of the 923 hospitalized patients, 26 (2.8%) had neurosurgical complications. The imaging and clinical data of the patients were retrospectively studied regarding the anatomical location of the injury, the severity of spinal injury and associated neurological deficit. To further analyze the findings, Magerl (AO) and Frankel’s classifications were used. The injuries without any fracture were considered as minor spinal injuries. The mean age of the patients was 44.54±22.52 (range: 5-88) years. We detected a total of 38 vertebral injuries including 24 major (63.15%) and 14 minor injuries (36.85%). The most common injuries were observed in the lumbar spine (19 injuries, 50%). The 24 major injuries chiefly included Magerl type A (14 injuries, 58.3%). According to the Frankel’s classification, majority of the patients (88.46%) had no neurological deficit. In this study, three patients had nerve injuries. In conclusion, the number and proportion of spinal fractures patients in the recent twin earthquakes, northwest Iran was limited and caused less nerve injuries compared to the previous similar disasters. This might be due to the milder earthquake consequences since the incident happened in the middle of the day when men were working their fields. Potential complications in patients traumatized in earthquake incidents should be monitored for and early assessment of the neurological function is required to prioritize care for the victims.

Ghabili, Kamyar; Golzari, Samad E J; Salehpour, Firooz; Imani, Taghi; Bazzazi, Amir Mohammad; Ghaffari, Alireza; Khanli, Hadi Mohammad; Tizro, Parastou; Taghizade, Shabnam; Shakouri, Seyed Kazem

2013-01-01

141

Spinal injuries in the 2012 twin earthquakes, northwest iran.  

PubMed

On 11 August 2012, twin earthquakes measured 6.3 and 6.4 on the Richter scale hit three towns (Ahar, Varzaqan, and Heris) in East Azerbaijan Province, Iran resulting in tragic loss of three hundred lives and leaving thousands of injured. The aim of the present study was to report the spinal injuries during recent earthquake in northwest Iran, its consequences and management. Of the 923 hospitalized patients, 26 (2.8%) had neurosurgical complications. The imaging and clinical data of the patients were retrospectively studied regarding the anatomical location of the injury, the severity of spinal injury and associated neurological deficit. To further analyze the findings, Magerl (AO) and Frankel's classifications were used. The injuries without any fracture were considered as minor spinal injuries. The mean age of the patients was 44.54±22.52 (range: 5-88) years. We detected a total of 38 vertebral injuries including 24 major (63.15%) and 14 minor injuries (36.85%). The most common injuries were observed in the lumbar spine (19 injuries, 50%). The 24 major injuries chiefly included Magerl type A (14 injuries, 58.3%). According to the Frankel's classification, majority of the patients (88.46%) had no neurological deficit. In this study, three patients had nerve injuries. In conclusion, the number and proportion of spinal fractures patients in the recent twin earthquakes, northwest Iran was limited and caused less nerve injuries compared to the previous similar disasters. This might be due to the milder earthquake consequences since the incident happened in the middle of the day when men were working their fields. Potential complications in patients traumatized in earthquake incidents should be monitored for and early assessment of the neurological function is required to prioritize care for the victims. PMID:23568085

Ghabili, Kamyar; Golzari, Samad E J; Salehpour, Firooz; Imani, Taghi; Bazzazi, Amir Mohammad; Ghaffari, Alireza; Khanli, Hadi Mohammad; Tizro, Parastou; Taghizade, Shabnam; Shakouri, Seyed Kazem

2013-03-27

142

Osteoporotic fractures and hospitalization risk in chronic spinal cord injury  

Microsoft Academic Search

Summary  Osteoporosis is a well acknowledged complication of spinal cord injury. We report that motor complete spinal cord injury and\\u000a post-injury alcohol consumption are risk factors for hospitalization for fracture treatment. The clinical assessment did not\\u000a include osteoporosis diagnosis and treatment considerations, indicating a need for improved clinical protocols.\\u000a \\u000a \\u000a \\u000a Introduction  Treatment of osteoporotic long bone fractures often results in lengthy hospitalizations for

L. R. Morse; R. A. Battaglino; K. L. Stolzmann; L. D. Hallett; A. Waddimba; D. Gagnon; A. A. Lazzari; E. Garshick

2009-01-01

143

34 CFR 359.1 - What is the Special Projects and Demonstrations for Spinal Cord Injuries Program?  

Code of Federal Regulations, 2010 CFR

...Projects and Demonstrations for Spinal Cord Injuries Program? 359.1 Section...PROJECTS AND DEMONSTRATIONS FOR SPINAL CORD INJURIES General § 359.1 What...Projects and Demonstrations for Spinal Cord Injuries Program? This...

2010-07-01

144

34 CFR 359.1 - What is the Special Projects and Demonstrations for Spinal Cord Injuries Program?  

Code of Federal Regulations, 2010 CFR

...Projects and Demonstrations for Spinal Cord Injuries Program? 359.1 Section...PROJECTS AND DEMONSTRATIONS FOR SPINAL CORD INJURIES General § 359.1 What...Projects and Demonstrations for Spinal Cord Injuries Program? This...

2009-07-01

145

The prevention of spinal injuries in rugby football.  

PubMed

The incidence of injuries to the spinal cord sustained at rugby in South Africa, New Zealand and Australia is reviewed. Ninety-seven injuries seen at Stoke Mandeville Hospital at the National Spinal Injuries Centre (NSIC) between 1956 and 1993 are analysed in detail. There were 93 accidents at rugby union, two at American football and two at rugby league. The injuries were of the cervical spine apart from four hysterics and one thoracic injury. The thoracic injury occurred after the game when the player fell downstairs. The injuries were analysed according to the mechanism of injury, the neurological condition, the causation, the standard of the player and the position in the field. The injuries caused were the result of force being applied to the skull which was transmitted to the cervical spine resulting in injury to the cervical cord. As a result of this research, representations were made to the appropriate authorities and changes in the laws were made. As a result of these law changes there has been a dramatic reduction in the overall number of injuries and the elimination of the injury from the loose scrum. This paper discusses the historical sequence of how these preventative measures came about to reduce the incidence of injuries and the legal implications whereby the authors took part in two law suits. The legal consequences are analysed in detail. PMID:7970845

Silver, J R; Stewart, D

1994-07-01

146

Risk Factors for Chest Illness in Chronic Spinal Cord Injury  

PubMed Central

Objective Chest illnesses commonly cause morbidity in persons with chronic spinal cord injury. Risk factors remain poorly characterized because previous studies have not accounted for factors other than spinal cord injury. Design Between 1994 and 2005, 403 participants completed a respiratory questionnaire and underwent spirometry. Participants were contacted at a median of 1.7 yrs [interquartile range: 1.3–2.5 yrs] apart over a mean (SD) of 5.1 ± 3.0 yrs and asked to report chest illnesses that had resulted in time off work, spent indoors, or in bed since prior contact. Results In 97 participants, there were 247 chest illnesses (0.12/person-year) with 54 hospitalizations (22%). Spinal cord injury level, completeness of injury, and duration of injury were not associated with illness risk. Adjusting for age and smoking history, any wheeze (relative risk = 1.92; 95% confidence interval: 1.19, 3.08), pneumonia or bronchitis since spinal cord injury (relative risk = 2.29; 95% confidence interval: 1.40, 3.75), and physician-diagnosed chronic obstructive pulmonary disease (relative risk = 2.17; 95% confidence interval: 1.08, 4.37) were associated with a greater risk of chest illness. Each percent-predicted decrease in forced expiratory volume in 1 sec was associated with a 1.2% increase in risk of chest illness (P = 0.030). Conclusions In chronic spinal cord injury, chest illness resulting in time spent away from usual activities was not related to the level or completeness of spinal cord injury but was related to reduced pulmonary function, wheeze, chronic obstructive pulmonary disease, a history of pneumonia and bronchitis, and smoking.

Stolzmann, Kelly L.; Gagnon, David R.; Brown, Robert; Tun, Carlos G.; Garshick, Eric

2011-01-01

147

Treadmill training promotes spinal changes leading to locomotor recovery after partial spinal cord injury in cats.  

PubMed

After a spinal hemisection at thoracic level in cats, the paretic hindlimb progressively recovers locomotion without treadmill training but asymmetries between hindlimbs persist for several weeks and can be seen even after a further complete spinal transection at T13. To promote optimal locomotor recovery after hemisection, such asymmetrical changes need to be corrected. In the present study we determined if the locomotor deficits induced by a spinal hemisection can be corrected by locomotor training and, if so, whether the spinal stepping after the complete spinal cord transection is also more symmetrical. This would indicate that locomotor training in the hemisected period induces efficient changes in the spinal cord itself. Sixteen adult cats were first submitted to a spinal hemisection at T10. One group received 3 wk of treadmill training, whereas the second group did not. Detailed kinematic and electromyographic analyses showed that a 3-wk period of locomotor training was sufficient to improve the quality and symmetry of walking of the hindlimbs. Moreover, after the complete spinal lesion was performed, all the trained cats reexpressed bilateral and symmetrical hindlimb locomotion within 24 h. By contrast, the locomotor pattern of the untrained cats remained asymmetrical, and the hindlimb on the side of the hemisection was still deficient. This study highlights the beneficial role of locomotor training in facilitating bilateral and symmetrical functional plastic changes within the spinal circuitry and in promoting locomotor recovery after an incomplete spinal cord injury. PMID:23554433

Martinez, Marina; Delivet-Mongrain, Hugo; Rossignol, Serge

2013-04-03

148

Motor Vehicle Mismatch-Related Spinal Injury  

PubMed Central

Background/Objective: Motor vehicle collision (MVC)-related spinal cord injury (SCI) is the most prevalent etiology of SCI. Few studies have defined SCI risk factors. Vehicle mismatch occurs in 2-vehicle MVCs in which there are significant differences in vehicle weight, stiffness, and height. This study examined SCI risk and vehicle mismatch. Methods: A matched case-control study using the 1995 to 2003 National Automotive Sampling System (NASS). Study subjects were identified from 2-vehicle MVCs. Cases were occupants who had suffered a cervical, thoracic, or lumbar SCI. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: There were 101,682 cases of SCI matched to 805,091 controls. Occupants of passenger vehicles involved in MVCs with a light truck or van (LTV) were at increased risk for SCI (OR = 1.87, 95% CI = 1.07–3.24) and this risk was greatest for thoracic SCI (OR = 5.09, 95% CI = 2.33–11.13). In addition, occupants of LTVs involved in MVCs with passenger vehicles were at significant increased risk for cervical (OR = 1.39) and lumbar (OR = 2.65) SCI; and occupants of LTVs involved in MVCs with other LTVs were at increased risk of any SCI (OR = 2.02, 95% CI = 1.52–2.69). For these subjects, significant increased risks were seen for all spine regions: cervical (OR = 1.41), thoracic (OR = 2.86), and lumbar (OR = 2.38). Conclusions: The results of this study suggest that occupants of passenger vehicles are at increased SCI risk when involved in 2-vehicle MVCs with LTVs; and that occupants of LTVs are at increased SCI risk, regardless.

Cobb, Jason D; MacLennan, Paul A; McGwin, Gerald; Metzger, Jesse S; Rue, Loring W

2005-01-01

149

Long-Term Survival After Childhood Spinal Cord Injury  

PubMed Central

Objective: To determine whether persons who incur a spinal cord injury as children are at increased risk of mortality compared with persons injured as adults given comparable current age, sex, and injury severity. Methods: A total of 25,340 persons admitted to the National Spinal Cord Injury Statistical Center database or the National Shriners Spinal Cord Injury database who were not ventilator dependent and who survived more than 2 years after injury were included in this study. These persons contributed 274,020 person-years of data, with 3,844 deaths, over the 1973–2004 study period. Data were analyzed using pooled repeated observations analysis of person-years. For each person-year the outcome variable was survival/mortality, and the explanatory variables included current age, sex, race, cause of injury, severity of injury, and age at injury (the focus of the current analysis). Results: Other factors being equal, persons who were less than 16 years of age at time of injury had a 31% (95% CI = 3%–65%) increase in the annual odds of dying compared with persons injured at older ages (P = 0.013). This increased risk did not vary significantly by current age, sex, race, injury severity, or era of injury (P > 0.05). Conclusion: Life expectancy for persons injured as children appears to be slightly lower than that of otherwise comparably injured persons who suffered their injuries as adults. Nonetheless, persons who are injured young can enjoy relatively long life expectancies, ranging from approximately 83% of normal life expectancy for persons with minimal deficit incomplete injuries to approximately 50% of normal in high-cervical-level injuries without ventilator dependence.

Shavelle, Robert M; DeVivo, Michael J; Paculdo, David R; Vogel, Lawrence C; Strauss, David J

2007-01-01

150

Biomaterial design strategies for the treatment of spinal cord injuries.  

PubMed

The highly debilitating nature of spinal cord injuries has provided much inspiration for the design of novel biomaterials that can stimulate cellular regeneration and functional recovery. Many experts agree that the greatest hope for treatment of spinal cord injuries will involve a combinatorial approach that integrates biomaterial scaffolds, cell transplantation, and molecule delivery. This manuscript presents a comprehensive review of biomaterial-scaffold design strategies currently being applied to the development of nerve guidance channels and hydrogels that more effectively stimulate spinal cord tissue regeneration. To enhance the regenerative capacity of these two scaffold types, researchers are focusing on optimizing the mechanical properties, cell-adhesivity, biodegradability, electrical activity, and topography of synthetic and natural materials, and are developing mechanisms to use these scaffolds to deliver cells and biomolecules. Developing scaffolds that address several of these key design parameters will lead to more successful therapies for the regeneration of spinal cord tissue. PMID:19698073

Straley, Karin S; Foo, Cheryl Wong Po; Heilshorn, Sarah C

2010-01-01

151

Nocturnal polyuria and antidiuretic hormone levels in spinal cord injury  

Microsoft Academic Search

Objective: To establish baseline ADH levels in spinal cord injury patients and to evaluate whether spinal cord patients have attenuation of diurnal variation of ADH similar to children with enuresis and elderly with nocturnal polyuria.Design: Twenty-seven healthy quadriplegic patients, ASIA impairment scale A, were evaluated for serum ADH levels at night and during the day.Main Outcome Measures: Evaluation of whether

Suzanne M. Szollar; Kathleen L. Dunn; Shannon Brandt; Janice Fincher

1997-01-01

152

Regional Spinal Cord Blood Flow and Energy Metabolism in Rats after Laminectomy and Acute Compression Injury  

Microsoft Academic Search

Many data are available concerning spinal cord blood flow (SCBF) and metabolism on various models and timing after spinal cord injury, however, detailed information on their exact relationship in the same injury model is lacking. This relationship is a crucial factor in the understanding of the pathophysiology of spinal cord trauma. Rats were subjected to lumbar laminectomy or lumbar spinal

Angelika E. M. Mautes; Helmut Schröck; Amadeo C. Nacimiento; Wulf Paschen

2000-01-01

153

Effect of the trauma mechanism on the bladder-sphincteric behavior after spinal cord injury  

Microsoft Academic Search

Study design: Retrospective study.Objective: To determine if spinal cord injuries due to gunshot wounds (GW) are associated with different bladder and sphincteric behavior compared to other trauma mechanisms.Setting: Spinal injury center, Brazilian university hospital.Methods: We retrospectively evaluated the records and urodynamic studies of 71 patients with spinal cord injury (SCI) referred to the Brazilian National Spinal Cord Injury Center over

C A R Sacomani; F E Trigo-Rocha; C M Gomes; J A Greve; T E P Barros; S Arap

2003-01-01

154

Rugby union injuries to the cervical spine and spinal cord.  

PubMed

Injuries to the cervical spine are among the most serious injuries occurring as a result of participation in rugby. Outcomes of such injuries range from complete recovery to death, depending on the degree of spinal cord damage sustained. Much information has been gained regarding the mechanisms and frequency of such injuries, from case reports and case series studies. The most commonly reported mechanism of injury has been hyperflexion of the cervical spine, resulting in fracture dislocation of C4-C5 or C5-C6. Tracking both the trends of incidence of spinal injuries, and the effectiveness of injury prevention initiatives has proved difficult because of a lack of properly conducted epidemiological studies. Within the constraints of the research published to date, it appears that hookers and props have been at disproportionate risk of cervical spine injury, predominantly because of injuries sustained during scrummaging. While the scrum was the phase of play most commonly associated with spinal injuries throughout the 1980s in most rugby playing countries, there has been a trend through the 1990s of an increasing proportion of spinal injuries occurring in the tackle situation. The majority of injuries have occurred early in the season, when grounds tend to be harder, and players are lacking both practice and physical conditioning for the physical contact phases of the sport. A number of injury prevention measures have been launched, including changes to the laws of the game regarding scrummaging, and education programmes aimed at enforcing safe techniques and eliminating illegal play. Calls for case-registers and effective epidemiological studies have been made by researchers and physicians in most countries where rugby is widespread, but it appears to be only recently that definite steps have been made towards this goal. Well-designed epidemiological studies will be able to provide more accurate information about potential risk factors for injury such as age, grade, position, gender and ethnicity. Research into the long-term effects of participation in rugby on the integrity of the spinal column is warranted. PMID:12141883

Quarrie, Kenneth L; Cantu, Robert C; Chalmers, David J

2002-01-01

155

Earthquake-related versus non-earthquake-related injuries in spinal injury patients: differentiation with multidetector computed tomography  

Microsoft Academic Search

INTRODUCTION: In recent years, several massive earthquakes have occurred across the globe. Multidetector computed tomography (MDCT) is reliable in detecting spinal injuries. The purpose of this study was to compare the features of spinal injuries resulting from the Sichuan earthquake with those of non-earthquake-related spinal trauma using MDCT. METHODS: Features of spinal injuries of 223 Sichuan earthquake-exposed patients and 223

Zhi-hui Dong; Zhi-gang Yang; Tian-wu Chen; Zhi-gang Chu; Qi-ling Wang; Wen Deng; Joseph C Denor

2010-01-01

156

Exploring positive adjustment in people with spinal cord injury.  

PubMed

This study explored adjustment in people with spinal cord injury; data from four focus groups are presented. Thematic analysis revealed four themes, managing goals and expectations, comparison with others, feeling useful and acceptance, showing participants positively engaged in life, positively interpreted social comparison information and set realistic goals and expectations. These positive strategies show support for adjustment theories, such as the Cognitive Adaptation Theory, the Control Process Theory and Response Shift Theory. These results also provide insight into the adjustment process of a person with spinal cord injury and may be useful in tailoring support during rehabilitation. PMID:23682061

Dibb, Bridget; Ellis-Hill, Caroline; Donovan-Hall, Maggie; Burridge, Jane H; Rushton, David

2013-05-16

157

Evaluation of artificial sweat in athletes with spinal cord injuries  

Microsoft Academic Search

Athletes with spinal cord injury often experience high heat storage due to reduced sweating capacity below the spinal injury.\\u000a Spray bottle (SB) maybe used to apply mist for evaporative cooling during breaks in competitions. This study examined the\\u000a efficacy of SB during rest breaks. Seven participants, four female and three males, (mean ± SD age 24 ± 4.1 year, weight 56.2 ± 7.0 kg,\\u000a upper-body VO2 peak 2.4 ± 0.6 l\\/min)

R. C. Pritchett; P. A. Bishop; Z. Yang; K. L. Pritchett; J. M. Green; C. P. Katica; A. T. Del Pozzi

2010-01-01

158

The immunological response to spinal cord injury: helpful or harmful?  

PubMed

The role of the immune response in spinal cord injury has become a frequent object of debate. Evidence exists to suggest that autoimmunity following neurotrauma can be either beneficial or detrimental to recovery. The following commentary examines the recent findings indicating that mice lacking mature B- and T-lymphocytes have improved behavioral and histological outcomes following thoracic spinal cord injury. These data, presented in the October issue of Experimental Neurology are discussed within the context of previous findings and differing viewpoints in the field of neuroimmunology. Limitations on the translation of immune modulation therapeutics, and clinical perspectives on their future potential are also examined. PMID:23333564

Laliberte, A M; Fehlings, M G

2013-01-15

159

Rehabilitation outcomes following traumatic spinal cord injury in a tertiary spinal cord injury centre: a comparison with an international standard  

Microsoft Academic Search

Study design:Retrospective descriptive analysis of data of patients with traumatic spinal cord injury (SCI) in a tertiary SCI centre.Objectives:To identify the characteristics of the rehabilitation outcomes of patients with different levels of traumatic SCI and to compare the results with data reported in the American Consortium for Spinal Cord Medicine.Setting:A newly established tertiary SCI centre in Tai Po Hospital, Tai

S C C Chan; A P S Chan; SCC Chan

2005-01-01

160

Glycyrrhizin protects spinal cord and reduces inflammation in spinal cord ischemia-reperfusion injury.  

PubMed

Objective: Inflammation, which is detrimental to the neurologic defect after ischemia-reperfusion, provides a potential target for therapeutic approach for spinal cord ischemia-reperfusion injury. High mobility group box 1 (HMGB-1) was recently discovered to be a crucial cytokine that mediates the response to infection, injury and inflammation. The present study aimed to gain a deep insight into the neuroprotective effect of glycyrrhizin in the process of ischemia and reperfusion injury in spinal cord of mice. Methods: Spinal cord ischemia was induced in male C57BL/6 mice by occlusion of the thoracic aorta. The experimental groups (n = 6 per group) included sham operation, control (receiving phosphate buffered saline (PBS)) and glycyrrhizin (10 mg/kg, when cross-clamped). Neurologic function was assessed by the motor function score of the hind limbs at 72 hours after reperfusion. Histologic changes were studied using hematoxylin and eosin staining. Expression changes of inflammatory cytokines or their receptors at messenger RNA level or protein level were determined by real-time transcription polymerase chain reaction or enzyme-linked immunosorbent assay at different time points post reperfusion. Nuclear factor ?B (NF-?B) activity was examined with Western blotting. Results: Compared with the control group, the glycyrrhizin group showed significantly improved neurologic outcome, reduced apoptosis of motoneurons of spinal anterior horn, decreased the activation of NF-?B and subsequent inflammatory cytokines expression [tumor necrosis factor (TNF) and interleukin 1? (IL-1?)], and alleviated neutrophil infiltration in ischemic spinal cord. HMGB-1 treatment also reduced the expressions of itself. Conclusions: Treatment with glycyrrhizin exerted a neuroprotective effect against spinal cord ischemia-reperfusion injury. The anti-inflammatory effect was believed to be one of the contributing mechanisms. Our findings provided experimental and therapeutic options for the treatment of spinal cord ischemia-reperfusion injury. PMID:23594088

Ni, Bin; Cao, Zhenyu; Liu, Yan

2013-08-15

161

Dietary restriction started after spinal cord injury improves functional recovery.  

PubMed

Spinal cord injury typically results in limited functional recovery. Here we investigated whether therapeutic dietary restriction, a multi-faceted, safe, and clinically-feasible treatment, can improve outcome from cervical spinal cord injury. The well-established notion that dietary restriction increases longevity has kindled interest in its potential benefits in injury and disease. When followed for several months prior to insult, prophylactic dietary restriction triggers multiple molecular responses and improves outcome in animal models of stroke and myocardial infarction. However, the efficacy of the clinically-relevant treatment of post-injury dietary restriction is unknown. Here we report that "every-other-day fasting" (EODF), a form of dietary restriction, implemented after rat cervical spinal cord injury was neuroprotective, promoted plasticity, and improved behavioral recovery. Without causing weight loss, EODF improved gait-pattern, forelimb function during ladder-crossing, and vertical exploration. In agreement, EODF preserved neuronal integrity, dramatically reduced lesion volume by >50%, and increased sprouting of corticospinal axons. As expected, blood beta-hydroxybutyrate levels, a ketone known to be neuroprotective, were increased by 2-3 fold on the fasting days. In addition, we found increased ratios of full-length to truncated trkB (receptor for brain-derived neurotrophic factor) in the spinal cord by 2-6 folds at both 5 days (lesion site) and 3 weeks after injury (caudal to lesion site) which may further enhance neuroprotection and plasticity. Because EODF is a safe, non-invasive, and low-cost treatment, it could be readily translated into the clinical setting of spinal cord injury and possibly other insults. PMID:18585708

Plunet, Ward T; Streijger, Femke; Lam, Clarrie K; Lee, Jae H T; Liu, Jie; Tetzlaff, Wolfram

2008-04-22

162

Long-term changes in expressions of spinal glutamate transporters after spinal cord injury.  

PubMed

Glutamate is a major excitatory transmitter in the central nervous system that may produce cellular injury when its concentration is abnormally increased in the synaptic cleft. Glial glutamate transporters GLAST and GLT-1, which are responsible for clearing synaptic glutamate into glial cells, play an important role in the regulation of the glutamate concentration in the synaptic cleft. However, there has been no report on long-term changes in the levels of glutamate transporters following spinal cord injury. Spinal cord injury (SCI) was induced at T12 by a New York University (NYU) impactor. Segments of the spinal cord at T9-10, L1-2, L4-5 and at the epicenter were removed after SCI, and Western blots for GLAST, GLT-1 and EAAC1 were performed. GLAST and GLT-1 were significantly decreased in the epicenter from 1day up to 8weeks after SCI. GLT-1 was significantly decreased in the spinal segments rostral to the injury site, and GLAST expression was significantly increased in the L4-5 region of the spinal cord for 8weeks. Because strategies to modulate the regulation of glutamate transporters may be applied, the present data serve as a reference for further research, although the long-term roles of glutamate transporters in pathological processes caused by SCI are not clear. PMID:21439271

Kim, Youngkyung; Park, Young-Keun; Cho, Hwi-Young; Kim, Junesun; Yoon, Young Wook

2011-03-22

163

Spinal cord injury in Manitoba: a provincial epidemiological study  

PubMed Central

Objective To define the epidemiological trends and identify populations at risk of traumatic and non-traumatic spinal cord injury (NTSCI) for the province of Manitoba, Canada. Methods We reviewed records retrospectively for subjects in three cohorts (1981–1985, 1998–2002, and 2003–2007). A total of 553 individuals with spinal cord injury (SCI) were studied for variables such as age, level of injury, severity of injury, First Nations (FN) status, and etiology of injury. Results Incidence of overall SCI has increased from 22.0 to 46.5 per million (P < 0.001). Incidence of NTSCI increased from 3.12 per million to 16.7 per million (P < 0.001). Incidence of traumatic spinal cord injury (TSCI) has increased from the 17.1 per million to 25.6 per million (P < 0.001). There was a significant increase in the mean age at injury from 30.23 to 45.768 years of age (P < 0.0001). Female and NTSCI have a higher mean and median age at injury. There was a significant (P = 0.0008) increase in the proportion of females with a most recent male/female ratio of 3.4:1. A temporal increase in incomplete injuries was observed (P < 0.0001). Incomplete and thoracic level injuries are more common with NTSCI. Conclusion The results demonstrate that there are significant differences between NTSCI and TSCI in Manitoba, and that Manitoba trends in SCI are in keeping with those seen on a national and an international level. There is a high risk of SCI in Manitoba FN, for which preventive strategies need to be put in place, and higher resource structure geared towards. Additionally, the trend of older age at injury has significant implications for structuring acute care and rehabilitation programs for these individuals, enhancing the need for treating older and more medically complicated individuals with SCI.

McCammon, James R.; Ethans, Karen

2011-01-01

164

Acute Leptin Treatment Enhances Functional Recovery after Spinal Cord Injury  

PubMed Central

Background Spinal cord injury is a major cause of long-term disability and has no current clinically accepted treatment. Leptin, an adipocyte-derived hormone, is best known as a regulator of food intake and energy expenditure. Interestingly, several studies have demonstrated that leptin has significant effects on proliferation and cell survival in different neuropathologies. Here, we sought to evaluate the role of leptin after spinal cord injury. Findings Based on its proposed neuroprotective role, we have evaluated the effects of a single, acute intraparenchymal injection of leptin in a clinically relevant animal model of spinal cord injury. As determined by quantitative Real Time-PCR, endogenous leptin and the long isoform of the leptin receptor genes show time-dependent variations in their expression in the healthy and injured adult spinal cord. Immunohistochemical analysis of post-injury tissue showed the long isoform of the leptin receptor expression in oligodendrocytes and, to a lesser extent, in astrocytes, microglia/macrophages and neurons. Moreover, leptin administered after spinal cord injury increased the expression of neuroprotective genes, reduced caspase-3 activity and decreased the expression of pro-inflammatory molecules. In addition, histological analysis performed at the completion of the study showed that leptin treatment reduced microglial reactivity and increased caudal myelin preservation, but it did not modulate astroglial reactivity. Consequently, leptin improved the recovery of sensory and locomotor functioning. Conclusions Our data suggest that leptin has a prominent neuroprotective and anti-inflammatory role in spinal cord damage and highlights leptin as a promising therapeutic agent.

Fernandez-Martos, Carmen Maria; Gonzalez, Pau; Rodriguez, Francisco Javier

2012-01-01

165

Sexuality, Identity and Women with Spinal Cord Injury  

Microsoft Academic Search

Sexuality is an integral component of every individual’s identity. The literature offers limited information about the sexuality\\u000a and sexual identity of women with spinal cord injury (SCI), beyond the physiological and neurological aspects. The qualitative\\u000a study described in this paper aimed to explore the experiences and perceptions of a small sample of adult women with SCI regarding\\u000a their sexuality post-injury.

Malorie G. Parker; Matthew K. Yau

166

Alternative, complementary, energy-based medicine for spinal cord injury  

Microsoft Academic Search

This paper provides an overview on various alternative, complementary, or energy-based therapies that expand the healing spectrum\\u000a of individuals with spinal cord injury (SCI). Not only do they have the capability to help a variety of secondary conditions,\\u000a they have the ability in some people, for certain injuries, to restore function, sometimes dramatically. After providing an\\u000a overall contextual rationale for

L. Johnston

167

Coping in Caregivers of Youth with Spinal Cord Injury  

Microsoft Academic Search

This study examined coping among caregivers of youth with spinal cord injuries (SCI). Using a cross-sectional survey study\\u000a design, 164 caregivers completed a demographics questionnaire and the Brief COPE. Their children, youth with SCI ages 7–18,\\u000a completed the Kidcope. T-tests were conducted to examine differences in caregiver coping by demographic and injury-related\\u000a factors. Further, logistic regression models were evaluated to

Kimberly B. Dasch; Heather F. Russell; Erin H. Kelly; Julie A. Gorzkowski; Mary Jane Mulcahey; Randal R. Betz; Lawrence C. Vogel

168

Megacolon in patients with chronic spinal cord injury  

Microsoft Academic Search

Purpose: To investigate the clinical and functional correlates of megacolon in individuals with chronic spinal cord injury (SCI).Patients and methods: This is a cross-sectional study of 128 patients consecutively admitted to a SCI in-patient service in a US Veterans Administration Medical Centre (mean age 57±15 years, mean years since injury 20±13, 97% male) who underwent plain abdominal radiography for study

D Harari; K L Minaker

2000-01-01

169

Spinal cord injury immediately changes the state of the brain.  

PubMed

Spinal cord injury can produce extensive long-term reorganization of the cerebral cortex. Little is known, however, about the sequence of cortical events starting immediately after the lesion. Here we show that a complete thoracic transection of the spinal cord produces immediate functional reorganization in the primary somatosensory cortex of anesthetized rats. Besides the obvious loss of cortical responses to hindpaw stimuli (below the level of the lesion), cortical responses evoked by forepaw stimuli (above the level of the lesion) markedly increase. Importantly, these increased responses correlate with a slower and overall more silent cortical spontaneous activity, representing a switch to a network state of slow-wave activity similar to that observed during slow-wave sleep. The same immediate cortical changes are observed after reversible pharmacological block of spinal cord conduction, but not after sham. We conclude that the deafferentation due to spinal cord injury can immediately (within minutes) change the state of large cortical networks, and that this state change plays a critical role in the early cortical reorganization after spinal cord injury. PMID:20519527

Aguilar, Juan; Humanes-Valera, Desiré; Alonso-Calviño, Elena; Yague, Josué G; Moxon, Karen A; Oliviero, Antonio; Foffani, Guglielmo

2010-06-01

170

New canine spinal cord injury model free from laminectomy  

Microsoft Academic Search

The present report details the successful development of a model for spinal cord injury (SCI). This model is simple, reproducible, and requires no laminectomy. Development of the model was carried out using fourteen dogs. A balloon catheter was inserted into the extradural space via the intervertebral foramen of each dog, then the balloon was inflated at the L1 level by

Seijun Fukuda; Tatsuo Nakamura; Yoshihiro Kishigami; Katsuaki Endo; Takashi Azuma; Takamitsu Fujikawa; Sadami Tsutsumi; Yasuhiko Shimizu

2005-01-01

171

Interlimb reflexes following cervical spinal cord injury in man  

Microsoft Academic Search

The reflex interconnection of lower and upper extremity muscles was investigated in subjects with chronic (> 1 year post-injury) lesions to the cervical spinal cord. Lower extremity mixed nerves were stimulated with single shocks or with brief trains of high-frequency stimuli of varying intensities. EMG from a number of lower and upper extremity muscles was recorded on magnetic tape for

B. Calancie

1991-01-01

172

Stem cells for the treatment of spinal cord injury  

Microsoft Academic Search

This article reviews stem cell-based strategies for spinal cord injury repair, and practical issues concerning their translation to the clinic. Recent progress in the stem cell field includes clinically compliant culture conditions and directed differentiation of both embryonic stem cells and somatic stem cells. We provide a brief overview of the types of stem cells under evaluation, comparing their advantages

Margaret Coutts; Hans S. Keirstead

2008-01-01

173

Ascending cystic degeneration of the cord after spinal cord injury  

Microsoft Academic Search

We have reported a series of 15 cases of ascending cystic degenerative myelopathy from a total of 1500 spinal injuries over a period of 30 years, an incidence of 1 per cent. Although sensory impairment was troublesome in many cases, motor loss was infrequent and minimal and never became severe enough to warrant further investigation or active surgical treatment. A

Norval Watson

1981-01-01

174

Early intensive hand rehabilitation after spinal cord injury (\\  

Microsoft Academic Search

BACKGROUND: Loss of hand function is one of the most devastating consequences of spinal cord injury. Intensive hand training provided on an instrumented exercise workstation in conjunction with functional electrical stimulation may enhance neural recovery and hand function. The aim of this trial is to compare usual care with an 8-week program of intensive hand training and functional electrical stimulation.

Lisa A Harvey; Sarah A Dunlop; Leonid Churilov; Ya-Seng Arthur Hsueh; Mary P Galea

2011-01-01

175

Men, sport, spinal cord injury, and narratives of hope  

Microsoft Academic Search

Drawing on data from a life history study of a small group of men who have suffered spinal cord injury and become disabled through playing sport, this article explores the meanings of hope in their lives. It focuses upon the life stories of 14, white, predominantly working-class men, aged 26–51. The most common kinds of hope used by the men

Brett Smith; Andrew C. Sparkes

2005-01-01

176

Quality of Life After Spinal Cord Injury: A Qualitative Study  

Microsoft Academic Search

ABSTRACT. Objective: To describe the subjective quality of life (QOL) of persons with a spinal cord injury (SCI). Study Design: Qualitative analysis of transcribed interviews. Participants: Forty community-dwellers with SCI. Results: Few participants could define QOL, but most could identify indicators of QOL and provided clear ratings of their own QOL. Individuals were grouped into three QOL ratings categories (excellent

Colette Hillebrand Duggan; Marcel Dijkers

2001-01-01

177

Quality of Life in Patients with Spinal Cord Injury  

ERIC Educational Resources Information Center

|The primary objective of this study was to assess the quality of life (QoL) in spinal cord injury (SCI) survivors. Secondary objectives were to determine the effects of various sociodemographic and clinical characteristics on QoL. This cross-sectional study included 54 patients with SCI. The Turkish version of the Short-Form-36 Health Survey was…

Gurcay, Eda; Bal, Ajda; Eksioglu, Emel; Cakci, Aytul

2010-01-01

178

Acute spinal cord injury patients—Who cares?  

Microsoft Academic Search

Pertinent aspects of the remarkable advances instituted and developed for the management of patients who have sustained serious spinal injuries are discussed in this communication, and the responsibilities of medical doctors and others who care for such patients is taken up in relation to some of the recent advances in our knowledge, both experimental, and clinical. There are new challenges

Phillip Harris

1985-01-01

179

A comparison of women and men with spinal cord injury  

Microsoft Academic Search

While research on spinal cord injury (SCI) is abundant, few studies focus on women. This population-based study investigates differences in the prevalence of secondary conditions between 128 women and 522 men. Case managers retrospectively interviewed 650 persons regarding medical and psychological conditions secondary to SCI, as well as other life issues. Overall, males and females show more similarities than differences

Monisa Shackelford; Thomas Farley; Cheryl L Vines

1998-01-01

180

US Experience With Bladder Management Following Spinal Cord Injury  

Microsoft Academic Search

This review of management of the neurogenic bladder due to spinal cord injury focuses specifically on the most current literature\\u000a (2007–2009) regarding therapies offered in the United States. Urodynamic surveillance, indwelling and intermittent catheterization,\\u000a sphincterotomy, urinary diversion, continent catheterizable stomas, and botulinum toxin usage are all reviewed.

Anne P. Cameron; J. Quentin Clemens

2010-01-01

181

Postural arm control following cervical spinal cord injury  

Microsoft Academic Search

This study used estimates of dynamic endpoint stiffness to quantify postural arm stability following cervical spinal cord injury (SCI) and to investigate how this stability was affected by functional neuromuscular stimulation (FNS). Measurements were made in the horizontal plane passing through the glenohumeral joint on three SCI-impaired arms, which ranged in functional level from a weak C5 to a strong

Eric J. Perreault; Patrick E. Crago; Robert F. Kirsch

2001-01-01

182

Transient spinal cord injuries in the young athlete.  

PubMed

Spinal cord injuries are be potentially devastating. Despite initial presentation, they may be permanent or transient. A small percentage of spinal cord patients with motor or sensory dysfunction recover rapidly and completely with no neurological sequelae. Cervical cord neurapraxia is a frequent cause of transient neurologic symptoms. This transient neurological phenomenon involves bilateral motor paralysis and/or sensory manifestations that appear in the absence of any structural deficiencies of the cervical spine as evidence by negative diagnostic imaging. All patients with any history of neurologic deficits should be assessed thoroughly and rendered care appropriately to avoid secondary injury. This article will present a case study of a 15-year-old high school football player who complained of motor and sensory deficits after tackling another player. Treatment was provided and his neurological symptoms resolved completely. The pathophysiology of cellular injury related to the spinal cord and cervical cord neurapraxia is reviewed. In addition treatment modalities such as high dose steroids to reduce secondary spinal cord injury are discussed. PMID:16602338

Perks, Diane H

183

Preserving transfer independence among individuals with spinal cord injury  

Microsoft Academic Search

Study design: Literature review.Objectives: Upper extremity (UE) joint degeneration, particularly at the shoulder, detrimentally influences functional independence, quality of life, cardiovascular disease risk, and life expectancy of individuals following spinal cord injury (SCI). This review (1) describes UE use for transfers among individuals with SCI; (2) describes contributing factors associated with UE joint degeneration and loss of transfer independence; (3)

J Nyland; P Quigley; C Huang; J Lloyd; J Harrow; A Nelson

2000-01-01

184

Environmentally responsive temperature instability in pediatric spinal cord injury  

Microsoft Academic Search

Objective: To study the frequency and clinical implications of environmentally responsive temperature instability in hospitalized pediatric patients with spinal cord injury (SCI). Setting: A tertiary level SCI rehabilitation unit located in a free standing children's hospital in Wilmington, DE, USA. Study Design: Temperature data and corresponding clinical responses were collected prospectively between January 1991 and June 1993. Fifty-four consecutive patients

DE McLean; J Kearney; MF Cawley

1999-01-01

185

Pediatric spinal cord injury: Approach for urological rehabilitation and treatment  

Microsoft Academic Search

PurposeAs proposed in this report, early urological rehabilitative management of patients with spinal cord injuries (SCIs) is mandatory, in order to prevent a poorly compliant bladder with related upper urinary tract complications and secondary renal failure. Moreover, the approach to treating this traumatic condition in children must be as much rapid as appropriate.

M. Silveri; L. Salsano; M. M. Pierro; G. Mosiello; M. L. Capitanucci; M. De Gennaro

2006-01-01

186

Longitudinal Study of Bone Turnover after Acute Spinal Cord Injury  

Microsoft Academic Search

Increased bone turnover is a sequel of spinal cord injury (SCI) and predisposes to a number of clinically relevant complications, includ- ing osteoporosis and fractures. There are limited data available re- garding the changes in modern markers of bone metabolism after SCI. We report a 6-month longitudinal follow-up of biochemical markers of bone metabolism (free and total deoxypyridinoline, total pyridino-

DAVID ROBERTS; WINNIFRED LEE; ROSS C. CUNEO; JOHANNES WITTMANN; GREG WARD; ROBERT FLATMAN; BRETT MCWHINNEY; PETER E. HICKMAN

187

Postpartum spinal cord injury in a woman with HELLP syndrome  

Microsoft Academic Search

OBJECTIVE: To report a rare cause of spinal cord injury. STUDY DESIGN: Case report. CASE REPORT: A 36-year-old woman presented with acute onset of paresis of the upper and lower extremity (level C5, ASIA B) the day after delivering a healthy daughter (39 weeks' gestation). Prior to giving birth, she was admitted with gestational hypertension. Directly postpartum, blood pressure increased

J. T. Groothuis; DH van Kuppevelt

2008-01-01

188

Clinical and Experimental Advances in Regeneration of Spinal Cord Injury  

PubMed Central

Spinal cord injury (SCI) is one of the major disabilities dealt with in clinical rehabilitation settings and is multifactorial in that the patients suffer from motor and sensory impairments as well as many other complications throughout their lifetimes. Many clinical trials have been documented during the last two decades to restore damaged spinal cords. However, only a few pharmacological therapies used in clinical settings which still have only limited effects on the regeneration, recovery speed, or retraining of the spinal cord. In this paper, we will introduce recent clinical trials, which performed pharmacological treatments and cell transplantations for patients with SCI, and evaluate recent in vivo studies for the regeneration of injured spinal cord, including stem-cell transplantation, application of neurotrophic factors and suppressor of inhibiting factors, development of biomaterial scaffolds and delivery systems, rehabilitation, and the combinations of these therapies to evaluate what can be appropriately applied in the future to the patients with SCI.

Hyun, Jung Keun; Kim, Hae-Won

2010-01-01

189

Spinal-cord injuries in Australian footballers, 1960-1985.  

PubMed

A review of 107 footballers who suffered a spinal-cord injury between 1960 and 1985 has been undertaken. Since 1977, the number of such injuries in Rugby Union, Rugby League and Australian Rules has increased, from an average of about two injuries a year before 1977 to over eight injuries a year since then. Rugby Union is clearly the most dangerous game, particularly for schoolboys; all of the injuries in schoolboy games for this code have occurred since 1977. This study has shown that collision at scrum engagement, and not at scrum collapse, is the way in which the majority of scrum injuries are sustained. These injuries are largely preventable, and suggestions for rule changes are made. Half the injured players recovered to Frankel grades D or E. The financial entitlements of those injured were grossly inadequate; this warrants action. A national register for spinal-cord injuries from football should be established to monitor the effects of desirable rule changes in Rugby Union and Rugby League. PMID:3600465

Taylor, T K; Coolican, M R

1987-08-01

190

Long-Term Changes in Spinal Cord Evoked Potentials After Compression Spinal Cord Injury in the Rat  

Microsoft Academic Search

SUMMARY  1. After traumatic spinal cord injury (SCI), histological and neurological consequences are developing for several days and even weeks. However, little is known about the dynamics of changes in spinal axonal conductivity. The aim of this study was to record and compare repeated spinal cord evoked potentials (SCEP) after SCI in the rat during a 4 weeks’ interval. These recordings

Ivo Vanický; Tomáš Ondrej?ák; Miriam Ondrej?áková; Igor Šulla; Ján Gálik

2006-01-01

191

The Animal Model of Spinal Cord Injury as an Experimental Pain Model  

PubMed Central

Pain, which remains largely unsolved, is one of the most crucial problems for spinal cord injury patients. Due to sensory problems, as well as motor dysfunctions, spinal cord injury research has proven to be complex and difficult. Furthermore, many types of pain are associated with spinal cord injury, such as neuropathic, visceral, and musculoskeletal pain. Many animal models of spinal cord injury exist to emulate clinical situations, which could help to determine common mechanisms of pathology. However, results can be easily misunderstood and falsely interpreted. Therefore, it is important to fully understand the symptoms of human spinal cord injury, as well as the various spinal cord injury models and the possible pathologies. The present paper summarizes results from animal models of spinal cord injury, as well as the most effective use of these models.

Nakae, Aya; Nakai, Kunihiro; Yano, Kenji; Hosokawa, Ko; Shibata, Masahiko; Mashimo, Takashi

2011-01-01

192

Secondary pathology following contusion, dislocation, and distraction spinal cord injuries.  

PubMed

Preclinical studies for spinal cord injury (SCI) have utilized transection and contusion injury paradigms even though human SCIs occur by a spectrum of primary injury mechanisms such as spinal cord contusion from vertebral burst fracture, shearing from fracture-dislocation, and stretching from distraction injuries. We contrasted the neuropathology in animal models mimicking these clinically relevant injuries at an early 3-hour time-point in order to relate patterns of secondary pathology to the primary injury mechanism. Axolemma compromise, detected by the intracellular penetration of dextran-conjugated fluorophores, was localized to the contusion epicentre but extended rostrally following dislocation and distraction injuries. Dextran infused post-trauma revealed extensive axolemma resealing whereas only modest membrane recovery was detected in neuronal somata. Fracture-dislocations produced greater axonal degeneration than either contusion or distraction injuries as evidenced by reduced neurofilament immunostaining in ventral tracts, increased beta-amyloid precursor protein accumulation in lateral funiculi, and a longer lesion in the dorsal corticospinal tract. In the gray matter, cytochrome c release from neuronal mitochondria, indicative of early apoptosis, was detected within the penumbrae of the contusion and dislocation injuries only. Neurons positive for the oxidative stress marker 3-nitrotyrosine were most numerous rostral to the dislocation epicentre. Microglial activation was localized to the contusion epicentre, extended rostro-caudally following dislocation, but was similar to surgical controls after distraction injuries. Reactive astrocytes extended rostro-caudally only following dislocation injuries. Hence, the primary injury mechanism alters the pattern of secondary degeneration indicating that different neuroprotective strategies may ultimately be required for treating distinct clinically relevant SCIs. PMID:18561916

Choo, Anthony M; Liu, Jie; Dvorak, Marcel; Tetzlaff, Wolfram; Oxland, Thomas R

2008-05-14

193

Pushrim biomechanics and injury prevention in spinal cord injury: Recommendations based on CULP-SCI investigations  

Microsoft Academic Search

Over 50 percent of manual wheelchair users with spinal cord injury (SCI) are likely to develop upper-limb pain and injury. The majority of studies related to pain have impli- cated wheelchair propulsion as a cause. This paper draws from a large multisite trial and a long-standing research program to make specific recommendations related to wheelchair propul- sion that may decrease

Michael L. Boninger; Alicia M. Koontz; Trevor A. Dyson-Hudson; Michael Chang; Rory A. Cooper

2005-01-01

194

Endogenous Proliferation after Spinal Cord Injury in Animal Models  

PubMed Central

Spinal cord injury (SCI) results in motor and sensory deficits, the severity of which depends on the level and extent of the injury. Animal models for SCI research include transection, contusion, and compression mouse models. In this paper we will discuss the endogenous stem cell response to SCI in animal models. All SCI animal models experience a similar peak of cell proliferation three days after injury; however, each specific type of injury promotes a specific and distinct stem cell response. For example, the transection model results in a strong and localized initial increase of proliferation, while in contusion and compression models, the initial level of proliferation is lower but encompasses the entire rostrocaudal extent of the spinal cord. All injury types result in an increased ependymal proliferation, but only in contusion and compression models is there a significant level of proliferation in the lateral regions of the spinal cord. Finally, the fate of newly generated cells varies from a mainly oligodendrocyte fate in contusion and compression to a mostly astrocyte fate in the transection model. Here we will discuss the potential of endogenous stem/progenitor cell manipulation as a therapeutic tool to treat SCI.

McDonough, Ashley; Martinez-Cerdeno, Veronica

2012-01-01

195

Relationships between the changes in compound muscle action potentials and selective injuries to the spinal cord and spinal nerve roots  

Microsoft Academic Search

Objective: Compound muscle action potentials (CMAPs) evoked by transcranial electrical stimulation have been widely introduced to monitor motor function during spinal surgery. They may reflect segmental injuries as well as injuries to motor-related tracts in the spinal cord. However, we have experience with some patients who developed postoperative segmental motor weakness without any potential changes during surgery. To evaluate the

Shunji Tsutsui; Tetsuya Tamaki; Hiroshi Yamada; Hiroshi Iwasaki; Masanari Takami

2003-01-01

196

Secondary injury mechanisms in traumatic spinal cord injury: a nugget of this multiply cascade.  

PubMed

The pathophysiology of acute spinal cord injury (SCI) involves primary and secondary mechanisms of injury. Though both mechanisms are involved in the neurological dysfunction in SCI most research however has focused on understanding the pathophysiology of the secondary damage and reducing the amount of delayed cell loss following SCI. Research has revealed extensive therapeutic windows in secondary injury mechanisms that could be manipulated by appropriate exogenous interventions. In contrast, primary injury to the cord happens unexpectedly, and it is associated with inevitable delays; ranging from several hours to days before care intervention is administered. Therefore, apart from achieving patient's stabilization, the therapeutic window in the primary phase of injury is essentially obliterated, and consequently inaccessible for specialized. Coupled to this, the exacerbating effect of secondary injury mechanisms has generally commenced before the specialist intervention. Hence, knowledge of secondary injury mechanisms and their intricacies are invaluable requisite for any tailored therapeutic strategy in the persistent search for a cure of SCI. There are about 25 well-established secondary injury mechanisms in SCI, and are found in bits or clusters in literature. A vast number of these articles are not open access. Besides, articles with a comprehensive catalog of these mechanisms are not readily available. This article has cataloged over twenty five identified secondary mechanisms of injury in the spinal cord in an open access portal, and is particularly versatile for starters in spinal cord injury research. PMID:21731081

Oyinbo, Charles Aidemise

2011-01-01

197

Long-lasting Involuntary Motor Activity After Spinal Cord Injury  

PubMed Central

Study Design Prospective cohort study Objective This study was designed to neurophysiologically characterize spinal motor activity during recovery from spinal cord injury (SCI). Setting University of Louisville, Louisville, Kentucky, USA. Material Twenty five consecutive acute SCI admissions were recruited for this study. Methods The American Spinal Injury Association Impairment Scale (AIS) was used to categorize injury level and severity at onset. Surface EMG recording, was carried out initially between the day of admission and 17 days post onset (6.0 ± 4.3, mean ± SD days). Follow-up recordings were performed for up to 9 months after injury. Initial AIS distribution was: 7 AIS-A; 3 AIS-B; 2 AIS-C; 13 AIS-D. Results Twelve subjects (48%) showed long-duration involuntary motor unit activation during relaxation. This activity was seen on initial examination in nine and on follow-up by three months post-injury in three others. It was seen in muscles innervated from the injury zone in 11 and caudal to the lesion in 9 subjects. This activity was independent of the presence or absence of tendon reflexes and the ability to volitionally suppress plantar stimulation elicited reflex withdrawal. Conclusions The form of involuntary activity described here is the likely result of the altered balance of excitation and inhibition reaching spinal motor neurons due to the loss of inhibitory interneurons or their reduced activation by damaged supraspinal drive and the synaptic reorganization that follows SCI. As such, this activity may be useful for monitoring the effects of neuroprotective and restorative intervention strategies in persons with SCI.

McKay, WB; Ovechkin, AV; Vitaz, TW; de Paleville, DGLTerson; Harkema, SJ

2010-01-01

198

Induction of angiopoietin-2 after spinal cord injury.  

PubMed

Angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) have opposing effects on blood vessels, with Ang-2 being mainly induced during the endothelial barrier breakdown. It is known that spinal cord injury (SCI) induces lasting decreases in Ang-1 levels, underlying endothelial barrier disruption, but the expression of Ang-2 in spinal cord injury has not been studied. We characterized Ang-2 after SCI using a clinically relevant rat model of contusion SCI. We found that SCI induces marked and persistent upregulation of Ang-2 (up to 10 weeks after SCI), which does not reflect well-characterized temporal profile of the blood-spinal cord barrier (BSCB) breakdown after SCI, and thus suggests other role(s) for Ang-2 in injured spinal cords. Furthermore, we also found that higher Ang-2 levels were associated with more successful locomotor recovery after SCI, both in SCI rats with markedly better spontaneous motor recovery and in SCI rats receiving a neuroprotective pharmacological intervention (amiloride), suggesting a beneficial role for Ang-2 in injured spinal cords. Immunocytochemical analyses revealed that Ang-2 was not induced in endothelial cells, but in perivascular and non-vascular cells labeled with glial fibrillary acidic protein (GFAP) or with chondroitin sulfate proteoglycan (NG2). Therefore, it is unlikely that induction of Ang-2 contributes to vascular dysfunction underlying functional impairment after SCI, but rather that it contributes to the beneficial pro-angiogenic and/or gliogenic processes underlying recovery processes after SCI. PMID:22020092

Durham-Lee, J C; Wu, Y; Mokkapati, V U L; Paulucci-Holthauzen, A A; Nesic, O

2011-10-04

199

A novel porcine model of traumatic thoracic spinal cord injury.  

PubMed

Spinal cord injury (SCI) researchers have predominately utilized rodents and mice for in vivo SCI modeling and experimentation. From these small animal models have come many insights into the biology of SCI, and a growing number of novel treatments that promote behavioral recovery. It has, however, been difficult to demonstrate the efficacy of such treatments in human clinical trials. A large animal SCI model that is an intermediary between rodent and human SCI may be a valuable translational research resource for pre-clinically evaluating novel therapies, prior to embarking upon lengthy and expensive clinical trials. Here, we describe the development of such a large animal model. A thoracic spinal cord injury at T10/11 was induced in Yucatan miniature pigs (20-25?kg) using a weight drop device. Varying degrees of injury severity were induced by altering the height of the weight drop (5, 10, 20, 30, 40, and 50?cm). Behavioral recovery over 12 weeks was measured using a newly developed Porcine Thoracic Injury Behavior Scale (PTIBS). This scale distinguished locomotor recovery among animals of different injury severities, with strong intra-observer and inter-observer reliability. Histological analysis of the spinal cords 12 weeks post-injury revealed that animals with the more biomechanically severe injuries had less spared white matter and gray matter and less neurofilament immunoreactivity. Additionally, the PTIBS scores correlated strongly with the extent of tissue sparing through the epicenter of injury. This large animal model of SCI may represent a useful intermediary in the testing of novel pharmacological treatments and cell transplantation strategies. PMID:23316955

Lee, Jae H T; Jones, Claire F; Okon, Elena B; Anderson, Lisa; Tigchelaar, Seth; Kooner, Paul; Godbey, Tamara; Chua, Bev; Gray, Gordon; Hildebrandt, Rhonda; Cripton, Peter; Tetzlaff, Wolfram; Kwon, Brian K

2013-01-14

200

Correlation between parameters of spinal cord impact and resultant injury.  

PubMed

It is difficult and expensive to produce and maintain animals with experimental spinal cord injuries. In order to reduce the expenditure of time, money, and animals, a method of predicting the final neurologic deficit from the mechanical parameters of the initial injury is needed. An attempt was made to ascertain the mechanical parameter(s) of a spinal cord injuring impact which best predict(s) the extent of the subsequent injury. Twelve rats were laminectomized and the spinal cords contused with an impactor which recorded force and cord surface displacement. Spinal cord lesion volume was measured after killing at 21 days. The records of displacement and force were used to generate velocity, momentum, power, and energy. The maximum values of the six descriptors of the impact were checked for linear statistical correlation with lesion volume. The nonparametric correlations of the impact descriptors with gait scores from other work were also examined. All descriptors correlated at the 1% level many times; force and displacement correlated at the 1% level most of the time. The displacement of one cord surface with respect to the other was judged to be the most useful parameter because it correlated very nearly as well as force with the subsequent measures of trauma and better than the others (but perhaps not significantly better), and because it is technically easier to measure and control. PMID:3817078

Noyes, D H

1987-03-01

201

The Acute Management of Spinal Cord Injuries: Proceedings of the Veterans Administration Spinal Cord Injury Conference (19th) Held at the Safari Hotel Convention Center, Scottsdale, Arizona, October 29-31, 1973.  

National Technical Information Service (NTIS)

Papers given at this conference considered the problem of acute management of spinal cord injuries. In particular, closed injuries of cervical, dorsal, and dorsilumbar spine and spinal cord were discussed. In addition, papers on open injuries of the spine...

L. Guttmann

1977-01-01

202

Segmental organization of spinal reflexes mediating autonomic dysreflexia after spinal cord injury  

PubMed Central

Spinal cord injuries above mid-thoracic levels can lead to a potentially life-threatening hypertensive condition termed autonomic dysreflexia that is often triggered by distension of pelvic viscera (bladder or bowel). This syndrome is characterized by episodic hypertension due to sudden, massive discharge of sympathetic preganglionic neurons in the thoracolumbar spinal cord. This hypertension is usually accompanied by bradycardia, particularly if the injury is caudal to the 2nd to 4th thoracic spinal segments. The development of autonomic dysreflexia is correlated with aberrant sprouting of peptidergic afferent fibers into the spinal cord below the injury. In particular, sprouting of nerve growth factor-responsive afferent fibers has been shown to have a major influence on dysreflexia, perhaps by amplifying the activation of disinhibited sympathetic neurons. Using a model of noxious bowel distension after complete thoracic spinal transection at the 4th thoracic segment in rats, we selectively altered C-fiber sprouting, at specified spinal levels caudal to the injury, with microinjections of adenovirus encoding the growth-promoting nerve growth factor or the growth-inhibitory semaphorin 3A. This was followed by assessment of physiological responses to colorectal distension and subsequent histology. Additionally, anterograde tract tracers were injected into the lumbosacral region to compare the extent of labeled propriospinal rostral projections in uninjured cords to those incords after complete 4th thoracic transection. In summary, over-expression of chemorepulsive semaphorin 3A impeded C-fiber sprouting in lumbosacral segments and mitigated hypertensive autonomic dysreflexia, whereas the opposite results were obtained with nerve growth factor over-expression. Furthermore, compared to naïve rats there were significantly more labeled lumbosacral propriospinal projections rostrally after thoracic injury. Collectively, our findings suggest that distension of pelvic viscera increases the excitation of expanded afferent terminals in the disinhibited lumbosacral spinal cord. This, in turn, triggers excitation and sprouting of local propriospinal neurons to relay visceral sensory stimuli and amplify the activation of sympathetic preganglionic neurons in the thoracolumbar cord, to enhance transmission in the spinal viscero-sympathetic reflex pathway. These responses are manifested as autonomic dysreflexia.

Rabchevsky, Alexander G.

2012-01-01

203

Thoracic disc herniation and spinal cord injury.  

PubMed

A 52-yr-old male developed progressive thoracic myelopathy after a fall. At laminectomy using the standard posterior approach, he was found to have a herniated thoracic disc compressing the spinal cord. Postoperatively, he was paraplegic. We had a series of three such patients. This paper discusses the problems associated with discectomy using the standard posterior approach and reviews the literature about the alternative approaches for surgical treatment available today. PMID:3179014

Hegde, S; Staas, W E

1988-10-01

204

WORK PARTICIPATION AMONG PERSONS WITH TRAUMATIC SPINAL CORD INJURY AND MENINGOMYELOCELE1  

Microsoft Academic Search

Objective: To study injury-related and individual factors as predictors of work participation in persons with traumatic and congenital spinal cord injury. Design: Cross-sectional questionnaire study. Subjects: One hundred and eighty-two persons with traumatic spinal cord injury treated in the Spinal Injuries Unit in Sahlgrenska University Hospital, Goteborg, Sweden, and 48 persons with meningomyelocele admitted to the Young Adult Teams in

Kirsi Valtonen; Ann-Katrin Karlsson; Hannu Alaranta; Eira Viikari-Juntura

2006-01-01

205

Pain as a presenting feature of acute abdomen in spinal injuries.  

PubMed

The diagnosis of acute abdomen can be difficult in patients with spinal injuries. We reviewed all the 1039 case records of patients admitted with spinal injuries to the Queen Elizabeth National Spinal Injuries Unit, Glasgow over a 7-year-period and found 5 (0.48%) cases of acute abdomen that required surgical intervention and were not caused by original injury. Their presenting signs and symptoms were analysed. Pain was found to be an unreliable symptom in these patients. PMID:12531374

Deep, Kamal; Bhalaik, Vijay

2003-01-01

206

Rodent Estrous Cycle Response to Incomplete Spinal Cord Injury, Surgical Interventions, and Locomotor Training  

Microsoft Academic Search

Estrous cycle disruption after spinal cord injury (SCI) in female rats is a common phenomenon. It remains unknown, however, if the aberrant estrous cycle is a result of an injury to the spinal cord itself or due to the general stress associated with surgical interventions. We addressed this issue by determining estrous cyclicality in female rats after a spinal cord

Prithvi K. Shah; James Song; Samuel Kim; Hui Zhong; Roland R. Roy; V. Reggie Edgerton

2011-01-01

207

A test of the 1992 International Standards for Neurological and Functional Classification of Spinal Cord Injury  

Microsoft Academic Search

This study was designed to test the 1992 International Standards for Neurological and Functional Classification of Spinal Cord Injury. One hundred and six professionals in the field of spinal cord injury attending an instructional course at the 1994 ASIA Meeting participated in the test. Participants completed a pretest and posttest in which they classified two patients who had a spinal

Michelle E Cohen; John F Ditunno Jr; William H Donovan; Frederick M Maynard Jr

1998-01-01

208

Spinal Activation of Serotonin 1A Receptors Enhances Latent Respiratory Activity After Spinal Cord Injury  

PubMed Central

Background/Objective: Hemisection of the cervical spinal cord results in paralysis of the ipsilateral hemidiaphragm. Removal of sensory feedback through cervical dorsal rhizotomy activates latent respiratory motor pathways and restores hemidiaphragm function. Because systemic administration of serotonin 1A receptor (5HT1A) agonists reversed the altered breathing patterns after spinal cord injury (SCI), we predicted that 5HT1A receptor activation after SCI (C2) would activate latent crossed motor pathways. Furthermore, because 5HT1A receptors are heavily localized to dorsal horn neurons, we predicted that spinal administration of 5HT1A agonists should also activate latent motor pathways. Methods: Hemisection of the C2 spinal cord was performed 24 to 48 hours, 1 week, or 16 weeks before experimentation. Bilateral phrenic nerve activity was recorded in anesthetized, vagotomized, paralyzed Sprague-Dawley rats, and 8-OH-DPAT (5HT1A agonist) was applied to the dorsal aspect of the cervical spinal cord (C3–C7) or injected systemically. Results: Systemic administration of 8-OH-DPAT led to a significant increase in phrenic frequency and amplitude, whereas direct application to the spinal cord increased phrenic amplitude alone. Both systemic and spinal administration of 8-OH-DPAT consistently activated latent crossed phrenic activity. 8-OH-DPAT induced a greater respiratory response in spinal injured rats compared with controls. Conclusion: The increase in crossed phrenic output after application of 8-OH-DPAT to the spinal cord suggests that dorsal horn inputs, respiratory and/or nonrespiratory, may inhibit phrenic motor output, especially after SCI. These findings support the idea that the administration of 5HT1A agonists may be a beneficial therapy in enhancing respiratory neural output in patients with SCI.

Zimmer, M. Beth; Goshgarian, Harry G

2006-01-01

209

Experimental Studies on Surgical Treatment of Avulsed Spinal Nerve Roots in Brachial Plexus Injury  

Microsoft Academic Search

This review summarises studies aiming at a surgical treatment of spinal nerve root avulsions from the spinal cord in brachial plexus lesions. After dorsal root injury, regrowth of nerve fibres into the spinal cord occurs only in the immature animal. After ventral root avulsion and subsequent implantation into the spinal cord, neuroanatomical and neurophysiological data show that motoneurons are capable

T. CARLSTEDT

1991-01-01

210

Re-expression of Locomotor Function After Partial Spinal Cord Injury  

NSDL National Science Digital Library

After a complete spinal section, quadruped mammals (cats, rats, and mice) can generally regain hindlimb locomotion on a treadmill because the spinal cord below the lesion can express locomotion through a neural circuitry termed the central pattern generator (CPG). In this review, we propose that the spinal CPG also plays a crucial role in the locomotor recovery after incomplete spinal cord injury.

G. Barriere (Universite de Montreal)

2009-04-01

211

Schwann cells in therapy of spinal cord injuries.  

PubMed

Schwann cells (SC) have a special activity in the repair processes after injury of the nervous system because of the capability of differentiation, migration, proliferation and myelinization of axons. They enhance production of numerous neurotrophic factors, thus creating a permissive environment for axonal regeneration. Experimental studies using SC in neuronal transplants showed that these cells with their basal membrane with adhesion molecules are attractive material for neural prostheses facilitating axon growth. Moreover, SC can produce stable myelin, restoring normal function of the neuron. Transplantations of SC in myelin injury have been used in animal models of multiple sclerosis, Parkinson's disease, and brain and spinal cord injuries. Because the transplanted SC have no ability to migrate within the normal nervous system, in many experiments SC derived from rat embryos were applied. Such cells migrated through normal nervous tissue and co-operated with host cells, their survival was longer, and myelin was not destroyed in multiple sclerosis. Also, fast recovery of motor activity in injured axons in rat spinal cord was observed, especially after transplantation of SC derived from skin progenitor cells or progenitor cells which have a phenotype characteristic for SC. Many authors have reported early apoptosis of transplanted SC, so a more complex repair strategy is needed that combines SC transplantation with other methods in order to achieve longer survival and optimal functional recovery following spinal cord injury. PMID:24018432

Woszczycka-Korczy?ska, Izabella; Olakowska, Edyta; Marcol, Wies?aw; Lewin-Kowalik, Joanna; J?drzejowska-Szypu?ka, Halina

2013-07-23

212

Spinal cord decompression reduces rat neural cell apoptosis secondary to spinal cord injury*  

PubMed Central

Objective: To determine whether spinal cord decompression plays a role in neural cell apoptosis after spinal cord injury. Study design: We used an animal model of compressive spinal cord injury with incomplete paraparesis to evaluate neural cell apoptosis after decompression. Apoptosis and cellular damage were assessed by staining with terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) and immunostaining for caspase-3, Bcl-2 and Bax. Methods: Experiments were conducted in male Sprague-Dawley rats (n=78) weighing 300~400 g. The spinal cord was compressed posteriorly at T10 level using a custom-made screw for 6 h, 24 h or continuously, followed by decompression by removal of the screw. The rats were sacrificed on Day 1 or 3 or in Week 1 or 4 post-decompression. The spinal cord was removed en bloc and examined at lesion site, rostral site and caudal site (7.5 mm away from the lesion). Results: The numbers of TUNEL-positive cells were significantly lower at the site of decompression on Day 1, and also at the rostral and caudal sites between Day 3 and Week 4 post-decompression, compared with the persistently compressed group. The numbers of cells between Day 1 and Week 4 were immunoreactive to caspase-3 and B-cell lymphoma-2 (Bcl-2)-associated X-protein (Bax), but not to Bcl-2, correlated with those of TUNEL-positive cells. Conclusion: Our results suggest that decompression reduces neural cell apoptosis following spinal cord injury.

Xu, Kan; Chen, Qi-xin; Li, Fang-cai; Chen, Wei-shan; Lin, Min; Wu, Qiong-hua

2009-01-01

213

Impact of multiple injuries on functional and neurological outcomes of patients with spinal cord injury  

PubMed Central

Background The effects of multiple injuries on the neurological and functional outcomes of patients with traumatic spinal cord injury (SCI) are debated—some groups have shown that subjects with multiple injuries have the same neurological and functional outcomes of those without them, whereas others have found that SCI patients with associated traumatic brain injury have worse functional status at admission and discharge and longer rehabilitation stays than patients without brain injury. Thus, the aim of this study was to compare the outcomes of SCI subjects with or without multiple injuries. Methods A total of 245 patients with a traumatic SCI during the first rehabilitation stay after the development of the lesion (202 males and 43 females; age 39.8 ± 17 years; lesion to admission time 51.1 ± 58 days) were examined on a referral basis. Patients were assessed using the following measures: American Spinal Injury Association standards, Barthel Index, Rivermead Mobility Index, and Walking Index for Spinal Cord Injury. The statistical analysis comprised Poisson regression models with relative risks and 95% confidence intervals, adjusted for the following confounders: age, sex, lesion level, and ASIA impairment scale (AIS) grade. Student’s T test was used to compare the outcomes of patients divided by AIS impairment and lesion level. Results SCI patients with and without multiple injuries differed significantly with regard to the level and completeness of the lesion. Overall, patients with multiple injuries had worse functional status at admission and discharge than monotraumatic subjects. However, when adjusted for neurological features, the populations had comparable functional and neurological status at admission and discharge and similar rates of complications and discharge destinations. The separate analysis per each level of lesion/AIS grade showed that in some groups, patients with multiple injuries had a significant longer length of stay or worse functional status at rehabilitation admission (but not at discharge) than their monotraumatic counterparts. Conclusions Multiple injuries do not affect the neurological or rehabilitative prognosis of spinal cord injuries. At discharge, patients with spinal cord injuries with and without multiple injuries achieved similar results with regard to neurological and functional improvement. Some groups of patients with multiple injuries had a longer length of stay.

2013-01-01

214

Reliability of a New Classification System for Mobility and Self-Care in Spinal Cord Injury Rehabilitation: The Spinal Cord Injury-Interventions Classification System  

Microsoft Academic Search

van Langeveld SA, Post MW, van Asbeck FW, ter Horst P, Leenders J, Postma K, Lindeman E. Reliability of a new classification system for mobility and self-care in spinal cord injury rehabilitation: the Spinal Cord Injury-Interventions Classification System.

Sacha A. van Langeveld; Marcel W. Post; Floris W. van Asbeck; Paul ter Horst; Jacqueline Leenders; Karin Postma; Eline Lindeman

2009-01-01

215

Adaptation of motor function after spinal cord injury: novel insights into spinal shock.  

PubMed

The mechanisms underlying spinal shock have not been clearly defined. At present, clinical assessment remains the mainstay to describe progression through spinal shock following traumatic spinal cord injury. However, nerve excitability studies in combination with conventional nerve conduction and clinical assessments have the potential to investigate spinal shock at the level of the peripheral axon. Therefore, peripheral motor axon excitability was prospectively and systematically evaluated in more than 400 studies of 11 patients admitted to hospital after traumatic spinal cord injury, with cord lesions above T9 (nine cervical, two thoracic). Recordings commenced within 15 days of admission from the median nerve to abductor pollicis brevis in the upper limb and the common peroneal nerve to tibialis anterior in both lower limbs, and were continued until patient discharge from hospital. Excitability was assessed using threshold tracking techniques and recordings were compared with data from healthy controls. In addition, concurrent clinical measures of strength, serum electrolytes and nerve conduction were collected. High threshold stimulus-response relationships were apparent from the early phase of spinal shock that coincided with depolarization-like features that reached a peak on Day 16.9 (± 2.7 standard error) for the common peroneal nerve and Day 11.8 (± 2.0 standard error) for the median nerve. Overall, changes in the common peroneal nerve were of greater magnitude than for the median nerve. For both nerves, the most significant changes were in threshold electrotonus, which was 'fanned in', and during the recovery cycle superexcitability was reduced (P < 0.001). However, refractoriness was increased only for the common peroneal nerve (P < 0.05). Changes in the spinal injured cohort could not be explained on the basis of an isolated common peroneal nerve palsy. By the time patients with spinal injury were discharged from hospital between Days 68 and 215, excitability for upper and lower limbs had returned towards normative values, but not for all parameters. Electrolyte levels and results for nerve conduction studies remained within normal limits throughout the period of admission. Contrary to prevailing opinion, these data demonstrate that significant changes in peripheral motor axonal excitability occur early during spinal shock, with subsequent further deterioration in axonal function, before recovery ensues. PMID:20952380

Boland, Robert A; Lin, Cindy S-Y; Engel, Stella; Kiernan, Matthew C

2010-10-15

216

Cervical spinal injury in children's community rugby football  

PubMed Central

Objective To examine the characteristics of cervical spinal injury (CSI) in school aged children injured in community based rugby football who presented to the emergency department for assessment. Methods This is a retrospective descriptive case series study reviewing the medical records of all children younger than 15 years of age who presented to the emergency department at the Children's Hospital at Westmead, Sydney, Australia for assessment of injury to the cervical spine between 2000 and 2003. Results There were 125 children with CSI; most (97%) were boys of mean age 12.7 years. Injuries occurred throughout the season, with an unexpected peak in June. Neck pain was the main presenting complaint (98%). Neurological symptoms were reported in 43%, half having concussion. Hyperextension of the neck accounted for a third of all cases and was usually the result of a spear tackle. Appropriate treatment of the cervical spine on the field of play before transport to hospital was inconsistently performed. Half of the players with CSI suffered secondary injuries, consisting of concussive head injury, faciomaxillary injury, eye injury, or limb fracture. Admission to hospital was common, with all children admitted undergoing further radiological assessment. Two minor fractures were reported and no permanent neurological disability. Overall, no adverse events were reported and the clinical outcome was good. Conclusion CSI in children playing rugby football is rarely catastrophic although often associated with other injuries. Continued efforts are needed to educate players and referees to prevent injury.

Browne, G J

2006-01-01

217

Spinal injuries from swimming and diving treated in the spinal department of Royal Perth Rehabilitation Hospital: 1956-1978  

Microsoft Academic Search

Over the past 23 years, 67 patients have been admitted with spinal cord injuries resulting from swimming and diving. These numbers comprise 10.5 per cent of all traumatic spinal cord injuries received, and 20.6 per cent of all cervical spine injuries received. Ninety-five per cent of these patients were male, and more than three-quarters were young males under the age

E R Griffiths

1980-01-01

218

Neuroprotective effects of infliximab in experimental spinal cord ischemic injury.  

PubMed

Reactive oxygen species (ROS) have been implicated in the pathogenesis of spinal cord injury after both ischemia-reperfusion (I/R) and trauma. This experimental study was designed to investigate the potential effects of infliximab, an anti-tumor necrosis factor-? agent, on I/R injury of the rabbit spinal cord. Eighteen New Zealand white rabbits were divided into three groups, each consisting of six rabbits: sham (no I/R), I/R, and infliximab (I/R + infliximab). Spinal cord ischemia was induced by applying an infrarenal aortic cross clamp for 30 minutes. At 48 hours after ischemia, animals were functionally evaluated using the Tarlov score. Changes in the spinal cord were observed by measuring tissue levels of malondialdehyde (MDA), glutathione (GSH), advanced oxidation protein products (AOPP), and superoxide dismutase (SOD) and by evaluating hematoxylin-eosin-stained sections. At 48 hours after ischemia, the Tarlov scores in the infliximab group were higher than those of the I/R group, MDA and AOPP levels in the I/R group were significantly higher than those in the sham and infliximab groups (p < 0.05), and SOD levels in the infliximab group were significantly higher than those in the I/R and sham groups (p < 0.05). The sham group had higher GSH levels than the infliximab group; however, the difference was not statistically significant (p > 0.05). Histological examination revealed that the infliximab group had significantly less vascular proliferation, edema, and neuron loss than the I/R group. These results indicate that infliximab may protect the spinal cord against injury in a rabbit I/R model. PMID:20817464

Guven, Cagatay; Borcek, Alp Ozgun; Cemil, Berker; Kurt, Gokhan; Yildirim, Zuhal; Ucankus, Nese Lortlar; Kilic, Nedret; Ceviker, Necdet

2010-12-01

219

Development and Treatments of Inflammatory Cells and Cytokines in Spinal Cord Ischemia-Reperfusion Injury  

PubMed Central

During aortic surgery, interruption of spinal cord blood flow might cause spinal cord ischemia-reperfusion injury (IRI). The incidence of spinal cord IRI after aortic surgery is up to 28%, and patients with spinal cord IRI might suffer from postoperative paraplegia or paraparesis. Spinal cord IRI includes two phases. The immediate spinal cord injury is related to acute ischemia. And the delayed spinal cord injury involves both ischemic cellular death and reperfusion injury. Inflammation is a subsequent event of spinal cord ischemia and possibly a major contributor to spinal cord IRI. However, the development of inflammatory mediators is incompletely demonstrated. And treatments available for inflammation in spinal cord IRI are insufficient. Improved understanding about spinal cord IRI and the development of inflammatory cells and cytokines in this process will provide novel therapeutic strategies for spinal cord IRI. Inflammatory cytokines (e.g., TNF-? and IL-1) may play an important role in spinal cord IRI. For treatment of several intractable autoimmune diseases (e.g., rheumatoid arthritis), where inflammatory cytokines are involved in disease progression, anti-inflammatory cytokine antagonist is now available. Hence, there is great potential of anti-inflammatory cytokine antagonist for therapeutic use of spinal cord IRI. We here review the mediators and several possibilities of treatment in spinal cord IRI.

Zhu, Ping; Li, Jia-xin; Fujino, Masayuki; Zhuang, Jian; Li, Xiao-Kang

2013-01-01

220

Catastrophic rugby injuries of the spinal cord: changing patterns of injury.  

PubMed

In reports from the UK and New Zealand, it is noted that the incidence of rugby injuries to the cervical spinal cord has dropped and that the percentage of players injured in the tackle has similarly decreased. In contrast, this does not appear to be the pattern in South Africa and an analysis has therefore been made of 40 rugby players sustaining injuries to the spinal cord during the period 1985 to 1989. The radiological appearances on admission have been correlated with the circumstances of injury, associated orthopaedic injuries and neurological deficits. The tackle was responsible for the majority of injuries, causing more than the scrum. Tackles were also responsible for more cases of complete, permanent quadriplegia than the scrum. The commonest cause of injury in players being tackled was the high tackle around the neck, while the commonest cause of injury in players making the tackle was the dive tackle. This survey has shown that the tackle is now the major cause of spinal cord injury in South African rugby, in contrast to earlier analyses in which the scrum was identified as the most common cause. PMID:1913034

Scher, A T

1991-03-01

221

Proceedings of Annual Clinical Spinal Cord Injury Conference (16th), September 27-29, 1967.  

National Technical Information Service (NTIS)

The forty-five papers, illustrations, references and discussion are reproduced. Presentations were made on spinal injuries centers in Victoria and Perth, Australia and in California. EEG patterns in sleep and wakefulness, properties of deafferented spinal...

1967-01-01

222

Activity-dependent plasticity in spinal cord injury  

PubMed Central

The adult mammalian central nervous system (CNS) is capable of considerable plasticity, both in health and disease. After spinal neurotrauma, the degrees and extent of neuroplasticity and recovery depend on multiple factors, including the level and extent of injury, postinjury medical and surgical care, and rehabilitative interventions. Rehabilitation strategies focus less on repairing lost connections and more on influencing CNS plasticity for regaining function. Current evidence indicates that strategies for rehabilitation, including passive exercise, active exercise with some voluntary control, and use of neuroprostheses, can enhance sensorimotor recovery after spinal cord injury (SCI) by promoting adaptive structural and functional plasticity while mitigating maladaptive changes at multiple levels of the neuraxis. In this review, we will discuss CNS plasticity that occurs both spontaneously after SCI and in response to rehabilitative therapies.

Lynskey, James V.; Belanger, Adam; Jung, Ranu

2008-01-01

223

Spinal Cord Injury--Past, Present, and Future  

PubMed Central

Summary: This special report traces the path of spinal cord injury (SCI) from ancient times through the present and provides an optimistic overview of promising clinical trials and avenues of basic research. The spinal cord injuries of Lord Admiral Sir Horatio Nelson, President James A. Garfield, and General George Patton provide an interesting perspective on the evolution of the standard of care for SCI. The author details the contributions of a wide spectrum of professionals in the United States, Europe, and Australia, as well as the roles of various government and professional organizations, legislation, and overall advances in surgery, anesthesia, trauma care, imaging, pharmacology, and infection control, in the advancement of care for the individual with SCI.

Donovan, William H

2007-01-01

224

Shoulder-hand syndrome in cervical spinal cord injury.  

PubMed

To characterize the occurrence of shoulder-hand syndrome (SHS) complicating the rehabilitation of patients with cervical spinal cord injury, we reviewed the medical records of 43 consecutive patients admitted to the Burke Rehabilitation Center with cervical spinal cord injury, focusing on the clinical features of SHS: shoulder pain, hand/wrist pain, edema, vasomotor changes, trophic changes and osteoporosis on x-ray. Twenty-seven patients (63%) had three or more features of SHS. The number of features correlated with age (r = 0.495, p = 0.0007), but not with the presence of upper or lower motor neuron findings in the arms, or with autonomic dysfunction. Twenty-three of 25 (92%) SHS patients with adequate follow up had satisfactory resolution of symptoms with conservative therapy (i.e. neither systemic corticosteroids nor stellate ganglion block), but only after a mean of 121 days (range 42-274 days). PMID:7527910

Aisen, P S; Aisen, M L

1994-09-01

225

Critical rehabilitation of the patient with spinal cord injury.  

PubMed

Most healthcare practitioners have worked with patients with spinal cord injury at some point in their career, for some it is a specialty. The critical care area usually only has patient with spinal cord injury for a brief time before they are transferred. More recently, there are longer intensive care unit stays due to multiple trauma and lack of insurance. Nurses must be cognizant of indications, contraindications, and best practice interventions to contribute positively to patient's long-term outcomes. As part of the multispecialty team, nurses can be pivotal in preventing secondary complications, especially pressure ulcers. Rehabilitation team members can be consulted early to provide expertise in managing this complex diagnostic group. PMID:15875447

Fries, Joyce M

226

Mitochondrial fusion and fission after spinal sacord injury in rats.  

PubMed

Responsible for orchestrating cellular energy production, mitochondria are central to the maintenance of life and the gatekeepers of cell death. Its morphology is dynamic and controlled by continual and balanced fission and fusion events. In this study, we analyzed the mitochondrial dynamics and functions after spinal cord injury in rats and further to discuss the mechanisms of the mitochondria regulated cell injury during SCI. Using adult rat spinal cord injury model, it was found that the absolute number of mitochondria per area was significantly less and the individual mitochondrial cross-sectional area was significantly greater in the neurons of rats in SCI group than in the sham-operated group at 3h and 6h after SCI, and the reverse pattern at 12h and 24h after SCI. The results from Western blot and RT-PCR assays showed that the protein and mRNA levels of mitochondrial fusion-related genes (Mfn1 and Mfn2) decreased and fission-related genes (Drp1 and Fis1) increased at 3h and 6h after SCI. At 12h and 24h after SCI the reverse pattern of Mfn1, Mfn2, Drp1 and Fis1 expression was found. Taken together the results of the present study showed the mitochondrial tendency of elongation and fusion in the injured spinal cord at 3h and 6h after SCI, and the tendency of mitochondrial fission at 12h and 24h after SCI in our SCI models of rat. These findings have important implications for our understanding of the mechanisms of mitochondrial dynamics and functions after SCI injury. And mitochondrial fusion may potentially be used as a target for improving spinal cord function in the first 6h after SCI. Mitochondrial fusion may be inhibited at 12-24h after SCI for improving functional outcomes following SCI. PMID:23727406

Cao, Yang; Lv, Gang; Wang, Yan-Song; Fan, Zhong-Kai; Bi, Yun-Long; Zhao, Liang; Guo, Zhan-Peng

2013-05-28

227

Spinal cord injury sequelae alter drug pharmacokinetics: an overview  

Microsoft Academic Search

Study design:Literature review.Objectives:Critical review of the literature published on the physiological alterations caused by spinal cord injury (SCI) and their effect on the pharmacokinetic parameters of commonly employed drugs. The review introduces the most recent treatment protocols of a variety of drugs, enabling the modern clinician to apply efficacious and cost-effective solutions to the pharmacological treatment of SCI patients.Methods:Studies published

H Mestre; T Alkon; S Salazar; A Ibarra

2011-01-01

228

A survey of spinal cord injuries resulting from sport  

Microsoft Academic Search

We surveyed 35 patients who had been admitted to the Hakone National Hospital with a traumatic spinal cord injury (SCI) resulting from sports accidents, from 1975 to 1991. There were 32 males and three females. Thirty-one patients (88.6%) under the age of 30 had been injured. The most common sport was swimming (51.4%), followed by gymnastics (22.8%). The most common

T Noguchi

1994-01-01

229

Cellular transplantation strategies for spinal cord injury and translational neurobiology  

Microsoft Academic Search

Summary  Basic science advances in spinal cord injury and regeneration research have led to a variety of novel experimental therapeutics\\u000a designed to promote functionally effective axonal regrowth and sprouting. Among these interventions are cell-based approaches\\u000a involving transplantation of neural and non-neural tissue elements that have potential for restoring damaged neural pathways\\u000a or reconstructing intraspinal synaptic circuitries by either regeneration or neuronal\\/glial

Paul J. Reier

2004-01-01

230

In Delicate Balance: Stem Cells and Spinal Cord Injury Advocacy  

Microsoft Academic Search

Spinal cord injury (SCI) is a major focus for stem cell therapy (SCT). However, the science of SCT has not been well matched\\u000a with an understanding of perspectives of persons with SCI. The online advocacy community is a key source of health information\\u000a for primary stakeholders and their caregivers. In this study, we sought to characterize the content of SCI

Sara Parke; Judy Illes

2011-01-01

231

Relation between Motorcycle Helmet Use and Cervical Spinal Cord Injury  

Microsoft Academic Search

A case-control study was conducted to determine the relationship between motorcycle helmets, including type (i.e. partial or full coverage) and fastening status (i.e. loose or firm), and cervical spinal cord injuries (SCIs) in Taiwan. Based on a nationwide registry consisting of 396 motorcycle riders with traumatic SCIs during the 4-year period from July 1992 to June 1996, 229 subjects injured

Mau-Roung Lin; Jau-Yih Tsauo; Hei-Fen Hwang; Chih-Yi Chen; Lung-Wen Tsai; Wen-Ta Chiu

2004-01-01

232

Epidemiology of spinal cord injuries in Novosibirsk, Russia  

Microsoft Academic Search

The incidence of spinal cord injuries (SCI) in Novosibirsk is 29.7 per million per year. Almost all of these SCI patients (94.3%) are hospitalized to our clinic. Over the past 5 years (since 1989), a total of 196 patients with SCI were admitted. SCI were distributed as follows: cervical, 96 patients (49.0%); thoracic, 54 (27.5%); and lumbar, 46 (23.5%). SCI

B Silberstein; S Rabinovich

1995-01-01

233

Male erectile dysfunction following spinal cord injury: a systematic review  

Microsoft Academic Search

Study design:Systematic review.Objective:To review sexuality in persons with spinal cord injuries (SCIs), and to report the effectiveness of erectile interventions.Methods:Reports from six databases (1966–2003), selected annual proceedings (1997–2002) and manufacturer's information were screened against eligibility criteria. Included reports were abstracted and data pooled from case-series reports regarding intracavernous injections and sildenafil.Results:From 2127 unique reports evaluated, 49 were included. Male sexual

D DeForge; J Blackmer; C Garritty; F Yazdi; V Cronin; N Barrowman; M Fang; V Mamaladze; L Zhang; M Sampson; D Moher

2006-01-01

234

Activity-based Therapies in Spinal Cord Injury:  

PubMed Central

This article summarizes presentations of a symposium examining the potential impact of activity-based therapies (ABT) in promoting neurological and functional recovery after spinal cord injury (SCI). The symposium addressed 3 key questions concerning activity-based therapy in SCI: (1) What clinical approaches are used? (2) Is there empirical evidence supporting efficacy of ABT in promoting neurological recovery and improving overall function, health, and quality of life? (3) What are the issues related to long-term viability of ABT?

Jones, Michael L.; Harness, Eric; Denison, Paula; Tefertiller, Candy; Evans, Nicholas; Larson, Cathy A.

2012-01-01

235

An electroactive conduit for spinal cord injury repair  

Microsoft Academic Search

Electrospun fibrous scaffolds of piezoelectric polyvinylidene fluoride-trifluoroethylene (PVDF-TrFE) were evaluated to enhance neurite extension for spinal cord injury (SCI) repair. An aligned fibrous piezoelectric scaffold was investigated in order to provide physical cues (via contact guidance) and local electrical activity to promote neuronal differentiation and neurite extension. Rat pheochromocytoma (PC12) and dorsal root ganglion explants (DRGs) were cultured on random

Y.-S. Lee; C. Ezebuiroh; C. Collins; T. L. Arinzeh

2009-01-01

236

Urinary Tract Infections in Patients with Spinal Cord Injuries  

Microsoft Academic Search

Spinal cord injuries (SCI) result in different lower urinary tract dysfunctions. Because of both the disease and the bladder\\u000a drainage method, urinary tract infections (UTIs) are one of the most frequent conditions seen in SCI patients. Diagnosis is\\u000a not always easy due to lack of symptoms. Asymptomatic bacteriuria needs no treatment. If symptoms occur, antibiotherapy is\\u000a indicated. Duration depends mainly

Frederiek D’Hondt; Karel Everaert

237

Acute Leptin Treatment Enhances Functional Recovery after Spinal Cord Injury  

Microsoft Academic Search

BackgroundSpinal cord injury is a major cause of long-term disability and has no current clinically accepted treatment. Leptin, an adipocyte-derived hormone, is best known as a regulator of food intake and energy expenditure. Interestingly, several studies have demonstrated that leptin has significant effects on proliferation and cell survival in different neuropathologies. Here, we sought to evaluate the role of leptin

Carmen María Fernández-Martos; Pau González; Francisco Javier Rodriguez

2012-01-01

238

Amitriptyline Pharmacokinetics in Experimental Spinal Cord Injury in the Rabbit  

PubMed Central

Previous studies have demonstrated that pharmacokinetic behavior of several drugs such as paracetamol, theophylline, and aminoglycosides are significantly altered in spinal cord injured patients. No pharmacokinetic study of amitriptyline has been performed in patients and experimental models of spinal cord injury. Pharmacokinetic parameters of amitriptyline in orally treated rabbits subjected to laminectomy and spinal cord injury compared with those underwent laminectomy alone. Among twenty four male rabbits were included in this study, nine of them subjected to spinal cord injury at the 8th thoracic level by knife severance method and six rabbits underwent laminectomy alone (sham group) and nine rabbits treated as control. All received a single oral dose of amitriptyline (20 mg/kg) 24 h after injury. Blood sampling were done at predetermined times to 36 h after drug administration. Amitriptyline concentration in serum samples was determined by high-performance liquid chromatography. Pharmacokinetic parameters including maximum concentration (Cmax), time to reach maximum concentration (Tmax), half life, and the area under the curve to last detectable concentration time point (AUC0-t) were directly determined from the concentration-time curve. Maximum concentration was observed at 6.5 h after administration in sham group with a concentration of 439.6 ng/ml, whereas in SCI group Tmax was at 2.7 h with a concentration of 2763.9 ng/ml. In control group it was 3.3 h and 396 ng/ml, respectively. In SCI group, AUC was 9465.6 ng.h/ml and half life was 6 h and for control group it was 2817.4 ng.h/ml and 6.4 h, respectively. Statistical analysis of data showed that SCI didn't induce significant changes in amitriptyline pharmacokinetic parameters.

Reihanikermani, H.; Ansari, M.; Soltani, A.; Meymandi, M. S.

2008-01-01

239

Therapeutic approaches for spinal cord injury induced spasticity  

Microsoft Academic Search

Spasticity is evident in both humans and animals following spinal cord injury (SCI) and can contribute to significant functional\\u000a limitation and disruption in quality of life of patients with this disorder. This mini-review describes a number of preclinical\\u000a and clinical studies that promise to improve outcomes for, especially in terms of spasticity and hyper-reflexia, patients\\u000a with SCI. A gold standard

C. C. Yates; K. Garrison; A. Charlesworth; N. B. Reese; E. Garcia-Rill

2010-01-01

240

Spinal cord injury rehabilitation: the experience of women  

Microsoft Academic Search

Study Design:Qualitative study.Objectives:To develop the knowledge base regarding women's experiences of spinal cord injury (SCI) rehabilitation.Setting:United Kingdom.Methods:Qualitative interviews with 10 women from four regional SCI rehabilitation centres were transcribed verbatim and analysed according to grounded theory.Results:The central psychosocial problem identified for women during SCI rehabilitation was vulnerability. Vulnerability was amplified by lack of privacy within the rehabilitation centre, by negative

V M Samuel; J Moses; N North; H Smith; K Thorne

2007-01-01

241

Flexion reflex modulation during stepping in human spinal cord injury  

Microsoft Academic Search

The flexion reflex modulation pattern was investigated in nine people with a chronic spinal cord injury during stepping using\\u000a body weight support on a treadmill and manual assistance by therapists. Body weight support was provided by an upper body\\u000a harness and was adjusted for each subject to promote the best stepping pattern with the least manual assistance required by\\u000a the

Maria Knikou; Claudia A. Angeli; Christie K. Ferreira; Susan J. Harkema

2009-01-01

242

Cost of spinal cord injuries caused by rollover automobile crashes  

Microsoft Academic Search

ObjectiveTo determine the reduction in direct cost for treatment of spinal cord injuries (SCI) in belted occupants involved in rollover automobile crashes in the USA that would result if severe roof intrusion were eliminated.MethodsRisk of SCI per rollover crash and by belted\\/unbelted status was calculated for roof intrusion magnitude categories using 1993–2006 National Automotive Sampling System Crashworthiness Data System (CDS)

Stephen P Burns; Robert P Kaufman; Christopher D Mack; Eileen Bulger

2010-01-01

243

A contusion model of severe spinal cord injury in rats.  

PubMed

The translational potential of novel treatments should be investigated in severe spinal cord injury (SCI) contusion models. A detailed methodology is described to obtain a consistent model of severe SCI. Use of a stereotactic frame and computer controlled impactor allows for creation of reproducible injury. Hypothermia and urinary tract infection pose significant challenges in the post-operative period. Careful monitoring of animals with daily weight recording and bladder expression allows for early detection of post-operative complications. The functional results of this contusion model are equivalent to transection models. The contusion model can be utilized to evaluate the efficacy of both neuroprotective and neuroregenerative approaches. PMID:23979022

Krishna, Vibhor; Andrews, Hampton; Jin, Xing; Yu, Jin; Varma, Abhay; Wen, Xuejun; Kindy, Mark

2013-08-17

244

Evaluation and treatment of spinal injuries in the obese patient.  

PubMed

Given the increasing incidence and severity of obesity in the adult population, orthopaedic surgeons are evaluating and treating more acutely injured obese patients. Management of obese patients is complicated given their body habitus and associated medical comorbidities. Although evaluation and treatment are almost the same as for nonobese patients, some special considerations are necessary to prevent errors in diagnosis and treatment of obese trauma patients. This article focuses on spine injuries in obese patients. Predisposition to spinal injury, effective evaluation and early management, principles of treatment planning, operative technical pearls, and postoperative management are discussed. PMID:21095437

Greenleaf, Robert M; Altman, Daniel T

2011-01-01

245

Prevention of spinal cord injury: an elementary education approach.  

PubMed

Spinal cord injury (SCI) results in permanent paralysis and most often happens to teenagers and young adults. High risk behaviors are most often the cause; therefore these injuries are often preventable. In response to a gap in existing prevention programs, an elementary age SCI prevention program was developed, designed for implementation by teachers. Evaluation was carried out via a quasi-experimental pre-post comparison group design. Experimental students demonstrated significantly improved knowledge of SCI and its prevention. Similar changes in self-reported safety belt use were not noted. Development of the curriculum, related grant activities, and plans for national dissemination are described. PMID:1744808

Richards, J S; Hendricks, C; Roberts, M

1991-10-01

246

Spinal cord injury detection and monitoring using spectral coherence.  

PubMed

In this paper, spectral coherence (SC) is used to study the somatosensory evoked potential (SEP) signals in rodent model before and after spinal cord injury (SCI). The SC technique is complemented with the Basso, Beattie, and Bresnahan (BBB) behavior analysis method to help us assess the status of the motor recovery. SC can be used to follow the effects of SCI without any preinjury baseline information. In this study, adult female Fischer rats received contusion injury at T8 level with varying impact heights using the standard New York University impactor. The results show that the average SC between forelimb and hindlimb SEP signals before injury was relatively high ( > or =0.7). Following injury, the SC between the forelimb and hindlimb SEP signals dropped to various levels ( < or =0.7) corresponding to the severity of SCI. The SC analysis gave normalized quantifiable results for the evaluation of SCI and recovery thereafter using the forelimb signals as an effective control, without the need of any baseline data. This technique solves the problems associated with the commonly used time-domain analysis like the need of a trained neurophysiologist to interpret the data and the need for baseline data. We believe that both SC and BBB may provide a comprehensive and complementary picture of the health status of the spinal cord after injury. The presented method is applicable to SCIs not affecting the forelimb SEP signals. PMID:19362907

Al-Nashash, Hasan; Fatoo, Noreen A; Mirza, Nabil N; Ahmed, Rabi I; Agrawal, Gracee; Thakor, Nitish V; All, Angelo H

2009-04-07

247

Autologous mucosal transplant in chronic spinal cord injury: an Indian Pilot Study  

Microsoft Academic Search

Study design:Prospective Pilot Study.Objectives:To determine the safety and feasibility of autologous olfactory mucosal transplantation into the spinal cord in chronic spinal cord injured using the technique developed by Carlos Lima et al.Setting:Spinal Injury Center, New Delhi.Methods:Five chronic, motor complete, traumatic spinal cord injury (SCI) patients with neurological level C5–T12 underwent the procedure. Participants were assessed at baseline and at 6

H S Chhabra; C Lima; S Sachdeva; A Mittal; V Nigam; D Chaturvedi; M Arora; A Aggarwal; R Kapur; T A H Khan

2009-01-01

248

Spinal injury considerations in the competitive diver: a case report and review of the literature  

Microsoft Academic Search

Background contextDespite significant literature associated with spinal injuries and recreational diving, few articles exist regarding competitive diving injuries, with no reports pertaining specifically to spinal injuries. As a result, a case report of a collegiate diver with C5–C6 ligamentous instability requiring operative stabilization is currently presented in addition to a review of the literature.

Brian L. Badman; Glenn R. Rechtine

2004-01-01

249

Impact of spinal cord injury on sexual health and quality of life  

Microsoft Academic Search

To provide a comprehensive insight into sexuality after spinal cord injury, 120 patients received a questionnaire to assess their sexual activities, abilities, desires, satisfaction and sexual adjustment after injury. In the 63 responding patients, spinal cord injury had a major impact on sexual function. Relationship to partner, social life, bladder management and physical well-being had a significant impact on quality

A Reitz; V Tobe; P A Knapp; B Schurch

2004-01-01

250

Extensive spontaneous plasticity of corticospinal projections after primate spinal cord injury  

Microsoft Academic Search

Although axonal regeneration after CNS injury is limited, partial injury is frequently accompanied by extensive functional recovery. To investigate mechanisms underlying spontaneous recovery after incomplete spinal cord injury, we administered C7 spinal cord hemisections to adult rhesus monkeys and analyzed behavioral, electrophysiological and anatomical adaptations. We found marked spontaneous plasticity of corticospinal projections, with reconstitution of fully 60% of pre-lesion

Ephron S Rosenzweig; Gregoire Courtine; Devin L Jindrich; John H Brock; Adam R Ferguson; Sarah C Strand; Yvette S Nout; Roland R Roy; Darren M Miller; Michael S Beattie; Leif A Havton; Jacqueline C Bresnahan; V Reggie Edgerton; Mark H Tuszynski

2010-01-01

251

Serotonergic pharmacotherapy promotes cortical reorganization after spinal cord injury.  

PubMed

Cortical reorganization plays a significant role in recovery of function after injury of the central nervous system. The neural mechanisms that underlie this reorganization may be the same as those normally responsible for skilled behaviors that accompany extended sensory experience and, if better understood, could provide a basis for further promoting recovery of function after injury. The work presented here extends studies of spontaneous cortical reorganization after spinal cord injury to the role of rehabilitative strategies on cortical reorganization. We use a complete spinal transection model to focus on cortical reorganization in response to serotonergic (5-HT) pharmacotherapy without any confounding effects from spared fibers left after partial lesions. 5-HT pharmacotherapy has previously been shown to improve behavioral outcome after SCI but the effect on cortical organization is unknown. After a complete spinal transection in the adult rat, 5-HT pharmacotherapy produced more reorganization in the sensorimotor cortex than would be expected by transection alone. This reorganization was dose dependent, extended into intact (forelimb) motor cortex, and, at least in the hindlimb sensorimotor cortex, followed a somatotopic arrangement. Animals with the greatest behavioral outcome showed the greatest extent of cortical reorganization suggesting that the reorganization is likely to be in response to both direct effects of 5-HT on cortical circuits and indirect effects in response to the behavioral improvement below the level of the lesion. PMID:23262119

Ganzer, Patrick D; Moxon, Karen A; Knudsen, Eric B; Shumsky, Jed S

2012-12-19

252

Neuroarthropathy of the hip following spinal cord injury  

PubMed Central

We present the case of a 33-year-old male who sustained a burst fracture D12 vertebrae with spinal cord injury (ASIA impairment scale A) and a right mid-diaphysial femoral shaft fracture around 1.5 years back. The patient reported 1.5 years later with a swelling over the right buttock. Arthrotomy revealed serous fluid and fragmented bone debris. The biopsy showed a normal bony architecture with no evidence of infection and malignant cells. Hence, a diagnosis of Charcot’s hip was made. Charcot’s neuroarthropathy of the feet is a well-recognized entity in the setting of insensate feet resulting from causes such as diabetes or spina bifida. Although Charcot’s disease of the hips has been described, it is uncommon in association with spinal cord injury, syphilis and even with the use of epidural injection. The present case highlights the fact that neuroarthropathy of the hip can occur in isolation in the setting of a spinal cord injury, and this can lead to considerable morbidity.

Banskota, Bibek; Bijukachhe, Binod; Kazi, ShresthaBabu; Banskota, Ashok K

2011-01-01

253

A graded forceps crush spinal cord injury model in mice.  

PubMed

Given the rising availability and use of genetically modified animals in basic science research, it has become increasingly important to develop clinically relevant models for spinal cord injury (SCI) for use in mice. We developed a graded forceps crush model of SCI in mice that uses three different forceps with spacers of 0.25, 0.4, and 0.55 mm, to produce severe, moderate, and mild injuries, respectively. Briefly, each mouse was subjected to laminectomy of T5-T7, 15-second spinal cord crush using one of those forceps, behavioral assessments, and post-mortem neuroanatomical analyses. There were significant differences among the three injury severity groups on behavioral measures (Basso Mouse Score, footprint, and ladder analyses), demonstrating an increase in neurological deficits for groups with greater injury severity. Quantitative analysis of the lesion demonstrated that as injury severity increased, lesion size and GFAP negative area increased, and spared tissue, spinal cord cross-sectional area, spared grey matter and spared white matter decreased. These measures strongly correlated with the behavioral outcomes. Similar to other studies of SCI in mice, we report a dense laminin and fibronectin positive extracellular matrix in the lesion sites of injured mice, but unlike those previous studies, we also report the presence of numerous p75 positive Schwann cells in and around the lesion epicenter. These results provide evidence that the graded forceps crush model is an attractive alternative for the study of SCI and related therapeutic interventions. Because of its demonstrated consistency, ease of use, low cost, and clinical relevance, this graded forceps crush is an attractive alternative to the other mouse models of SCI currently available. PMID:18373484

Plemel, Jason R; Duncan, Greg; Chen, Kai-Wei K; Shannon, Casey; Park, Sophia; Sparling, Joseph S; Tetzlaff, Wolfram

2008-04-01

254

Hyponatremia-induced transient visual disturbances in acute spinal cord injury  

Microsoft Academic Search

Study design: Case report and literature review.Objective: To report an unusual case of prolonged hyponatremia in acute cervical spinal cord injury complicated by visual disturbances and to review the literature regarding the issue.Settings: Spinal Cord Injury Unit in Göteborg, Sweden.Methods: Retrospective analysis of clinical charts of an individual with traumatic spinal cord injury.Results: A previously healthy 28-year-old man sustained a

A-K Karlsson; A V Krassioukov

2004-01-01

255

Access to the environment and life satisfaction after spinal cord injury  

Microsoft Academic Search

Objective: To determine the potential relation between satisfaction with life after spinal cord injury and access to the environment as measured by selected items from the Craig Handicap Assessment and Reporting Technique (CHART).Design: Prospective, correlational\\/predictive study using cross-sectional and longitudinal data from 18 Model Spinal Cord Injury Systems of Care.Subjects: Adult persons with traumatic-onset spinal cord injury (n = 650)

J. Scott Richards; Charles H. Bombardier; Denise Tate; Marcel Dijkers; Wayne Gordon; Richard Shewchuk; Michael J. DeVivo

1999-01-01

256

Characterizing Phospholipase A2-Induced Spinal Cord Injury--A Comparison with Contusive Spinal Cord Injury in Adult Rats  

PubMed Central

To assess whether phospholipase A2 (PLA2) plays a role in the pathogenesis of spinal cord injury (SCI), we compared lesions either induced by PLA2 alone or by a contusive SCI. At 24-h post-injury, both methods induced a focal hemorrhagic pathology. The PLA2 injury was mainly confined within the ventrolateral white matter, whereas the contusion injury widely affected both the gray and white matter. A prominent difference between the two models was that PLA2 induced a massive demyelination with axons remaining in the lesion area, whereas the contusion injury induced axonal damage and myelin breakdown. At 4 weeks, no cavitation was found within the PLA2 lesion, and numerous axons were myelinated by host-migrated Schwann cells. Among them, 45% of animals had early transcranial magnetic motor-evoked potential (tcMMEP) responses. In contrast, the contusive SCI induced a typical centralized cavity with reactive astrocytes forming a glial border. Only 15% of rats had early tcMMEP responses after the contusion. BBB scores were similarly reduced in both models. Our study indicates that PLA2 may play a unique role in mediating secondary SCI likely by targeting glial cells, particularly those of oligodendrocytes. This lesion model could also be used for studying demyelination and remyelination in the injured spinal cord associated with PLA2-mediated secondary SCI.

Liu, Nai-Kui; Titsworth, William Lee; Zhang, Yi Ping; Xhafa, Aurela I.; Shields, Christopher B.

2012-01-01

257

Characterizing Phospholipase A2-Induced Spinal Cord Injury-A Comparison with Contusive Spinal Cord Injury in Adult Rats.  

PubMed

To assess whether phospholipase A2 (PLA2) plays a role in the pathogenesis of spinal cord injury (SCI), we compared lesions either induced by PLA2 alone or by a contusive SCI. At 24-h post-injury, both methods induced a focal hemorrhagic pathology. The PLA2 injury was mainly confined within the ventrolateral white matter, whereas the contusion injury widely affected both the gray and white matter. A prominent difference between the two models was that PLA2 induced a massive demyelination with axons remaining in the lesion area, whereas the contusion injury induced axonal damage and myelin breakdown. At 4 weeks, no cavitation was found within the PLA2 lesion, and numerous axons were myelinated by host-migrated Schwann cells. Among them, 45% of animals had early transcranial magnetic motor-evoked potential (tcMMEP) responses. In contrast, the contusive SCI induced a typical centralized cavity with reactive astrocytes forming a glial border. Only 15% of rats had early tcMMEP responses after the contusion. BBB scores were similarly reduced in both models. Our study indicates that PLA2 may play a unique role in mediating secondary SCI likely by targeting glial cells, particularly those of oligodendrocytes. This lesion model could also be used for studying demyelination and remyelination in the injured spinal cord associated with PLA2-mediated secondary SCI. PMID:23585818

Liu, Nai-Kui; Titsworth, William Lee; Zhang, Yi Ping; Xhafa, Aurela I; Shields, Christopher B; Xu, Xiao-Ming

2011-12-01

258

Spinal cord stress injury assessment (SCOSIA): clinical applications of mechanical modeling of the spinal cord and brainstem  

NASA Astrophysics Data System (ADS)

Abnormal stretch and strain is a major cause of injury to the spinal cord and brainstem. Such forces can develop from age-related degeneration, congenital malformations, occupational exposure, or trauma such as sporting accidents, whiplash and blast injury. While current imaging technologies provide excellent morphology and anatomy of the spinal cord, there is no validated diagnostic tool to assess mechanical stresses exerted upon the spinal cord and brainstem. Furthermore, there is no current means to correlate these stress patterns with known spinal cord injuries and other clinical metrics such as neurological impairment. We have therefore developed the spinal cord stress injury assessment (SCOSIA) system, which uses imaging and finite element analysis to predict stretch injury. This system was tested on a small cohort of neurosurgery patients. Initial results show that the calculated stress values decreased following surgery, and that this decrease was accompanied by a significant decrease in neurological symptoms. Regression analysis identified modest correlations between stress values and clinical metrics. The strongest correlations were seen with the Brainstem Disability Index (BDI) and the Karnofsky Performance Score (KPS), whereas the weakest correlations were seen with the American Spinal Injury Association (ASIA) scale. SCOSIA therefore shows encouraging initial results and may have wide applicability to trauma and degenerative disease involving the spinal cord and brainstem.

Wong, Kenneth H.; Choi, Jae; Wilson, William; Berry, Joel; Henderson, Fraser C., Sr.

2009-02-01

259

Chronic neuropathic pain of spinal cord injury: What is the effectiveness of psychocomportemental management?  

Microsoft Academic Search

ObjectivesTo determine the efficacy of treating neuropathic pain in spinal cord injury (SCI) patients by psychological, cognitive or behavioral therapies and suggest recommendations for clinical practices.

D. Gault; M. Morel-Fatio; T. Albert; C. Fattal

2009-01-01

260

Spinal cord injury II: Prognostic indicators, standards of care, and clinical trials  

PubMed Central

This is the second of a 2-part review of spinal cord injury. The focus herein is to highlight recent findings regarding prognostic indicators used for spinal cord injury (SCI) in dogs, promote an awareness of the current recommendations of standard of care for traumatic spinal cord injury in veterinary medicine, and highlight the findings of clinical trials of therapies for spinal cord injury in dogs. This 2-part review provides information that will assist general and specialty veterinary practitioners in evidence-based veterinary medical practice in an area that has become particularly specialized.

Webb, Aubrey A.; Ngan, Sybil; Fowler, David

2010-01-01

261

Length of Hospital Stay in Patients with Spinal Cord Injury  

PubMed Central

Objective To provide the latest statistics about the length of hospital stay (LOS) and the number of hospitals where the patient was admitted (NHA) for patients with spinal cord injury (SCI) and to investigate the correlated demographic characteristics. Method In total, 277 patients with SCI who were members of the Korea Spinal Cord Injury Association were included in the analysis. The survey was conducted by self-completed questionnaires to collect data on LOS, NHA, and demographic variables. Results Mean LOS was 13.5±9.7 months and the mean NHA was 2.7±1.4. Patients who suffered from SCI by traffic accidents showed a longer LOS and larger NHA than those with other causes. The mean LOS for patients with traumatic SCI was longer than that whose cause of injury was disease. Patients discharged in the 2000s had a longer LOS and a larger NHA than those discharged earlier. Other factors such as gender, age at the time of injury, neurological category, and ambulation capability did not result in a significant difference in either LOS or NHA. Conclusion The mean LOS of domestic patients with SCI was longer than the values reported in foreign studies. Interestingly, neither neurological category nor functional status were related to LOS. These findings suggest that other factors such as socio-psychological factors, other than the medical state of the patient, have an effect on the LOS of patients with SCI in Korea.

Jang, Hye Jin; Park, Jieung

2011-01-01

262

A Case of Spinal Cord Injury  

NSDL National Science Digital Library

“Jason Hendrix,” a 21-year-old student majoring in economics, is injured in a serious motorcycle accident while on spring break in Florida.  Students read the short case scenario, which provides a brief clinical history of the patient and a description of his injury, then answer a set of directed questions designed to probe the students’ knowledge of the anatomy, physiology, and pathology underlying the patient’s condition. The case study has been used in both a sophomore-level course in human anatomy and physiology and a senior-level course in general physiology.

Dean, David F.

2005-01-01

263

Spinal cord injury from electrocautery: observations in a porcine model using electromyography and motor evoked potentials.  

PubMed

We have previously investigated electromyographic (EMG) and transcranial motor evoked potential (MEP) abnormalities after mechanical spinal cord injury. We now report thermally generated porcine spinal cord injury, characterized by spinal cord generated hindlimb EMG injury activity and spinal cord motor conduction block (MEP loss). Electrocautery (EC) was delivered to thoracic level dural root sleeves within 6-8 mm of the spinal cord (n = 6). Temperature recordings were made near the spinal cord. EMG and MEP were recorded by multiple gluteobiceps intramuscular electrodes before, during, and after EC. Duration of EC was titrated to an end-point of spinal motor conduction block (MEP loss). In 5/6 roots, ipsilateral EMG injury activity was induced by EC. In 4/5 roots, EMG injury activity was identified before MEP loss. In all roots, a minimum of 20 s EC and a temperature maximum of at least 57 °C at the dural root sleeve were required to induce MEP loss. Unexpectedly, conduction block was preceded by an enhanced MEP in 4/6 trials. EMG injury activity, preceding MEP loss, can be seen during near spinal cord EC. Depolarization and facilitation of lumbar motor neurons by thermally excited descending spinal tracts likely explains both hindlimb EMG and an enhanced MEP signal (seen before conduction block) respectively. A thermal mechanism may play a role in some unexplained MEP losses during intraoperative monitoring. EMG recordings might help to detect abnormal discharges and forewarn the monitorist during both mechanical and thermal injury to the spinal cord. PMID:23179021

Skinner, Stanley A; Hsu, Brian; Transfeldt, Ensor E; Mehbod, Amir A; Rippe, David M; Wu, Chunhui; Erkan, Serkan

2012-11-23

264

Prolotherapy-induced Cervical Spinal Cord Injury - A Case Report -  

PubMed Central

A 49-year-old man received prolotherapy in the upper cervical region at a local medical clinic. Immediately after the procedure, he felt a sensation resembling an electric shock in his right upper and lower extremities, and continuously complained of numbness and discomfort in the right hemibody. He visited our clinic a week later. Upon physical examination, there were no significant abnormal findings. The visual analog scale was 60 points. T2-weight magnetic resonance images of the cervical spine showed a 0.7 cm sized bright oval spot on the right side of the spinal cord at the level of C4-C5 disc, suggesting spinal cord injury. There were no definite electrodiagnostic abnormalities. Digital infrared thermal images showed moderately decreased surface temperature on lateral aspect of the right forearm and dorsum of the right hand compared with the other side. Considering that very rare complications like spinal cord injury may develop after prolotherapy, we suggest that special interventions such as prolotherapy be performed by professional experts.

Yun, Hyun-Sik; Sun, Hyung-Seok; Seon, Hyo-Jeong; Han, Jae-Young; Choi, In-Sung

2011-01-01

265

International spinal cord injury urinary tract infection basic data set.  

PubMed

Objectives:To develop an International Spinal Cord Injury (SCI) Urinary Tract Infection (UTI) Basic Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on UTIs in daily practice or research.Setting:International working group.Methods:The draft of the Data Set developed by a working group was reviewed by the Executive Committee of the International SCI Standards and Data Sets, and later by the International Spinal Cord Society (ISCoS) Scientific Committee and the American Spinal Injury Association (ASIA) Board. Relevant and interested scientific and professional (international) organizations and societies (?40) were also invited to review the data set, and it was posted on the ISCoS and ASIA websites for 3 months to allow comments and suggestions. The ISCoS Scientific Committee, Executive Committee and ASIA Board received the data set for final review and approval.Results:The International SCI UTI Basic Data Set includes the following variables: date of data collection, length of time of sign(s)/symptom(s), results of urine dipstick test for nitrite and leukocyte esterase, urine culture results and resistance pattern. The complete instructions for data collection and the data form itself are freely available on the website of ISCoS (http://www.iscos.org.uk). PMID:23896666

Goetz, L L; Cardenas, D D; Kennelly, M; Bonne Lee, B S; Linsenmeyer, T; Moser, C; Pannek, J; Wyndaele, J-J; Biering-Sorensen, F

2013-07-30

266

Catastrophic rugby injuries of the spinal cord: changing patterns of injury  

Microsoft Academic Search

In reports from the UK and New Zealand, it is noted that the incidence of rugby injuries to the cervical spinal cord has dropped and that the percentage of players injured in the tackle has similarly decreased. In contrast, this does not appear to be the pattern in South Africa and an analysis has therefore been made of 40 rugby

A T Scher

1991-01-01

267

Chronic Pain Following Spinal Cord Injury: The Role of Immunogenetics and Time of Injury Pain Treatment.  

National Technical Information Service (NTIS)

We are one-year into the three-years of our research program into the immunogenetic and drug exposure factors that contribute to chronic pain following spinal cord injury. Owing to the planned data collection timeline of the 2 studies in this program we h...

J. Clark J. Coller J. Middleton M. Hutchinson R. Marshall

2012-01-01

268

Gastric dysreflexia after acute experimental spinal cord injury in rats  

PubMed Central

Gastric reflexes are mediated mainly by vago-vagal reflex circuits in the caudal medulla. Despite the fact that brainstem vago-vagal circuitry remains intact after spinal cord injury (SCI), patients with SCI at the cervical level most often present gastric stasis with an increased risk of reflux and aspiration of gastric contents. Using a miniature strain gauge sutured to the gastric surface; we tested gastric motility and reflexive gastric relaxation following oesophageal distension (oesophageal-gastric relaxation reflex) in animals 3 days after a severe spinal contusion at either the third or ninth thoracic spinal segment (acute T3- or T9 SCI, respectively). Both basal gastric motility and the oesophageal-gastric relaxation reflex were significantly diminished in animals with T3 SCI. Conversely, both basal gastric motility and the oesophageal-gastric relaxation reflex were not significantly reduced in T9 SCI animals compared to controls. The reduced gastric motility and oesophageal-gastric reflex in T3 SCI rats was not ameliorated by celiac sympathectomy. Our results show that gastric stasis following acute SCI is independent of altered spinal sympathetic input to the stomach caudal to the lesion. Our data suggest that SCI may alter the sensitivity of vagal reflex function, perhaps by interrupting ascending spinosolitary input to brainstem vagal nuclei.

Tong, M.; Holmes, G. M.

2009-01-01

269

Fibronectin Inhibits Chronic Pain Development after Spinal Cord Injury  

PubMed Central

Abstract Chronic pain following spinal cord injury (SCI) is a highly prevalent clinical condition that is difficult to treat. Using both von Frey filaments and radiant infrared heat to assess mechanical allodynia and thermal hyperalgesia, respectively, we have demonstrated that a one-time injection of fibronectin (50??g/mL) into the spinal dorsal column (1??L/min each injection for a total of 5??L) immediately after SCI inhibits the development of mechanical allodynia (but not thermal hyperalgesia) over an 8-month observation period following spinal cord dorsal column crush (DCC). DCC will only induce mechanical Allodynia, but not thermal hyperalgesia or overt motor deficits. By applying various fibronectin fragments as well as competitive inhibitors, these effects were shown to be dependent on the connecting segment-1 (CS-1) motif of fibronectin. Furthermore, we found that acute fibronectin treatment diminished inflammation and blood–spinal cord barrier permeability, which in turn leads to enhanced fiber sparing and sprouting. In particular, the reduction of serotonin (5-HT) in the superficial dorsal horn, an important descending brainstem system in the modulation of pain, was blocked with fibronectin treatment. We conclude that treatment of SCI with fibronectin preserves sensory regulation and prevents the development of chronic allodynia, providing a potential therapeutic intervention to treat chronic pain following SCI.

Lee, Yu-Shang; Lin, Vernon W.; Silver, Jerry

2012-01-01

270

Evaluating regional blood spinal cord barrier dysfunction following spinal cord injury using longitudinal dynamic contrast-enhanced MRI  

Microsoft Academic Search

BACKGROUND: In vivo preclinical imaging of spinal cord injury (SCI) in rodent models provides clinically relevant information in translational research. This paper uses multimodal magnetic resonance imaging (MRI) to investigate neurovascular pathology and changes in blood spinal cord barrier (BSCB) permeability following SCI in a mouse model of SCI. METHODS: C57BL\\/6 female mice (n = 5) were subjected to contusive

Ilkan Tatar; Peter Cheng-te Chou; Mohamed Mokhtar Desouki; Hanaa El Sayed; Mehmet Bilgen

2009-01-01

271

A new approach to catastrophic injury: spinal cord injury patients  

Microsoft Academic Search

Catastrophic injuries and illnesses create great financial strains on patients who require lifetime care. Families, health care providers and insurers recognise that individual patient care needs require a closer look at the prudent allocation of health care benefit dollars. Blue Cross Blue Shield of Michigan has initiated an approach to this problem called ‘case management’. Two ventilator dependent quadriplegics were

S I Weingarden; J P Kuric; J G Helen; P M Graham

1989-01-01

272

Influence of spinal reflexes on the locomotor pattern after spinal cord injury.  

PubMed

In complete spinal cord injured (cSCI) subjects a shift from dominant early (60-120ms latency) to dominant late (120-450ms latency) spinal reflex (SR) components occurs over time after injury. This shift is assumed to reflect a spinal neuronal dysfunction below the level of a spinal lesion. The neuronal pathways of SR are suggested to be closely connected with spinal locomotor circuits. The aim of this study was to explore the influence of the two SR components on the electromyographic (EMG) pattern induced by assisted locomotion in cSCI subjects. Leg muscle EMG activity was analysed during assisted locomotion in both healthy and motor cSCI subjects. SR were evoked by non-noxious tibial nerve stimulation during mid-stance phase of the gait cycle. Early and late SR components had a differential influence on the locomotor pattern. In healthy and cSCI subjects with a dominant early SR component the locomotor EMG pattern was modulated in the form of a short increase in leg flexors activity in the stance phase (tibialis anterior, biceps femoris). In contrast, in chronic cSCI subjects with a dominant late SR component no activation in biceps femoris but a long-lasting activation of tibialis anterior and rectus femoris muscles during the stance phase was evoked. It is concluded that the same tibial nerve stimuli activated two different neuronal pathways, resulting in divergent interactions with spinal locomotor circuitries. It is proposed that the two SR components have different physiological roles during locomotion. PMID:21763140

Hubli, M; Dietz, V; Bolliger, M

2011-07-16

273

Biomechanical responses to open experimental spinal cord injury.  

PubMed

This study evaluates the dynamic biomechanical responses of the cat spinal cord during experimental impact injury. Temporal deformations of the laminectomized spinal cord were recorded by a high speed camera (1500-3000 frames/sec). The cinematograph revealed large deformations, the cord being compressed to half its posterior-anterior diameter 7 msec after the onset of the impact. Peak impact force produced by a 20 gm mass falling from 15 cm height (300 GCF) averaged about 1.2 pounds, and the corresponding stress acting on the dural surface reached 42 pounds per square inch (or 2200 mm Hg). Both positive and negative pressure waves were found to be propagated in the cerebrospinal fluid. PMID:1162604

Hung, T K; Albin, M S; Brown, T D; Bunegin, L; Albin, R; Jannetta, P J

1975-08-01

274

Rehabilitative training and plasticity following spinal cord injury.  

PubMed

Rehabilitative training is currently one of the most successful treatments to promote functional recovery following spinal cord injury. Nevertheless, there are many unanswered questions including the most effective and beneficial design, and the mechanisms underlying the training effects on motor recovery. Furthermore, rehabilitative training will certainly be combined with pharmacological treatments developed to promote the "repair" of the injured spinal cord. Thus, insight into training-induced mechanisms will be of great importance to fine tune such combined treatments. In this review we address current challenges of rehabilitative training and mechanisms involved in promoting motor recovery with the focus on animal models. These challenges suggest that although rehabilitative training appears to be a relatively straight forward treatment approach, more research is needed to optimize its effect on functional outcome in order to enhance our chances of success when combining pharmacological treatments promoting axonal growth and rehabilitative training in the clinic. PMID:21333646

Fouad, K; Tetzlaff, W

2011-02-17

275

Critical care management of patients with acute spinal cord injury.  

PubMed

Spinal cord injury (SCI) inevitably extends beyond neurologic consequences. The relationship between the spinal cord and its control of other organ systems make SCI management complex, requiring treatment on a multisystem approach. Patients frequently have hemodynamic instability and respiratory insufficiency secondary to the neurologic insult. Rigorous monitoring and anticipation of potential complications are essential in managing SCI, requiring a level of care provided in a neurocritical care unit. This review covers the pathophysiology, initial assessment, and stabilization in addition to acute management of cardiovascular and respiratory issues following SCI. Subsequent potential complications of deep vein thrombosis, gastrointestinal, and urinary systems and their management in the critical care setting are also addressed in this review. PMID:24091430

Lo, V; Esquenazi, Y; Han, M K; Lee, K

2013-12-01

276

Lapbelt Injuries and the Seatbelt Syndrome in Pediatric Spinal Cord Injury  

PubMed Central

Background/Objective: Approximately 250,000 patients are presently living with spinal cord injury (SCI) in the United States. Approximately 20% of patients with SCI are less than 20 years old, and 15% are less than 15 years old. The most common cause of pediatric SCI is a motor vehicle collision (MVC; ?40%); lapbelt injuries and the seatbelt syndrome are seen more often in children involved in MVCs. Methods: A search and analysis of current literature on lapbelt injuries, seatbelt syndrome, and pediatric SCI using PubMed. Results: Children involved in MVCs who are improperly restrained are at higher risk of sustaining injuries. The risk of significant intra-abdominal injuries is increased almost fourfold in these children. Presence of abdominal wall ecchymosis (AWE) was associated with intra-abdominal injuries in up to 84% of children, with hollow viscus injury being the most common. Likewise, presence of AWE is associated with vertebral fractures, including Chance fractures, in up to 50% of patients. Vertebral fractures were associated with SCI in up to 11%. The presence of AWE in an improperly restrained child should warrant a thorough search for intra-abdominal injuries, vertebral fractures, and SCI. Conclusions: Lapbelt injuries and the seatbelt syndrome are often associated with pediatric SCI in improperly restrained children. This injury complex and its associated abdominal injuries are difficult to diagnose unless a high index of suspicion is maintained; delay in diagnosis increases morbidity, and early surgical intervention should be considered.

Achildi, Olga; Betz, Randal R; Grewal, Harsh

2007-01-01

277

Optimal control of helicopter seat cushions for the reduction of spinal injuries  

Microsoft Academic Search

The theoretically optimal performance of a helicopter seat cushion for the reduction of spinal injuries during vertical crashes is investigated using a limiting performance analysis. The spinal dynamic response index and the maximum spinal compression load are used as the system performance indices to be minimized. Three types of seat cushions (passive, active, and pre-acting) are studied. A trade-off curve

Z. Q. Cheng; W. D. Pilkey; D. V. Balandin; N. N. Bolotnik; J. R. Crandall; C. G. Shaw

2001-01-01

278

Respiratory Dysfunction and Management in Spinal Cord Injury  

PubMed Central

Respiratory dysfunction is a major cause of morbidity and mortality in spinal cord injury (SCI), which causes impairment of respiratory muscles, reduced vital capacity, ineffective cough, reduction in lung and chest wall compliance, and excess oxygen cost of breathing due to distortion of the respiratory system. Severely affected individuals may require assisted ventilation, which can cause problems with speech production. Appropriate candidates can sometimes be liberated from mechanical ventilation by phrenic-nerve pacing and pacing of the external intercostal muscles. Partial recovery of respiratory-muscle performance occurs spontaneously. The eventual vital capacity depends on the extent of spontaneous recovery, years since injury, smoking, a history of chest injury or surgery, and maximum inspiratory pressure. Also, respiratory-muscle training and abdominal binders improve performance of the respiratory muscles. For patients on long-term ventilation, speech production is difficult. Often, practitioners are reluctant to deflate the tracheostomy tube cuff to allow speech production. Yet cuff-deflation can be done safely. Standard ventilator settings produce poor speech quality. Recent studies demonstrated vast improvement with long inspiratory time and positive end-expiratory pressure. Abdominal binders improve speech quality in patients with phrenic-nerve pacers. Recent data show that the level and completeness of injury and older age at the time of injury may not be related directly to mortality in SCI, which suggests that the care of SCI has improved. The data indicate that independent predictors of all-cause mortality include diabetes mellitus, heart disease, cigarette smoking, and percent-of-predicted forced expiratory volume in the first second. An important clinical problem in SCI is weak cough, which causes retention of secretions during infections. Methods for secretion clearance include chest physical therapy, spontaneous cough, suctioning, cough assistance by forced compression of the abdomen (“quad cough”), and mechanical insufflation-exsufflation. Recently described but not yet available for general use is activation of the abdominal muscles via an epidural electrode placed at spinal cord level T9-L1.

Brown, Robert; DiMarco, Anthony F; Hoit, Jeannette D; Garshick, Eric

2008-01-01

279

Combined treatment with FK506 and nerve growth factor for spinal cord injury in rats  

PubMed Central

Following spinal cord injury in rats, FK506 is able to protect local nerve tissue, promote neural regeneration, reduce neuronal apoptosis and accelerate the recovery of spinal cord functions. Nerve growth factor (NGF) is important in the regulation of central and peripheral nerve cell regeneration, growth differentiation and functions. Previous studies have shown that FK506 and NGF exhibit a synergistic effect in the treatment of peripheral nerve injury; however, it remains unclear whether the synergistic effect is present in the treatment of spinal cord injury. In this study, we combined FK506 and NGF for the treatment of spinal cord injury in rats. The NF200 protein expression in rats with spinal cord injury was determined using immunohistochemical staining and NF200 mRNA expression levels were observed using the reverse transcription-polymerase chain reaction method. The restoration of spinal cord functions was evaluated using the Basso, Beattie and Bresnahan score. The results demonstrated that the combined treatment significantly enhanced the expression of NF200 and improved spinal cord functions compared with the results of the single treatment. Our experimental observations indicated that FK506 and NGF exhibit a synergistic effect in the treatment of spinal cord injury in rats and that the combined treatment may effectively promote neural regeneration and functional recovery in rats following spinal cord injury.

CHEN, GUANG; ZHANG, ZHEN; WANG, SHOUYU; LV, DECHENG

2013-01-01

280

Curcumin improves early functional results after experimental spinal cord injury  

Microsoft Academic Search

Background  Curcumin is a polyphenol extracted from the rhizome of Curcuma longa and well known as a multifunctional drug with anti-oxidative, anticancerous, and anti-inflammatory activities. The aim of\\u000a the study was to evaluate and compare the effects of the use of the curcumin and the methylprednisolone sodium succinate (MPSS)\\u000a functionally, biochemically, and pathologically after experimental spinal cord injury (SCI).\\u000a \\u000a \\u000a \\u000a \\u000a Method  Forty rats

Berker Cemil; Kivanc Topuz; Mehmet Nusret Demircan; Gokhan Kurt; Kagan Tun; Murat Kutlay; Osman Ipcioglu; Zafer Kucukodaci

2010-01-01

281

Advances in stem cell therapy for spinal cord injury  

PubMed Central

Spinal cord injury (SCI) is a devastating condition producing great personal and societal costs and for which there is no effective treatment. Stem cell transplantation is a promising therapeutic strategy, though much preclinical and clinical research work remains. Here, we briefly describe SCI epidemiology, pathophysiology, and experimental and clinical stem cell strategies. Research in stem cell biology and cell reprogramming is rapidly advancing, with the hope of moving stem cell therapy closer to helping people with SCI. We examine issues important for clinical translation and provide a commentary on recent developments, including termination of the first human embryonic stem cell transplantation trial in human SCI.

Mothe, Andrea J.; Tator, Charles H.

2012-01-01

282

Spinal cord injury research in mice: 2008 review.  

PubMed

Spinal cord injury (SCI) is an irreversible condition causing damage to myelinated fiber tracts that carry sensation and motor signals to and from the brain. SCI is also associated with gray matter damage and often life-threatening secondary complications. This mini-review aims to provide the nonspecialist reader with a comprehensive description of recent advances made in 2008 using murine models of SCI. A variety of approaches, including advanced genetics and molecular techniques, have allowed a number of key findings in the field of secondary degeneration, repair, regeneration (including insights from peripheral nerve lesion models), metabolic dysfunctions, and pharmacological neuromodulation. PMID:19526188

Steuer, Inge; Guertin, Pierre A

2009-06-12

283

Coping in caregivers of youth with spinal cord injury.  

PubMed

This study examined coping among caregivers of youth with spinal cord injuries (SCI). Using a cross-sectional survey study design, 164 caregivers completed a demographics questionnaire and the Brief COPE. Their children, youth with SCI ages 7-18, completed the Kidcope. T-tests were conducted to examine differences in caregiver coping by demographic and injury-related factors. Further, logistic regression models were evaluated to examine predictive relationships between caregiver coping and youth coping. Several demographic and injury-related factors were related to caregiver coping, including caregiver gender, race, and education, as well as youth gender, age at injury, and time since injury. In the logistic regressions, two caregiver coping strategies were related to youth coping: caregiver self-blame coping was related to youth self-criticism, and caregiver behavioral disengagement coping (giving up attempts to cope) was related to youth blaming others coping. The findings suggest that caregiver coping may play a role in the coping of their children, and should be considered when addressing coping among youth with SCI. PMID:21861066

Dasch, Kimberly B; Russell, Heather F; Kelly, Erin H; Gorzkowski, Julie A; Mulcahey, Mary Jane; Betz, Randal R; Vogel, Lawrence C

2011-12-01

284

Reference for the 2011 revision of the international standards for neurological classification of spinal cord injury  

PubMed Central

The latest revision of the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) was available in booklet format in June 2011, and is published in this issue of the Journal of Spinal Cord Medicine. The ISNCSCI were initially developed in 1982 to provide guidelines for the consistent classification of the neurological level and extent of the injury to achieve reliable data for clinical care and research studies. This revision was generated from the Standards Committee of the American Spinal Injury Association in collaboration with the International Spinal Cord Society's Education Committee. This article details and explains the updates and serves as a reference for these revisions and clarifications.

Kirshblum, Steven C.; Waring, William; Biering-Sorensen, Fin; Burns, Stephen P.; Johansen, Mark; Schmidt-Read, Mary; Donovan, William; Graves, Daniel E.; Jha, Amitabh; Jones, Linda; Mulcahey, M. J.; Krassioukov, Andrei

2011-01-01

285

Ischemic Preconditioning Protects against Spinal Cord Ischemia-Reperfusion Injury in Rabbits by Attenuating Blood Spinal Cord Barrier Disruption  

PubMed Central

Ischemic preconditioning has been reported to protect against spinal cord ischemia-reperfusion (I-R) injury, but the underlying mechanisms are not fully understood. To investigate this, Japanese white rabbits underwent I-R (30 min aortic occlusion followed by reperfusion), ischemic preconditioning (three cycles of 5 min aortic occlusion plus 5 min reperfusion) followed by I-R, or sham surgery. At 4 and 24 h following reperfusion, neurological function was assessed using Tarlov scores, blood spinal cord barrier permeability was measured by Evan’s Blue extravasation, spinal cord edema was evaluated using the wet-dry method, and spinal cord expression of zonula occluden-1 (ZO-1), matrix metalloproteinase-9 (MMP-9), and tumor necrosis factor-? (TNF-?) were measured by Western blot and a real-time polymerase chain reaction. ZO-1 was also assessed using immunofluorescence. Spinal cord I-R injury reduced neurologic scores, and ischemic preconditioning treatment ameliorated this effect. Ischemic preconditioning inhibited I-R-induced increases in blood spinal cord barrier permeability and water content, increased ZO-1 mRNA and protein expression, and reduced MMP-9 and TNF-? mRNA and protein expression. These findings suggest that ischemic preconditioning attenuates the increase in blood spinal cord barrier permeability due to spinal cord I-R injury by preservation of tight junction protein ZO-1 and reducing MMP-9 and TNF-? expression.

Fang, Bo; Li, Xiao-Man; Sun, Xi-Jia; Bao, Na-Ren; Ren, Xiao-Yan; Lv, Huang-Wei; Ma, Hong

2013-01-01

286

Ischemic Preconditioning Protects against Spinal Cord Ischemia-Reperfusion Injury in Rabbits by Attenuating Blood Spinal Cord Barrier Disruption.  

PubMed

Ischemic preconditioning has been reported to protect against spinal cord ischemia-reperfusion (I-R) injury, but the underlying mechanisms are not fully understood. To investigate this, Japanese white rabbits underwent I-R (30 min aortic occlusion followed by reperfusion), ischemic preconditioning (three cycles of 5 min aortic occlusion plus 5 min reperfusion) followed by I-R, or sham surgery. At 4 and 24 h following reperfusion, neurological function was assessed using Tarlov scores, blood spinal cord barrier permeability was measured by Evan's Blue extravasation, spinal cord edema was evaluated using the wet-dry method, and spinal cord expression of zonula occluden-1 (ZO-1), matrix metalloproteinase-9 (MMP-9), and tumor necrosis factor-? (TNF-?) were measured by Western blot and a real-time polymerase chain reaction. ZO-1 was also assessed using immunofluorescence. Spinal cord I-R injury reduced neurologic scores, and ischemic preconditioning treatment ameliorated this effect. Ischemic preconditioning inhibited I-R-induced increases in blood spinal cord barrier permeability and water content, increased ZO-1 mRNA and protein expression, and reduced MMP-9 and TNF-? mRNA and protein expression. These findings suggest that ischemic preconditioning attenuates the increase in blood spinal cord barrier permeability due to spinal cord I-R injury by preservation of tight junction protein ZO-1 and reducing MMP-9 and TNF-? expression. PMID:23685868

Fang, Bo; Li, Xiao-Man; Sun, Xi-Jia; Bao, Na-Ren; Ren, Xiao-Yan; Lv, Huang-Wei; Ma, Hong

2013-05-17

287

Therapeutic education in persons with spinal cord injury: A review of the literature  

Microsoft Academic Search

IntroductionTherapeutic education is an integrant part of the physical medicine and rehabilitation care of persons with spinal cord injury. It is often conducted in an empirical manner. The objective of this literature review was to evaluate the state of the art regarding the evaluations and therapeutic education programs for persons with spinal cord injury.

A. Gélis; A. Stéfan; D. Colin; T. Albert; D. Gault; D. Goossens; B. Perrouin-Verbe; C. Fattal; J. Pelissier; E. Coudeyre

2011-01-01

288

Towards improved clinical and physiological assessments of recovery in spinal cord injury: a clinical initiative  

Microsoft Academic Search

Clinical practice and scientific research may soon lead to treatments designed to repair spinal cord injury. Repair is likely to be partial in the first trials, extending only one or two segments below the original injury. Furthermore, treatments that are becoming available are likely to be applied to the thoracic spinal cord to minimise loss of function resulting from damage

P H Ellaway; P Anand; E M K Bergstrom; M Catley; N J Davey; H L Frankel; A Jamous; C Mathias; A Nicotra; G Savic; D Short; S Theodorou

2004-01-01

289

Chronic spinal cord injury: management of patients in acute hospital settings  

Microsoft Academic Search

Spinal cord injury (SCI) is a lifelong condition affecting over 40,000 people in the UK. When an individual with established SCI is admitted to hospital for a procedure or because of illness, hospital teams need to manage both the acute condition and the spinal cord injury. These guidelines aim to assist in their assessment and management to avoid the common

Angela Gall; Lynne Turner; Stokes FRCP

2008-01-01

290

High-dose methylprednisolone may do more harm for spinal cord injury  

Microsoft Academic Search

Because of the National Acute Spinal Cord Injury Studies (NASCIS), high-dose methylprednisolone became the standard of care for the acute spinal cord injury. In the NASCIS, there was no mention regarding the possibility of acute corticosteroid myopathy that high-dose methylprednisolone may cause. The dosage of methylprednisolone recommended by the NASCIS 3 is the highest dose of steroids ever being used

T. Qian; D. Campagnolo; S. Kirshblum

2000-01-01

291

Musculoskeletal changes after spinal cord injury: Effects of body weight supported treadmill training  

Microsoft Academic Search

The overall focus of this thesis was musculoskeletal changes after individuals with spinal cord injury. The bulk of the thesis investigated the impact of a rehabilitation intervention, namely body weight supported treadmill training (BWSTT), on skeletal health and muscle atrophy in individuals with acute and chronic spinal cord injury (SCI). The first two studies in this thesis were methodological in

Lora Giangregorio

2004-01-01

292

MUSCULOSKELETAL CHANGES AFTER SPINAL CORD INJURY: EFFECTS OF BODY WEIGHT SUPPORTED TREADMILL TRAINING  

Microsoft Academic Search

The overall focus of this thesis was musculoskeletal changes after individuals with spinal cord injury. The bulk ofthe thesis investigated the impact of a rehabilitation intervention, namely body weight supported treadmill training (BWSTT), on skeletal health and muscle atrophy in individuals with acute and chronic spinal cord injury (SCI). The first two studies in this thesis were methodological in nature.

LORA GIANGREGORIO

2004-01-01

293

Mouse strains that lack spinal dynorphin upregulation after peripheral nerve injury do not develop neuropathic pain  

Microsoft Academic Search

Several experimental models of peripheral neuropathy show that a significant upregulation of spinal dynorphin A and its precursor peptide, prodynorphin, is a common consequence of nerve injury. A genetically modified mouse strain lacking prodynorphin does not exhibit sustained neuropathic pain after nerve injury, supporting a pronociceptive role of elevated levels of spinal dynorphin. A null mutation of the ? isoform

L. R. GARDELL; M. IBRAHIM; R. WANG; Z. WANG; M. H. OSSIPOV; T. P. MALAN JR; F Porreca; J Lai

2004-01-01

294

Basal Metabolic Rate and Autonomic Nervous System Dysfunction in Men With Spinal Cord Injury  

Microsoft Academic Search

Objectives: The purpose of this study was to determine the relationship between autonomic nervous system dysfunction and basal metabolic rate (BMR), and the effect of spasticity on basal metabolic rate.Research Method and Procedures: Twenty men (11 paraplegic and 9 tetraplegic) with American Spinal Injury Association (ASIA)-A and -B grade chronic spinal cord injury (SCI) participated in this study. Total body

Bilge Yilmaz; Evren Yasar; Salim Goktepe; Ridvan Alaca; Kamil Yazicioglu; Ugur Dal; Haydar Mohur

2007-01-01

295

Wheelchair configuration and postural alignment in persons with spinal cord injury  

Microsoft Academic Search

Hastings JD, Rogers Fanucchi E, Burns SP. Wheelchair configuration and postural alignment in persons with spinal cord injury. Arch Phys Med Rehabil 2003;84:528-34. Objective: To determine whether postural alignment and shoulder flexion range differ for persons with spinal cord injury (SCI) seated in wheelchairs with standard configurations versus wheelchairs with posterior seat inclination and a low backrest set perpendicular to

Jennifer D. Hastings; Elaine Rogers Fanucchi; Stephen P. Burns

2003-01-01

296

Foot Cooling Reduces Exercise-Induced Hyperthermia in Men with Spinal Cord Injury  

Microsoft Academic Search

HAGOBIAN, T. A., K. A. JACOBS, B. J. KIRATLI, and A. L. FRIEDLANDER. Foot Cooling Reduces Exercise-Induced Hyperthermia in Men with Spinal Cord Injury. Med. Sci. Sports Exerc., Vol. 36, No. 3, pp. 411- 417, 2004. The number of individuals with spinal cord injury (SCI) participating in sports at recreational and elite levels is on the rise. However, loss of

TODD A. HAGOBIAN; KEVIN A. JACOBS; B. JENNY KIRATLI; ANNE L. FRIEDLANDER

2004-01-01

297

Spinal Cord Injury Causes Sustained Disruption of the Blood-Testis Barrier in the Rat  

Microsoft Academic Search

There is a high incidence of infertility in males following traumatic spinal cord injury (SCI). Quality of semen is frequently poor in these patients, but the pathophysiological mechanism(s) causing this are not known. Blood-testis barrier (BTB) integrity following SCI has not previously been examined. The objective of this study was to characterize the effects of spinal contusion injury on the

Jennifer N. Dulin; Meredith L. Moore; Kevin W. Gates; Joanna H. Queen; Raymond J. Grill; Andreas Meisel

2011-01-01

298

Bilateral extracorporeal shock wave lithotripsy in a spinal cord injury patient with a cardiac pacemaker  

Microsoft Academic Search

Objectives: To review the precautions to be observed before and during extracorporeal shock wave lithotripsy (ESWL) in spinal cord injury (SCI) patients with a cardiac pacemaker and the safety of bilateral ESWL performed on the same day.Design: A case report of bilateral ESWL in a SCI patient with a permanent cardiac pacemaker.Setting: The Regional Spinal Injuries Centre, Southport, the Lithotripsy

S Vaidyanathan; R Hirst; KF Parsons; G Singh; BM Soni; T Oo; A Zaidi; JWH Watt; P Sett

2001-01-01

299

Depletion of Hematogenous Macrophages Promotes Partial Hindlimb Recovery and Neuroanatomical Repair after Experimental Spinal Cord Injury  

Microsoft Academic Search

Traumatic injury to the spinal cord initiates a series of destructive cellular processes which accentuate tissue damage at and beyond the original site of trauma. The cellular inflammatory response has been implicated as one mechanism of secondary degeneration. Of the various leukocytes present in the spinal cord after injury, macrophages predominate. Through the release of chemicals and enzymes involved in

Phillip G. Popovich; Zhen Guan; Ping Wei; Inge Huitinga; Nico van Rooijen; Bradford T. Stokes

1999-01-01

300

Protective Factors and Posttraumatic Stress Disorder in Veterans With Spinal Cord Injury  

Microsoft Academic Search

This study examined the effects of putative protective factors, including current family structure (marital status and children), level of education, and perceived social support, upon posttraumatic stress disorder (PTSD) symptomatology in veterans with spinal cord injury (SCI). Participants were 124 veterans with traumatic spinal cord injuries, recruited from SCI services at Veterans Affairs Medical Centers in the Bronx, NY, Castle

Gina Danner; Cynthia L. Radnitz

2000-01-01

301

Mothers with spinal cord injuries: Impact on marital, family, and children's adjustment  

Microsoft Academic Search

Alexander CJ, Hwang K, Sipski ML. Mothers with spinal cord injuries: impact on marital, family, and children's adjustment. Arch Phys Med Rehabil 2002;83:24-30. Objective: To evaluate how mothers with spinal cord injury (SCI) adjust to parenting, their marriages, and their families, and how their children adjust to their mothers' disability. Design: Randomized control study of mothers with SCI and their

Craig J. Alexander; Karen Hwang; Marca L. Sipski

2002-01-01

302

Impact of altered sexuality and sexual function in spinal cord injury: A review  

Microsoft Academic Search

The purpose of this article is to review the literature regarding the impact of altered sexuality and sexual function in individuals with spinal cord injuries. Dependent on both biological and psychological factors, sexual behavior and identity can be deleteriously affected by a spinal injury. The relationship of sexuality, sexual identity, and self-concept is discussed, and a distinction between sex and

Meredith E. Drench

1992-01-01

303

Theory of Planned Behaviour, Skin Care and Pressure Sores Following Spinal Cord Injury  

Microsoft Academic Search

Objectives: To use the Theory of Planned Behaviour to explore factors associated with performing skin care behaviors and the occurrence of pressure sores in people with spinal cord injury. Design: A within-group cross-sectional design was used to assess 59 people with spinal cord injury living in the community. Of these, 17 participants returned a repeat assessment allowing a longitudinal examination

R. Sheppard; P. Kennedy; C. A. Mackey

2006-01-01

304

Key Role for Pregnenolone in Combination Therapy that Promotes Recovery After Spinal Cord Injury  

Microsoft Academic Search

Controlled compressive injury to rat spinal cord was chosen to test therapies that might attenuate the progression of tissue destruction and locomotor deficits that characteristically occur after spinal injury. A highly significant reduction of damage was achieved by immediate postinjury treatment with a combination of the following: an antiinflammatory substance, indomethacin; a stimulator of cytokine secretion, bacterial lipopolysaccharide; and the

Lloyd Guth; Ziyin Zhang; Eugene Roberts

1994-01-01

305

Obesity predictors in people with chronic spinal cord injury: an analysis by injury related variables  

PubMed Central

BACKGROUND: Despite an elevated obesity risk in people with spinal cord injury (SCI), investigation on the effects of age, obesity predictors, and injury related factors is yet to be unknown within the SCI population. METHODS: Obesity predictors were measured in 162 patients. RESULTS: 27.5% of the participants were overweight and 5.6% of them were obese. Mean BMI was different between patients with tetraplegia and paraplegia (p < 0.01). More than 20% of participants had central obesity, significantly patients with higher age and time since injury. CONCLUSIONS: Significant positive relationship was found between level of injury and BMI. Participants with higher age and time since injury had higher waist circumference.

Sabour, Hadis; Javidan, Abbas Noroozi; Vafa, Mohammad Reza; Shidfar, Farzad; Nazari, Maryam; Saberi, Hooshang; Rahimi, Abbas; Razavi, Hasan Emami

2011-01-01

306

1H-MRS in spinal cord injury: acute and chronic metabolite alterations in rat brain and lumbar spinal cord  

PubMed Central

A variety of tests of sensorimotor function are used to characterize outcome after experimental spinal cord injury (SCI). These tests typically do not provide information about chemical and metabolic processes in the injured CNS. Here, we used 1H-magnetic resonance spectroscopy (MRS) to monitor long-term and short-term chemical changes in the CNS in vivo following SCI. The investigated areas were cortex, thalamus/striatum and the spinal cord distal to injury. In cortex, glutamate (Glu) decreased 1 day after SCI and slowly returned towards normal levels. The combined glutamine (Gln) and Glu signal was similarly decreased in cortex, but increased in the distal spinal cord, suggesting opposite changes of the Glu/Gln metabolites in cortex and distal spinal cord. In lumbar spinal cord, a marked increase of myo-inositol was found 3 days, 14 days and 4 months after SCI. Changes in metabolite concentrations in the spinal cord were also found for choline and N-acetylaspartate. No significant changes in metabolite concentrations were found in thalamus/striatum. Multivariate data analysis allowed separation between rats with SCI and controls for spectra acquired in cortex and spinal cord, but not in thalamus/striatum. Our findings suggest MRS could become a helpful tool to monitor spatial and temporal alterations of metabolic conditions in vivo in the brain and spinal cord after SCI. We provide evidence for dynamic temporal changes at both ends of the neuraxis, cortex cerebri and distal spinal cord, while deep brain areas appear less affected.

Erschbamer, Matthias; Oberg, Johanna; Westman, Eric; Sitnikov, Rouslan; Olson, Lars; Spenger, Christian

2011-01-01

307

Orthostatic hypotension in the first month following acute spinal cord injury  

Microsoft Academic Search

Study Design:Retrospective data analysis.Objectives:To determine prevalence of orthostatic hypotension (OH) in patients with spinal cord injury (SCI) during the acute rehabilitation period.Setting:Quaternary care spinal unit, Vancouver General Hospital, British Columbia, CanadaMethods:Eighty-nine patients with acute SCI stratified by neurological level (cervical, 55 (62%); upper thoracic, 12 (13%); lower thoracic, 22 (25%)), and graded by American Spinal Injury Association standards. Non-invasive measurement

E V Sidorov; A F Townson; M F Dvorak; B K Kwon; J Steeves; A Krassioukov

2008-01-01

308

Quercetin attenuates inflammatory processes after spinal cord injury in an animal model  

Microsoft Academic Search

Objectives:We have shown earlier that administration of the flavonoid quercetin significantly contributed to recovery of motor function after spinal cord compression injury in the adult rat. Using the same animal model, we have now designed a set of experiments to test the hypothesis that quercetin attenuates oxidative stress-related inflammatory processes early after spinal cord trauma.Methods:Mid-thoracic spinal cord compression injury in

E Schültke; R W Griebel; B H J Juurlink

2010-01-01

309

Prevalence of pressure sores in a community sample of spinal injury patients  

Microsoft Academic Search

Objectives: To estimate the point prevalence of pressure sores in a community sample of spinal cord injured patients who were followed up by a spinal injuries unit and to evaluate whether self-management strategies were associated with decreased risk of pressure sores.Setting: A regional spinal injuries unit, UK.Design: Postal questionnaire survey. Main outcome measure: Presence of pressure sores.Subjects: All patients who

P. Raghavan; W. A. Raza; Y. S. Ahmed; M. A. Chamberlain

2003-01-01

310

Magnesium sulfate treatment in experimental spinal cord injury: emphasis on vascular changes and early clinical results  

Microsoft Academic Search

Injury to the spinal cord results in disruption of neurons, cell membranes, axons, myelin, and endothelial cells. The aim\\u000a of this study was to demonstrate the protective effect of magnesium sulfate on the blood-spinal cord barrier after acute spinal\\u000a cord injury (SCI). This experiment was conducted in two parts. In the first, rats were injected intravenously with Evans blue\\u000a 2 h

Erkan Kaptanoglu; Etem Beskonakli; Ihsan Solaroglu; Asuman Kilinc; Yamac Taskin

2003-01-01

311

Transfer and reprogramming of neural stem cells in spinal cord injury  

Microsoft Academic Search

Spinal cord injury affects 11.000 Europeans\\/year and there are 300.000 victims in Europe. Two decades ago, repair of the spinal cord was regarded as an impossible task. This gloomy outlook is slowly yielding to cautious optimism. To protect from secondary damage, replace and repair what has been lost, cell and tissue grafting strategies have shown promise. Injury to the spinal

Lars Olson

312

Functional outcome of patients with spinal cord injury: rehabilitation outcome study  

Microsoft Academic Search

Objective: To increase our knowledge of neurological recovery and functional outcome of patients with spinal cord injuries in order to make more successful rehabilitation programmes based on realistic goals.Design: Descriptive analysis of data gathered in an information system.Setting: Rehabilitation centre in The Netherlands with special department for patients with spinal cord injuries.Subjects: Fifty-five patients with traumatic spinal cord lesions admitted

M C Schönherr; J W Groothoff; G A Mulder; W H Eisma

1999-01-01

313

Inflammation and apoptosis: linked therapeutic targets in spinal cord injury.  

PubMed

The secondary cascade of cell death that follows central nervous system (CNS) injury or ischemia has long been considered a target for neuroprotective agents aimed at sparing tissue and function. Recently, several laboratories have shown remarkable protection and recovery of function in rodent models of spinal cord injury using treatments that target components of the CNS inflammatory response. The use of minocycline, an antibiotic that reduces microglial activation, antibody blockade of the CD95 (FAS) ligand and the blockade of glycosphingolipid-induced iNOS (inducible nitric oxide synthase) have recently been shown to reduce neuronal and glial apoptosis with concomitant improvement in neurological function, and appear to enhance the efficacy of cell transplantation strategies. PMID:15567326

Beattie, Michael S

2004-12-01

314

The impact of spinal cord injury on breathing during sleep.  

PubMed

The prevalence of sleep disordered breathing (SDB) following spinal cord injury (SCI) is considerably greater than in the general population. While the literature on this topic is still relatively small, and in some cases contradictory, a few general conclusions can be drawn. First, while both central and obstructive sleep apnea (OSA) has been reported after SCI, OSA appears to be more common. Second, SDB after SCI likely reflects a complex interplay between multiple factors including body mass, lung volume, autonomic function, sleep position, and respiratory neuroplasticity. It is not yet possible to pinpoint a "primary factor" which will predispose an individual with SCI to SDB, and the underlying mechanisms may change during progression from acute to chronic injury. Given the prevalence and potential health implications of SDB in the SCI population, we suggest that additional studies aimed at defining the underlying mechanisms are warranted. PMID:23791824

Fuller, David D; Lee, Kun-Ze; Tester, Nicole J

2013-06-17

315

Respiratory Management in the Patient with Spinal Cord Injury  

PubMed Central

Spinal cord injuries (SCIs) often lead to impairment of the respiratory system and, consequently, restrictive respiratory changes. Paresis or paralysis of the respiratory muscles can lead to respiratory insufficiency, which is dependent on the level and completeness of the injury. Respiratory complications include hypoventilation, a reduction in surfactant production, mucus plugging, atelectasis, and pneumonia. Vital capacity (VC) is an indicator of overall pulmonary function; patients with severely impaired VC may require assisted ventilation. It is best to proceed with intubation under controlled circumstances rather than waiting until the condition becomes an emergency. Mechanical ventilation can adversely affect the structure and function of the diaphragm. Early tracheostomy following short orotracheal intubation is probably beneficial in selected patients. Weaning should start as soon as possible, and the best modality is progressive ventilator-free breathing (PVFB). Appropriate candidates can sometimes be freed from mechanical ventilation by electrical stimulation. Respiratory muscle training regimens may improve patients' inspiratory function following a SCI.

Galeiras Vazquez, Rita; Rascado Sedes, Pedro; Montoto Marques, Antonio; Ferreiro Velasco, M. Elena

2013-01-01

316

Memokath® stents for the treatment of detrusor sphincter dyssynergia (DSD) in men with spinal cord injury: The Princess Royal Spinal Injuries Unit 10-year experience  

Microsoft Academic Search

Study design:Medical records review.Objective:To assess the effectiveness of the Memokath (Engineers & Doctors A\\/S, Denmark) thermosensitive stent as a ‘nondestructive’ means of reducing bladder outlet resistance by treating detrusor sphincter dyssynergia (DSD) of neurogenic bladder dysfunction associated with spinal cord injury.Setting:Spinal Injuries Unit, Sheffield, England.Methods:A medical records review was performed to examine our experience of Memokaths over the last 10

S S Mehta; P R Tophill

2006-01-01

317

A population-based study comparing traumatic spinal cord injury and non-traumatic spinal cord injury using a national rehabilitation database  

Microsoft Academic Search

Study design:A limitation of many studies of non-traumatic spinal cord injury (NT-SCI) and traumatic spinal cord injury (T-SCI) is potential lack of generalizability because of selection bias. An open cohort study using a national rehabilitation database was planned to address this.Objective:To compare the demographic characteristics and outcomes between NT-SCI and T-SCI patients.Setting:Rehabilitation hospitals in Australia.Methods:The Australasian Rehabilitation Outcomes Centre maintains

P W New; F Simmonds; T Stevermuer

2011-01-01

318

Traumatic Spinal Cord Injuries in Horseback Riding: A 35Year Review  

Microsoft Academic Search

Background: Spinal cord injury (SCI) is a potentially disabling neurologic injury that can occur in horseback riding. To date, no published study has examined the epidemiology of SCI from horseback riding in the United States, and few international studies exist on this topic. Several studies have described traumatic brain injuries, spine fractures, and extremity injuries; however, SCI patterns and outcomes

Cindy Y. Lin; Jerry Wright; Tamara Bushnik; Kazuko Shem

2011-01-01

319

Forced vital capacity in two large outpatient populations with chronic spinal cord injury  

Microsoft Academic Search

Objective: To determine the expected vital capacity in persons with chronic spinal cord injury (SCI) in relation to injury level, completeness of injury, smoking and duration of injury, as an aid to diagnosis and management of respiratory complications.Setting: A New York City veterans' hospital and a Los Angeles public rehabilitation hospital.Methods: Case series from the two hospitals were pooled. Participants

WS Linn; AM Spungen; RH Adkins; A Bauman; RL Waters

2001-01-01

320

Predictors of mortality in veterans with traumatic spinal cord injury.  

PubMed

Study design:Retrospective.Objectives:To determine the predictors of mortality in veterans with traumatic spinal cord injury (tSCI).Setting:Tertiary clinic in the state of Oklahoma.Methods:One hundred and forty-seven patients with tSCI who were enrolled in our Spinal Cord Injury program from 1 January 2000 to 31 December 2011 were retrospectively studied. The study sample was divided into two groups, based on the survival status by 31 December 2011.Results:In this sample of 147 patients with tSCI, survival at the end of the 12-year study period was 60%. There were three major causes of death: infection-related, such as pneumonia (21%), urinary infection (14%), and infection of the pressure ulcers (11%); cardiovascular-related, such as congestive heart failure (16%), coronary arterial disease (13%), and atrial fibrillation (2%); and cancer-related (16%). In veterans with complete SCI, deaths were mainly infection-related and occurred in the hospital (51%), while deaths in veterans with incomplete SCI were primarily cardiovascular and cancer-related and occurred in the community. A Cox regression analysis showed the age at the time of injury to be the main predictor of SCI-related mortality.Conclusion:This study suggests that an older age at the time of injury is a significant predictor of mortality following tSCI with patients more likely to die from cardiovascular deaths than the general population. These findings support the need for preventative strategies, including a focus on cardiovascular risk factor management, in order to decrease long-term mortality. PMID:23896672

Rabadi, M H; Mayanna, S K; Vincent, A S

2013-07-30

321

Low-dose methotrexate reduces peripheral nerve injury-evoked spinal microglial activation and neuropathic pain behavior in rats  

Microsoft Academic Search

Peripheral nerve injuries that provoke neuropathic pain are associated with microglial activation in the spinal cord. We have investigated the characteristics of spinal microglial activation in three distinct models of peripheral neuropathic pain in the rat: spared nerve injury (SNI), chronic constriction injury, and spinal nerve ligation. In all models, dense clusters of cells immunoreactive for the microglial marker CD11b

Joachim Scholz; Andrea Abele; Claudiu Marian; Annett Häussler; Teri A. Herbert; Clifford J. Woolf; Irmgard Tegeder

2008-01-01

322

Cellular transplantation strategies for spinal cord injury and translational neurobiology.  

PubMed

Basic science advances in spinal cord injury and regeneration research have led to a variety of novel experimental therapeutics designed to promote functionally effective axonal regrowth and sprouting. Among these interventions are cell-based approaches involving transplantation of neural and non-neural tissue elements that have potential for restoring damaged neural pathways or reconstructing intraspinal synaptic circuitries by either regeneration or neuronal/glial replacement. Notably, some of these strategies (e.g., grafts of peripheral nerve tissue, olfactory ensheathing glia, activated macrophages, marrow stromal cells, myelin-forming oligodendrocyte precursors or stem cells, and fetal spinal cord tissue) have already been translated to the clinical arena, whereas others have imminent likelihood of bench-to-bedside application. Although this progress has generated considerable enthusiasm about treating what once was thought to be a totally incurable condition, there are many issues to be considered relative to treatment safety and efficacy. The following review reflects on different experimental applications of intraspinal transplantation with consideration of the underlying pathological, pathophysiological, functional, and neuroplastic responses to spinal trauma that such treatments may target along with related issues of procedural and biological safety. The discussion then moves to an overview of ongoing and completed clinical trials to date. The pros and cons of these endeavors are considered, as well as what has been learned from them. Attention is primarily directed at preclinical animal modeling and the importance of patterning clinical trials, as much as possible, according to laboratory experiences. PMID:15717046

Reier, Paul J

2004-10-01

323

Cellular Transplantation Strategies for Spinal Cord Injury and Translational Neurobiology  

PubMed Central

Summary: Basic science advances in spinal cord injury and regeneration research have led to a variety of novel experimental therapeutics designed to promote functionally effective axonal regrowth and sprouting. Among these interventions are cell-based approaches involving transplantation of neural and non-neural tissue elements that have potential for restoring damaged neural pathways or reconstructing intraspinal synaptic circuitries by either regeneration or neuronal/glial replacement. Notably, some of these strategies (e.g., grafts of peripheral nerve tissue, olfactory ensheathing glia, activated macrophages, marrow stromal cells, myelin-forming oligodendrocyte precursors or stem cells, and fetal spinal cord tissue) have already been translated to the clinical arena, whereas others have imminent likelihood of bench-to-bedside application. Although this progress has generated considerable enthusiasm about treating what once was thought to be a totally incurable condition, there are many issues to be considered relative to treatment safety and efficacy. The following review reflects on different experimental applications of intraspinal transplantation with consideration of the underlying pathological, pathophysiological, functional, and neuroplastic responses to spinal trauma that such treatments may target along with related issues of procedural and biological safety. The discussion then moves to an overview of ongoing and completed clinical trials to date. The pros and cons of these endeavors are considered, as well as what has been learned from them. Attention is primarily directed at preclinical animal modeling and the importance of patterning clinical trials, as much as possible, according to laboratory experiences.

Reier, Paul J.

2004-01-01

324

Autonomic dysreflexia causes chronic immune suppression after spinal cord injury.  

PubMed

Autonomic dysreflexia (AD), a potentially dangerous complication of high-level spinal cord injury (SCI) characterized by exaggerated activation of spinal autonomic (sympathetic) reflexes, can cause pulmonary embolism, stroke, and, in severe cases, death. People with high-level SCI also are immune compromised, rendering them more susceptible to infectious morbidity and mortality. The mechanisms underlying postinjury immune suppression are not known. Data presented herein indicate that AD causes immune suppression. Using in vivo telemetry, we show that AD develops spontaneously in SCI mice with the frequency of dysreflexic episodes increasing as a function of time postinjury. As the frequency of AD increases, there is a corresponding increase in splenic leucopenia and immune suppression. Experimental activation of spinal sympathetic reflexes in SCI mice (e.g., via colorectal distension) elicits AD and exacerbates immune suppression via a mechanism that involves aberrant accumulation of norepinephrine and glucocorticoids. Reversal of postinjury immune suppression in SCI mice can be achieved by pharmacological inhibition of receptors for norepinephrine and glucocorticoids during the onset and progression of AD. In a human subject with C5 SCI, stimulating the micturition reflex caused AD with exaggerated catecholamine release and impaired immune function, thus confirming the relevance of the mouse data. These data implicate AD as a cause of secondary immune deficiency after SCI and reveal novel therapeutic targets for overcoming infectious complications that arise due to deficits in immune function. PMID:23926252

Zhang, Yi; Guan, Zhen; Reader, Brenda; Shawler, Todd; Mandrekar-Colucci, Shweta; Huang, Kun; Weil, Zachary; Bratasz, Anna; Wells, Jonathan; Powell, Nicole D; Sheridan, John F; Whitacre, Caroline C; Rabchevsky, Alexander G; Nash, Mark S; Popovich, Phillip G

2013-08-01

325

Vascular Endothelial Growth Factor and Spinal Cord Injury Pain  

PubMed Central

Abstract Vascular endothelial growth factor (VEGF)-A mRNA was previously identified as one of the significantly upregulated transcripts in spinal cord injured tissue from adult rats that developed allodynia. To characterize the role of VEGF-A in the development of pain in spinal cord injury (SCI), we analyzed mechanical allodynia in SCI rats that were treated with either vehicle, VEGF-A isoform 165 (VEGF165), or neutralizing VEGF165-specific antibody. We have observed that exogenous administration of VEGF165 increased both the number of SCI rats that develop persistent mechanical allodynia, and the level of hypersensitivity to mechanical stimuli. Our analysis identified excessive and aberrant growth of myelinated axons in dorsal horns and dorsal columns of chronically injured spinal cords as possible mechanisms for both SCI pain and VEGF165-induced amplification of SCI pain, suggesting that elevated endogenous VEGF165 may have a role in the development of allodynia after SCI. However, the neutralizing VEGF165 antibody showed no effect on allodynia or axonal sprouting after SCI. It is possible that another endogenous VEGF isoform activates the same signaling pathway as the exogenously-administered 165 isoform and contributes to SCI pain. Our transcriptional analysis revealed that endogenous VEGF188 is likely to be the isoform involved in the development of allodynia after SCI. To the best of our knowledge, this is the first study to suggest a possible link between VEGF, nonspecific sprouting of myelinated axons, and mechanical allodynia following SCI.

Sundberg, Laura M.; Herrera, Juan J.; Mokkapati, Venkata U.L.; Lee, Julieann; Narayana, Ponnada A.

2010-01-01

326

Electrical stimulation of spared corticospinal axons augments connections with ipsilateral spinal motor circuits after injury.  

PubMed

Activity-dependent competition shapes corticospinal (CS) axon outgrowth in the spinal cord during development. An important question in neural repair is whether activity can be used to promote outgrowth of CS axons in maturity. After injury, spared CS axons sprout and make new connections, but often not enough to restore function. We propose that electrically stimulating spared axons after injury will enhance sprouting and strengthen connections with spinal motor circuits. To study the effects of activity, we electrically stimulated CS tract axons in the medullary pyramid. To study the effects of injury, one pyramid was lesioned. We studied sparse ipsilateral CS projections of the intact pyramid as a model of the sparse connections preserved after CNS injury. We determined the capacity of CS axons to activate ipsilateral spinal motor circuits and traced their spinal projections. To understand the separate and combined contributions of injury and activity, we examined animals receiving stimulation only, injury only, and injury plus stimulation. Both stimulation and injury alone strengthened CS connectivity and increased outgrowth into the ipsilateral gray matter. Stimulation of spared axons after injury promoted outgrowth that reflected the sum of effects attributable to activity and injury alone. CS terminations were densest within the ventral motor territories of the cord, and connections in these animals were significantly stronger than after injury alone, indicating that activity augments injury-induced plasticity. We demonstrate that activity promotes plasticity in the mature CS system and that the interplay between activity and injury preferentially promotes connections with ventral spinal motor circuits. PMID:18077691

Brus-Ramer, Marcel; Carmel, Jason B; Chakrabarty, Samit; Martin, John H

2007-12-12

327

White Paper: A helmet for prevention and mitigation of spinal column and spinal cord injuries in Head First Impacts  

Microsoft Academic Search

Introduction & Background: Head first impacts can cause some devastating injuries to the cervical spine. In the worst cases cervical spine fracture and injury to the spinal cord can occur leaving those afflicted paralyzed for life. Transportation accidents and sporting events are two of the most common situations for head-first impacts and in many of these activities helmets are worn.

T. S. Nelson; P. A. Cripton

2008-01-01

328

A 10-year population survey of spinal trauma and spinal cord injuries after road accidents in the Rhône area.  

PubMed

Fatalities or injuries following motorized and non-motorized vehicle accidents (MNMVA) are reported by police or health care systems. However, limited data exist for spinal injuries. Using an epidemiological database of road accidents occurring in a defined geographic area, we measured the incidence of major spinal trauma (MST, Abbreviated Injury Scale [AIS] score 2 or more), spinal cord injury (SCI, AIS score 4 or more), and associated lesions over a 10-year period (1997-2006). Among the 97,341 victims included, 21,623 (22.2%) suffered spinal trauma, but only 1523 (1.6%) and 144 (0.2%) sustained an MST or SCI, respectively, and among those 10% and 43% died, respectively, before reaching hospital facilities. Men were more likely to have SCI and die. Cervical injuries were more frequently observed for SCI (58%) than for MST (39%; p < 0.001). Motorcyclists were overrepresented in SCI (33%) compared to MST (21%; p < 0.001), and were at significant risk for fatality. Non-restrained car occupants were at risk of MST and SCI, whereas motorcyclists wearing helmets were not. The chest was the most frequently-injured body region. Nearly half of MNMVA victims suffering SCI die quickly after the crash. Young age, male gender, a motorcyclist, and non-restrained car occupant were risk factors for serious injury. These groups should be targeted in specific programs to decrease fatalities, spinal trauma, and SCI after MNMVA. PMID:20233040

Lieutaud, Thomas; Ndiaye, Amina; Frost, Fanny; Chiron, Mireille

2010-06-01

329

Granulocyte colony-stimulating factor improves alternative activation of microglia under microenvironment of spinal cord injury.  

PubMed

Granulocyte colony-stimulating factor (G-CSF) was investigated in the present study to examine whether it could affect the activation status of microglia under microenvironment of spinal cord injury and provide a potential therapeutic treatment for spinal cord injury. We established mouse spinal cord hemisection model and injected recombinant human G-CSF (rhG-CSF) subcutaneously. The results demonstrated that G-CSF could recruit microglia to the injury site in the first 72h after spinal cord injury. Moreover, G-CSF inhibits the expression of pro-inflammatory factors and promotes the expression of neurotrophic factors. Additionally, G-CSF also increases the expression of markers of M2 macrophage and inhibits the expression of markers of M1 macrophage in BV2 microglia in vitro model, favoring the M2 polarization of microglia under the microenvironment of spinal cord hemisection. NF?B signal pathway was involved in G-CSF-induced polarization of BV2 microglia. As a conclusion, we suggested that administration of G-CSF within the first 72h after spinal cord injury might reduce early inflammation-induced detrimental effect and promote an anti-inflammatory response that favors repair via improving alternative activation of microglia. Administration of G-CSF in the acute phase of spinal cord injury may be a promising strategy in restorative therapy after spinal cord injury. PMID:23419550

Guo, Y; Zhang, H; Yang, J; Liu, S; Bing, L; Gao, J; Hao, A

2013-02-16

330

Spinal cord injuries in older children: is there a role for high-dose methylprednisolone?  

PubMed

We present a retrospective case series of 15 children (aged 8-16 years) with blunt traumatic spinal cord injury who were treated with methylprednisolone as per the National Acute Spinal Cord Injury Study protocol. Of all patients, 12 (80%) were male. Causes were sports injuries (n = 9), motor vehicle crashes (n = 2), and falls (n = 4). Most injuries were nonskeletal (n = 14), and all patients had incomplete injury of the spinal cord. The most common location of tenderness was cervical (n = 7). Of the 15 patients, methylprednisolone was initiated within 3 hours in 13 patients and between 3 and 8 hours in 2 patients. All patients received the medication for 23 hours as per the National Acute Spinal Cord Injury Study protocol. Of the 15 patients, 13 recovered completely by 24 hours and were discharged with a diagnosis of spinal cord concussion. One patient had compression fracture of T5 and T3-T5 spinal contusion but no long-term neurological deficit. One patient was discharged with diagnosis of C1-C3 spinal cord contusion (by magnetic resonance imaging) and had partial recovery at 2 years after injury. All patients with a diagnosis of cord concussion had normal plain films of the spine and computed tomographic and magnetic resonance imaging findings. None of the patients had any associated major traumatic injuries to other organ systems. The high-dose steroid therapy did not result in any serious bacterial infections. PMID:22158284

Arora, Bhawana; Suresh, Srinivasan

2011-12-01

331

'Crashing' the rugby scrum -- an avoidable cause of cervical spinal injury. Case reports.  

PubMed

Deliberate crashing of the opposing packs prior to a rugby scrum is an illegal but commonly practised manoeuvre which can lead to abnormal flexion forces being applied to players in the front row, with resultant cervical spine and spinal cord injury. Two cases of cervical spinal cord injury sustained in this manner are presented. The mechanism of injury, the forces involved and preventive measures are discussed. PMID:7089756

Scher, A T

1982-06-12

332

Role of electrical stimulation for rehabilitation and regeneration after spinal cord injury: an overview  

Microsoft Academic Search

Structural discontinuity in the spinal cord after injury results in a disruption in the impulse conduction resulting in loss\\u000a of various bodily functions depending upon the level of injury. This article presents a summary of the scientific research\\u000a employing electrical stimulation as a means for anatomical or functional recovery for patients suffering from spinal cord\\u000a injury. Electrical stimulation in the

Samar Hamid; Ray Hayek

2008-01-01

333

Spinal cord compression injury in the mouse: presentation of a model including assessment of motor dysfunction  

Microsoft Academic Search

The purpose of this study was to develop a spinal cord injury model in the mouse. Various degrees of extradural compression\\u000a were used to induce mild, moderate or severe compression injuries. Furthermore, a locomotor rating scale was developed by\\u000a which the functional outcome of the spinal cord injury could be assessed. The introduction of such a model will be useful

Mohammad Farooque

2000-01-01

334

Improved rat spinal cord injury model using spinal cord compression by percutaneous method  

PubMed Central

Here, percutaneous spinal cord injury (SCI) methods using a balloon catheter in adult rats are described. A balloon catheter was inserted into the epidural space through the lumbosacral junction and then inflated between T9-T10 for 10min under fluoroscopic guidance. Animals were divided into three groups with respect to inflation volume: 20 µL (n = 18), 50 µL (n = 18) and control (Fogarty catheter inserted but not inflated; n = 10). Neurological assessments were then made based on BBB score, magnetic resonance imaging and histopathology. Both inflation volumes produced complete paralysis. Gradual recovery of motor function occurred when 20 µL was used, but not after 50 µL was applied. In the 50 µL group, all gray and white matter was lost from the center of the lesion. In addition, supramaximal damage was noted, which likely prevented spontaneous recovery. This percutaneous spinal cord compression injury model is simple, rapid with high reproducibility and the potential to serve as a useful tool for investigation of pathophysiology and possible protective treatments of SCI in vivo.

Chung, Wook-Hun; Lee, Jae-Hoon; Chung, Dai-Jung; Yang, Wo-Jong; Lee, A-Jin; Choi, Chi-Bong; Chang, Hwa-Seok; Kim, Dae-Hyun; Chung, Hyo Jin; Suh, Hyun Jung; Hwang, Soo-Han; Han, Hoon; Do, Sun Hee

2013-01-01

335

Improved rat spinal cord injury model using spinal cord compression by percutaneous method.  

PubMed

Here, percutaneous spinal cord injury (SCI) methods using a balloon catheter in adult rats are described. A balloon catheter was inserted into the epidural space through the lumbosacral junction and then inflated between T9-T10 for 10min under fluoroscopic guidance. Animals were divided into three groups with respect to inflation volume: 20 ?L (n = 18), 50 ?L (n = 18) and control (Fogarty catheter inserted but not inflated; n = 10). Neurological assessments were then made based on BBB score, magnetic resonance imaging and histopathology. Both inflation volumes produced complete paralysis. Gradual recovery of motor function occurred when 20 ?L was used, but not after 50 ?L was applied. In the 50 ?L group, all gray and white matter was lost from the center of the lesion. In addition, supramaximal damage was noted, which likely prevented spontaneous recovery. This percutaneous spinal cord compression injury model is simple, rapid with high reproducibility and the potential to serve as a useful tool for investigation of pathophysiology and possible protective treatments of SCI in vivo. PMID:23820159

Chung, Wook-Hun; Lee, Jae-Hoon; Chung, Dai-Jung; Yang, Wo-Jong; Lee, A-Jin; Choi, Chi-Bong; Chang, Hwa-Seok; Kim, Dae-Hyun; Chung, Hyo Jin; Suh, Hyun Jung; Hwang, Soo-Han; Han, Hoon; Do, Sun Hee; Kim, Hwi-Yool

2013-06-28

336

Sensory Stimulation Prior to Spinal Cord Injury Induces Post-Injury Dysesthesia in Mice  

PubMed Central

Abstract Chronic pain and dysesthesias are debilitating conditions that can arise following spinal cord injury (SCI). Research studies frequently employ rodent models of SCI to better understand the underlying mechanisms and develop better treatments for these phenomena. While evoked withdrawal tests can assess hypersensitivity in these SCI models, there is little consensus over how to evaluate spontaneous sensory abnormalities that are seen in clinical SCI subjects. Overgrooming (OG) and biting after peripheral nerve injury or spinal cord excitotoxic lesions are thought to be one behavioral demonstration of spontaneous neuropathic pain or dysesthesia. However, reports of OG after contusion SCI are largely anecdotal and conditions causing this response are poorly understood. The present study investigated whether repeated application of sensory stimuli to the trunk prior to mid-thoracic contusion SCI would induce OG after SCI in mice. One week prior to SCI or laminectomy, mice were subjected either to nociceptive and mechanical stimulation, mechanical stimulation only, the testing situation without stimulation, or no treatment. They were then examined for 14 days after surgery and the sizes and locations of OG sites were recorded on anatomical maps. Mice subjected to either stimulus paradigm showed increased OG compared with unstimulated or uninjured mice. Histological analysis showed no difference in spinal cord lesion size due to sensory stimulation, or between mice that overgroomed or did not overgroom. The relationship between prior stimulation and contusion injury in mice that display OG indicates a critical interaction that may underlie one facet of spontaneous neuropathic symptoms after SCI.

Hoschouer, Emily L.; Finseth, Taylor; Flinn, Sharon; Basso, D. Michele

2010-01-01

337

Epidural spinal-cord stimulation facilitates recovery of functional walking following incomplete spinal-cord injury.  

PubMed

We investigated a novel treatment paradigm for developing functional ambulation in wheelchair-dependent individuals with chronic, incomplete spinal-cord injury. By coordinating epidural stimulation of the dorsal structures of the spinal cord with partial weight bearing treadmill therapy, we observed improvement in treadmill and over-ground ambulation in an individual with chronic incomplete tetraplegia. The application of partial weight-bearing therapy alone was not sufficient to achieve functional ambulation over ground, though treadmill ambulation improved significantly. Combining epidural spinal-cord stimulation (ESCS, T10-T12 vertebral levels) with partial weight-bearing therapy resulted in further improvement during treadmill ambulation. Moreover, the combination of therapies facilitated the transfer of the learned gait into over ground ambulation. Performance improvements were elicited by applying continuous, charge-balanced, monophasic pulse trains at a frequency of 40-60 Hz, a pulse duration of 800 micros, and an amplitude determined by the midpoint (50%) between the sensory and motor threshold values. The participant initially reported a reduction in sense of effort for over ground walking from 8/10 to 3/10 (Borg scale), and was able to double his walking speed. After several weeks of over ground training, he reached maximum walking speeds of 0.35 m/s, and was able to ambulate over 325 m. We propose that ESCS facilitated locomotor recovery in this patient by augmenting the use-dependent plasticity created by partial weight bearing therapy. Confirmation of these promising results in a controlled study of groups of spinal-cord-injured subjects is warranted. PMID:15068185

Carhart, Michael R; He, Jiping; Herman, Richard; D'Luzansky, S; Willis, Wayne T

2004-03-01

338

Neonatal hind-paw injury disrupts acquisition of an instrumental response in adult spinal rats.  

PubMed

The present study was designed to evaluate the impact of neonatal injury on adult spinal plasticity in rats. Subjects were randomly assigned to 1 of 4 experimental conditions: (a) hind-paw injury at Postnatal Day (PD) 2, (b) hind-paw injury at PD 5, (c) anesthesia exposure only on PD 2, or (d) anesthesia exposure only on PD 5. Subjects receiving a unilateral neonatal hind-paw injury showed decreased mechanical threshold (hyperalgesia) on the previously injured hind paw throughout development. This decrease in threshold survived spinal transection (at T2) at 12 weeks of age. Injured subjects also showed significant impairment in a spinal instrumental learning task performed by the previously injured hind paw. This disruption of learning indicates a disruption of spinal plasticity that may be due to induction of long-term changes in nociceptive processing within the spinal cord. PMID:17907840

Young, Erin E; Baumbauer, Kyle M; Elliot, Audrea; Joynes, Robin L

2007-10-01

339

U.S. Army Battlefield Exercise and Combat Related Spinal Cord Injury Research: Neuroprotection and Repair After Spinal Cord Injury. Addendum.  

National Technical Information Service (NTIS)

The purpose of this research program is to use a multidisciplinary approach to investigate the pathophysiology of spinal cord injury (SCI) with the major goal of developing therapies targeted at both the acute and more chronic injury setting. We are testi...

W. D. Dietrich

2009-01-01

340

Intrathecal bupivacaine protects against extension of lesions in an acute photochemical spinal cord injury model  

Microsoft Academic Search

Purpose  The photochemical spinal-cord injury model reproduces extensive secondary lesions that occur after spinal injury. We have\\u000a evaluated in 27 rats the functional, electrophysiological and anatomical consequences of a photochemical spinal-cord lesion\\u000a induced before or after intrathecal injection of bupivacaine.\\u000a \\u000a \\u000a \\u000a Methods  After randomization, nine rats received 20?-L of intrathecal bupivacaine 0.5% 15 min before a photochemical spinal-cord lesion (Group I) and eight

Sandrine Lopez; Alain Privat; Nathalie Bernard; Freddy Ohanna; Christine Vergnes; Xavier Capdevila

2004-01-01

341

Assessment and Evaluation of Primary Prevention in Spinal Cord Injury  

PubMed Central

Although the incidence of spinal cord injury (SCI) is low, the consequences of this disabling condition are extremely significant for the individual, family, and the community. Sequelae occur in the physical, psychosocial, sexual, and financial arenas, making global prevention of SCI crucial. Understanding how to assess and evaluate primary prevention programs is an important competency for SCI professionals. Assessing a program’s success requires measuring processes, outcomes, and impact. Effective evaluation can lead future efforts for program design while ensuring accountability for the program itself. The intended impact of primary prevention programs for SCI is to decrease the number of individuals who sustain traumatic injury; many programs have process and outcome goals as well. An understanding of the basic types of evaluation, evaluation design, and the overall process of program evaluation is essential for ensuring that these programs are efficacious. All health care professionals have the opportunity to put prevention at the forefront of their practice. With the current paucity of available data, it is important that clinicians share their program design, their successes, and their failures so that all can benefit and future injury can be prevented.

2013-01-01

342

Role of Neurotrophins in Recovery of Phrenic Motor Function Following Spinal Cord Injury  

PubMed Central

Many individuals who sustain a cervical spinal cord injury are unable to maintain adequate ventilation due to diaphragm muscle paralysis. These patients become dependent on mechanical ventilators and this situation is associated with ongoing problems with pulmonary clearance, infections, and lung injury leading to significant morbidity and reduced life expectancy. Therefore, functional recovery of rhythmic phrenic activity and the ability to generate expulsive forces would dramatically affect the quality of life of patients with cervical spinal cord injury. Neurotrophins are very promising in that they have been shown to play an important role in modulating functional neuroplasticity. Specifically, brain-derived neurotrophic factor (BDNF) acting via the tropomyosin-related kinase receptor type B (TrkB) has been implicated in neuroplasticity following spinal cord injury. Our central hypothesis is that functional recovery of rhythmic phrenic activity after cervical spinal cord injury is enhanced by an increase in BDNF/TrkB signaling in phrenic motoneurons, providing a novel therapeutic target for patients.

Sieck, Gary C.; Mantilla, Carlos B.

2009-01-01

343

A contusive model of unilateral cervical spinal cord injury using the infinite horizon impactor.  

PubMed

While the majority of human spinal cord injuries occur in the cervical spinal cord, the vast majority of laboratory research employs animal models of spinal cord injury (SCI) in which the thoracic spinal cord is injured. Additionally, because most human cord injuries occur as the result of blunt, non-penetrating trauma (e.g. motor vehicle accident, sporting injury) where the spinal cord is violently struck by displaced bone or soft tissues, the majority of SCI researchers are of the opinion that the most clinically relevant injury models are those in which the spinal cord is rapidly contused.(1) Therefore, an important step in the preclinical evaluation of novel treatments on their way to human translation is an assessment of their efficacy in a model of contusion SCI within the cervical spinal cord. Here, we describe the technical aspects and resultant anatomical and behavioral outcomes of an unilateral contusive model of cervical SCI that employs the Infinite Horizon spinal cord injury impactor. Sprague Dawley rats underwent a left-sided unilateral laminectomy at C5. To optimize the reproducibility of the biomechanical, functional, and histological outcomes of the injury model, we contused the spinal cords using an impact force of 150 kdyn, an impact trajectory of 22.5° (animals rotated at 22.5°), and an impact location off of midline of 1.4 mm. Functional recovery was assessed using the cylinder rearing test, horizontal ladder test, grooming test and modified Montoya's staircase test for up to 6 weeks, after which the spinal cords were evaluated histologically for white and grey matter sparing. The injury model presented here imparts consistent and reproducible biomechanical forces to the spinal cord, an important feature of any experimental SCI model. This results in discrete histological damage to the lateral half of the spinal cord which is largely contained to the ipsilateral side of injury. The injury is well tolerated by the animals, but does result in functional deficits of the forelimb that are significant and sustained in the weeks following injury. The cervical unilateral injury model presented here may be a resource to researchers who wish to evaluate potentially promising therapies prior to human translation. PMID:22871686

Lee, Jae H T; Streijger, Femke; Tigchelaar, Seth; Maloon, Michael; Liu, Jie; Tetzlaff, Wolfram; Kwon, Brian K

2012-07-24

344

Noninvasive respiratory management of high level spinal cord injury  

PubMed Central

This article describes noninvasive acute and long-term management of the respiratory muscle paralysis of high spinal cord injury (SCI). This includes full-setting, continuous ventilatory support by noninvasive intermittent positive pressure ventilation (NIV) to support inspiratory muscles and mechanically assisted coughing (MAC) to support inspiratory and expiratory muscles. The NIV and MAC can also be used to extubate or decannulate ‘unweanable’ patients with SCI, to prevent intercurrent respiratory tract infections from developing into pneumonia and acute respiratory failure (ARF), and to eliminate tracheostomy and resort to costly electrophrenic/diaphragm pacing (EPP/DP) for most ventilator users, while permitting glossopharyngeal breathing (GPB) for security in the event of ventilator failure.

Bach, John R.

2012-01-01

345

A quantitative skin impedance test to diagnose spinal cord injury  

PubMed Central

The purpose of this study was to develop a quantitative skin impedance test that could be used to diagnose spinal cord injury (SCI) if any, especially in unconscious and/or non-cooperative SCI patients. To achieve this goal, initially skin impedance of the sensory key points of the dermatomes (between C3 and S1 bilaterally) was measured in 15 traumatic SCI patients (13 paraplegics and 2 tetraplegics) and 15 control subjects. In order to classify impedance values and to observe whether there would be a significant difference between patient and subject impedances, an artificial neural network (ANN) with back-propagation algorithm was employed. Validation results of the ANN showed promising performance. It could classify traumatic SCI patients with a success rate of 73%. By assessing the experimental protocols and the validation results, the proposed method seemed to be a simple, objective, quantitative, non-invasive and non-expensive way of assessing SCI in such patients.

Ugur, Mukden; Arslan, Yunus Ziya; Palamar, Deniz

2009-01-01

346

Medicaid waiver programs for traumatic brain and spinal cord injury.  

PubMed

With policy makers facing the competing challenges of budget crises and pressures to expand Medicaid home and community- based service programs to populations including those with traumatic brain and spinal cord injuries (TBI/SCI), this paper addresses the need for information about the development of waiver programs for this target population. This study draws from the most recent and comprehensive available dataset to present national participation and expenditure trends for all TBI/SCI waivers for the period 1995-2002, it reports findings from a national survey of policies (e.g., eligibility criteria and cost controls) used on these waiver programs in 2002, and compares the Medicaid cost of serving this target group through institutional care and waiver programs. PMID:16236678

Kitchener, Martin; Ng, Terence; Grossman, Brian; Harrington, Charlene

2005-01-01

347

Spinal injuries caused by the acceleration of ejection.  

PubMed

The speed and altitude at which modern military aircraft operate are such that escape can only be achieved by some means of forcibly propelling the aircrew clear of the aircraft. The most common method of doing this is by use of an ejection seat. The use of such seats, whilst generally life saving, exposes aircrew to forces that may be at the limits of human tolerance. Each phase of the ejection sequence is associated with characteristic injury patterns and of particular concern is the occurrence of spinal compression fractures, which are caused by the upward acceleration of the ejection seat. Thorough investigation of aircrew who eject is necessary and magnetic resonance imaging of the spines of these aircrew is now becoming mandatory. Aircrew who sustain stable anterior wedge compression fractures usually require no invasive treatment, but are prevented from flying aircraft fitted with ejection seats for 3-4 months. PMID:12024887

Lewis, M E

2002-03-01

348

Blockage of lysophosphatidic acid signaling improves spinal cord injury outcomes.  

PubMed

Evidence suggests a proinflammatory role of lysophosphatidic acid (LPA) in various pathologic abnormalities, including in the central nervous system. Herein, we describe LPA as an important mediator of inflammation after spinal cord injury (SCI) in zebrafish and mice. Furthermore, we describe a novel monoclonal blocking antibody raised against LPA that potently inhibits LPA's effect in vitro and in vivo. This antibody, B3, specifically binds LPA, prevents it from interacting with its complement of receptors, and blocks LPA's effects on the neuronal differentiation of human neural stem/progenitor cells, demonstrating its specificity toward LPA signaling. When administered systemically to mice subjected to SCI, B3 substantially reduced glial inflammation and neuronal death. B3-treated animals demonstrated significantly more neuronal survival upstream of the lesion site, with some functional improvement. This study describes the use of anti-LPA monoclonal antibody as a novel therapeutic approach for the treatment of SCI. PMID:22819724

Goldshmit, Yona; Matteo, Rosalia; Sztal, Tamar; Ellett, Felix; Frisca, Frisca; Moreno, Kelli; Crombie, Duncan; Lieschke, Graham J; Currie, Peter D; Sabbadini, Roger A; Pébay, Alice

2012-07-20

349

Blockage of Lysophosphatidic Acid Signaling Improves Spinal Cord Injury Outcomes  

PubMed Central

Evidence suggests a proinflammatory role of lysophosphatidic acid (LPA) in various pathologic abnormalities, including in the central nervous system. Herein, we describe LPA as an important mediator of inflammation after spinal cord injury (SCI) in zebrafish and mice. Furthermore, we describe a novel monoclonal blocking antibody raised against LPA that potently inhibits LPA's effect in vitro and in vivo. This antibody, B3, specifically binds LPA, prevents it from interacting with its complement of receptors, and blocks LPA's effects on the neuronal differentiation of human neural stem/progenitor cells, demonstrating its specificity toward LPA signaling. When administered systemically to mice subjected to SCI, B3 substantially reduced glial inflammation and neuronal death. B3-treated animals demonstrated significantly more neuronal survival upstream of the lesion site, with some functional improvement. This study describes the use of anti-LPA monoclonal antibody as a novel therapeutic approach for the treatment of SCI.

Goldshmit, Yona; Matteo, Rosalia; Sztal, Tamar; Ellett, Felix; Frisca, Frisca; Moreno, Kelli; Crombie, Duncan; Lieschke, Graham J.; Currie, Peter D.; Sabbadini, Roger A.; Pebay, Alice

2013-01-01

350

Cardiovascular pathology in dialysis patients with spinal cord injury.  

PubMed

Necropsy findings were examined in 20 male patients with end-stage renal disease associated with longstanding spinal cord injury and treated with maintenance hemodialysis. All patients exhibited cardiovascular abnormalities. Fibrinous pericarditis was found in 50% of the patients. Left and right ventricular hypertrophy was present in 45% and 20% of the cases, respectively. The respective incidences of left and right ventricular dilatation were 40% and 30%. Cardiac amyloidosis was noted in 25% of the cases, whereas myocardial fibrosis was found in 45% of the patients. Valvular abnormalities were limited to one case of aortic stenosis and two cases of mitral ring dilatation. No evidence of infective endocarditis was observed despite the high incidence of infections in this population. Whereas 45% of the patients exhibited some degree of coronary arteriosclerosis, none exhibited evidence of acute myocardial infarction and only one showed pathologic changes consistent with old myocardial infarction. Aortic atherosclerosis was noted in the majority of patients. PMID:6228212

Pahl, M V; Vaziri, N D; Gordon, S; Tuero, S

1983-11-01

351

Respiratory neuroplasticity and cervical spinal cord injury: translational perspectives  

PubMed Central

Paralysis of the diaphragm is a severe consequence of cervical spinal cord injury. This condition can be experimentally modeled by lateralized, high cervical lesions that interrupt descending inspiratory drive to the corresponding phrenic nucleus. Although partial recovery of ipsilateral diaphragm function occurs over time, recent findings show persisting chronic deficits in ventilation and phrenic motoneuron activity. Some evidence suggests, however, that spontaneous recovery can be enhanced by modulating neural pathways to phrenic motoneurons via synaptic circuitries which appear more complex than previously envisioned. The present review highlights these and other recent experimental multi-disciplinary findings pertaining to respiratory neuroplasticity in the rat. Translational considerations are also emphasized, with specific attention directed at the clinical and interpretational strengths of different lesion models and outcome measures.

Lane, Michael A.; Fuller, David D.; White, Todd E.; Reier, Paul J.

2008-01-01

352

Dantrolene can reduce secondary damage after spinal cord injury  

PubMed Central

The aim of this experimental study was to investigate the possible protective effects of dantrolene on traumatic spinal cord injury (SCI). Twenty-four New Zealand rabbits were divided into three groups: Sham (no drug or operation, n = 8), Control (SCI + 1 mL saline intraperitoneally (i.p.), n = 8), and DNT (SCI + 10 mg/kg dantrolene in 1 mL, i.p., n = 8). Laminectomy was performed at T10 and balloon catheter was applied extradurally. Four and 24 h after surgery, rabbits were evaluated according to the Tarlov scoring system. Blood, cerebrospinal fluid and tissue sample from spinal cord were taken for measurements of antioxidant status or detection of apoptosis. After 4 h SCI, all animals in control or DNT-treated groups became paraparesic. Significant improvement was observed in DNT-treated group, 24 h after SCI, with respect to control. Traumatic SCI led to an increase in the lipid peroxidation and a decrease in enzymic or non-enzymic endogenous antioxidative defense systems, and increase in apoptotic cell numbers. DNT treatment prevented lipid peroxidation and augmented endogenous enzymic or non-enzymic antioxidative defense systems. Again, DNT treatment significantly decreased the apoptotic cell number induced by SCI. In conclusion, experimental results observed in this study suggest that treatment with dantrolene possess potential benefits for traumatic SCI.

Cemek, Mustafa; Buyukokuroglu, Mehmet Emin; Altunbas, Korhan; Bas, Orhan; Yurumez, Yusuf; Cosar, Murat

2009-01-01

353

Advances in the rehabilitation management of acute spinal cord injury.  

PubMed

Aggressive assessment and management of the secondary complications in the hours and days following spinal cord injury (SCI) leads to restoration of function in patients through intervention by a team of rehabilitation professionals. The recent certification of SCI physicians, newly validated assessments of impairment and function measures, and international databases agreed upon by SCI experts should lead to documentation of improved rehabilitation care. This chapter highlights recent advances in assessment and treatment based on evidence-based classification of literature reviews and expert opinion in the acute phase of SCI. A number of these reviews are the product of the Consortium for Spinal Cord Medicine, which offers clinical practice guidelines for healthcare professionals. Recognition of and early intervention for problems such as bradycardia, orthostatic hypotension, deep vein thrombosis/pulmonary embolism, and early ventilatory failure will be addressed although other chapters may discuss some issues in greater detail. Early assessment and intervention for neurogenic bladder and bowel function has proven effective in the prevention of renal failure and uncontrolled incontinence. Attention to overuse and disuse with training and advanced technology such as functional electrical stimulation have reduced pain and disability associated with upper extremity deterioration and improved physical fitness. Topics such as chronic pain, spasticity, sexual dysfunction, and pressure sores will be covered in more detail in additional chapters. However, the comprehensive and integrated rehabilitation by specialized SCI teams of physicians, nurses, therapists, social workers, and psychologists immediately following SCI has become the standard of care throughout the world. PMID:23098713

Ditunno, John F; Cardenas, Diana D; Formal, Christopher; Dalal, Kevin

2012-01-01

354

Posttraumatic Stress Disorder in Veterans with Spinal Cord Injury: Trauma-related Risk Factors  

Microsoft Academic Search

Trauma-related risk factors for posttraumatic stress disorder (PTSD) were examined in a sample of 125 veterans with spinal cord injury. Category of injury was found to be the most consistent predictor of PTSD diagnosis and symptom severity with paraplegia predicting more PTSD symptoms than quadriplegia. The occurrence of a head injury at the time of the trauma was found to

Cynthia L. Radnitz; Louis Hsu; Jeffrey Willard; Lysandra Perez-Strumolo; Joanne Festa; Lynn B. Lillian; Stacey Walczak; Dennis D. Tirch; Ilana S. Schlein; Martin Binks; Charles P. Broderick

1998-01-01

355

Prevention of pressure ulcers in spinal cord injury  

PubMed Central

Abstract: Pressure ulcers are a lifelong, serious complication of spinal cord injury. They have the potential to interfere with physical, psychological, and social well-being and to impact overall quality of life. Prevention Strategies: 1. Implementing pressure ulcer prevention strategies as part of the comprehensive management of acute SCI and reviewing all aspects of risk when determining prevention strategies. - Avoiding prolonged positional immobilization whenever possible. 2. Conducting daily comprehensive visual and tactile skin inspections, with particular attention to the regions most vulnerable to pressure ulcer development. 3. Turning or repositioning individuals with SCI initially every 2 hours in the acute and rehabilitation phases if the medical condition allows. 4. Evaluating the individual and his/her support environment for optimal maintenance of skin integrity. 5. Providing an individually prescribed wheelchair and pressure-reducing seating system. 6. Implementing an ongoing exercise regimen for the medically stable SCI individual to promote maintenance of skin integrity, improve cardiovascular e, and prevent fatigue and deconditioning. 7. Providing individuals with SCI, their families, significant others, on effective strategies for the prevention and treatment of pressure ulcers. 8. Assessing nutritional status of all SCI individuals on admission and as needed, based on medical status, including: 9. Providing adequate nutritional intake to meet the individual’s needs, especially: - Calories (or Energy) - Protein - Micronutrients (zinc, vitamin C, vitamin A, and vitamin E) - Fluids 10. Implementing aggressive nutritional support measures if dietary intake is inadequate or if an individual is nutritionally compromised. Treatment: Nonsurgical: - Cleansing - Debridement - Dressings - Electrical stimulation - Reassessment Surgical: - Excising of ulcer, surrounding scar, bursa, soft tissue calcification, and underlying necrotic or infected bone - Filling dead space, enhancing vascularity of the healing wound, and distributing pressure off the bone - Resurfacing with a large regional pedicle flap, with suture line away from the area of direct pressure, and one that does not encroach on adjacent flap territories - Preserving options for future potential break-downs Keywords: Prevention, Pressure ulcers, Spinal Cord Injury

Karam Pazhouh, Fereshteh; Parvaz, Nasrin; Saeidi Borojeni, Hamid Reza; Mahvar, Tayebeh; Alimoradi, Zhaleh

2012-01-01

356

Phrenic motoneuron discharge patterns following chronic cervical spinal cord injury.  

PubMed

Cervical spinal cord injury (SCI) dramatically disrupts synaptic inputs and triggers biochemical, as well as morphological, plasticity in relation to the phrenic motor neuron (PhMN) pool. Accordingly, our primary purpose was to determine if chronic SCI induces fundamental changes in the recruitment profile and discharge patterns of PhMNs. Individual PhMN action potentials were recorded from the phrenic nerve ipsilateral to lateral cervical (C2) hemisection injury (C2Hx) in anesthetized adult male rats at 2, 4 or 8wks post-injury and in uninjured controls. PhMNs were phenotypically classified as early (Early-I) or late inspiratory (Late-I), or silent according to discharge patterns. Following C2Hx, the distribution of PhMNs was dominated by Late-I and silent cells. Late-I burst parameters (e.g., spikes per breath, burst frequency and duration) were initially reduced but returned towards control values by 8wks post-injury. In addition, a unique PhMN burst pattern emerged after C2Hx in which Early-I cells burst tonically during hypocapnic inspiratory apnea. We also quantified the impact of gradual reductions in end-tidal CO2 partial pressure (PETCO2) on bilateral phrenic nerve activity. Compared to control rats, as PETCO2 declined, the C2Hx animals had greater inspiratory frequencies (breaths?min(-1)) and more substantial decreases in ipsilateral phrenic burst amplitude. We conclude that the primary physiological impact of C2Hx on ipsilateral PhMN burst patterns is a persistent delay in burst onset, transient reductions in burst frequency, and the emergence of tonic burst patterns. The inspiratory frequency data suggest that plasticity in brainstem networks is likely to play an important role in phrenic motor output after cervical SCI. PMID:23954215

Lee, Kun-Ze; Dougherty, Brendan J; Sandhu, Milapjit S; Lane, Michael A; Reier, Paul J; Fuller, David D

2013-08-13

357

Characteristics of Abdominal Obesity in Persons With Spinal Cord Injury  

PubMed Central

Objective To investigate the characteristics of community-dwelling spinal cord injury (SCI) persons with obesity, including diet, socioeconomic factors, weight reduction method, and frequency of body weight and abdominal circumference measurements. Methods We developed a questionnaire based on 'the Fourth Korea National Health and Nutrition Examination Survey, 2009'. A total of 371 community-dwelling SCI persons were enrolled in this study. Inclusion criteria were SCI persons older than 20 years with more than 1 year elapsed since the injury. Trained investigators visited SCI persons' home to complete the questionnaire and measure abdominal obesity (AO) as defined by the waist circumference. Results Prevalence of AO was 29.2% in SCI persons and 27.4% in the general population (GP), showing no significant difference. Education showed correlation with AO in both SCI persons and the GP. The injury level, type of injury and income did not show any correlation with AO in SCI persons. Only 28.8% and 48.8% of SCI persons measured their waist circumference and body weight within the past year, respectively. Also, SCI persons with AO thought that their body was less obese compared to persons with AO in the GP (p<0.001). The method of weight reduction was diet modification in 53.6% of SCI persons with AO, which was higher than 37.1% of persons with AO in the GP. Conclusion In SCI persons, obesity perception as well as socioeconomic factors correlated with AO, but these were not relevant factors in the GP. Therefore, development of a specific and intensive weight control program for SCI persons is necessary.

Kim, Kwang Dong; Nam, Hyung Seok

2013-01-01

358

Magnesium sulfate treatment in experimental spinal cord injury: emphasis on vascular changes and early clinical results.  

PubMed

Injury to the spinal cord results in disruption of neurons, cell membranes, axons, myelin, and endothelial cells. The aim of this study was to demonstrate the protective effect of magnesium sulfate on the blood-spinal cord barrier after acute spinal cord injury (SCI). This experiment was conducted in two parts. In the first, rats were injected intravenously with Evans blue 2 h after SCI. The laminectomy-only group had no trauma. Contusion injury (50 g-cm) was applied to the trauma and treatment groups. Magnesium sulfate (600 mg/kg) was given to the treatment group immediately after injury. For the second part, clinical evaluations were performed 24 h post surgery. Then, following Evans blue injection, spinal cord samples were obtained from the laminectomy-only, trauma, and treatment groups. For the control group, nontraumatized spinal cord samples were taken after Evans blue injection following clinical examination. Laminectomy did not affect the spinal cord Evans blue content in 2-h and 24-h groups. The trauma increased tissue Evans blue content, and 24-h samples showed more remarkable tissue Evans blue content, suggesting secondary injury. Application of 600 mg/kg of magnesium resulted in lower Evans blue content in the spinal cord than with injury. Remarkable clinical neuroprotection was observed in the treatment groups. Magnesium sulfate showed vaso- and neuroprotective properties after contusion injury to the rat spinal cord. The authors also demonstrated secondary injury of the blood-spinal cord barrier with the Evans blue clearance technique for the first time. PMID:12783273

Kaptanoglu, Erkan; Beskonakli, Etem; Solaroglu, Ihsan; Kilinc, Asuman; Taskin, Yamac

2003-05-29

359

Epidemiology and predictors of spinal injury in adult major trauma patients: European cohort study.  

PubMed

This is a European cohort study on predictors of spinal injury in adult (?16 years) major trauma patients, using prospectively collected data of the Trauma Audit and Research Network from 1988 to 2009. Predictors for spinal fractures/dislocations or spinal cord injury were determined using univariate and multivariate logistic regression analysis. 250,584 patients were analysed. 24,000 patients (9.6%) sustained spinal fractures/dislocations alone and 4,489 (1.8%) sustained spinal cord injury with or without fractures/dislocations. Spinal injury patients had a median age of 44.5 years (IQR = 28.8-64.0) and Injury Severity Score of 9 (IQR = 4-17). 64.9% were male. 45% of patients suffered associated injuries to other body regions. Age <45 years (?45 years OR 0.83-0.94), Glasgow Coma Score (GCS) 3-8 (OR 1.10, 95% CI 1.02-1.19), falls >2 m (OR 4.17, 95% CI 3.98-4.37), sports injuries (OR 2.79, 95% CI 2.41-3.23) and road traffic collisions (RTCs) (OR 1.91, 95% CI 1.83-2.00) were predictors for spinal fractures/dislocations. Age <45 years (?45 years OR 0.78-0.90), male gender (female OR 0.78, 95% CI 0.72-0.85), GCS <15 (OR 1.36-1.93), associated chest injury (OR 1.10, 95% CI 1.01-1.20), sports injuries (OR 3.98, 95% CI 3.04-5.21), falls >2 m (OR 3.60, 95% CI 3.21-4.04), RTCs (OR 2.20, 95% CI 1.96-2.46) and shooting (OR 1.91, 95% CI 1.21-3.00) were predictors for spinal cord injury. Multilevel injury was found in 10.4% of fractures/dislocations and in 1.3% of cord injury patients. As spinal trauma occurred in >10% of major trauma patients, aggressive evaluation of the spine is warranted, especially, in males, patients <45 years, with a GCS <15, concomitant chest injury and/or dangerous injury mechanisms (falls >2 m, sports injuries, RTCs and shooting). Diagnostic imaging of the whole spine and a diligent search for associated injuries are substantial. PMID:21644051

Hasler, Rebecca M; Exadaktylos, Aristomenis K; Bouamra, Omar; Benneker, Lorin M; Clancy, Mike; Sieber, Robert; Zimmermann, Heinz; Lecky, Fiona

2011-06-05

360

Spinal cord injury models in non human primates: Are lesions created by sharp instruments relevant to human injuries?  

PubMed

The worldwide incidence of traumatic spinal cord injury (SCI) is approximated at 180,000 new cases per year. Experiments using nonhuman primates (NHP) are often used to replicate the human condition in order to advance the understanding of SCI and to assist in the development of new treatments. Experimental spinal cord lesions in NHP have been created by a number of methods including blunt trauma, epidural balloons, circumferential cuffs, and dropping a precision weight over the spinal cord. As well, experimental lesions have been created with sharp instruments after opening the dura mater. However, spinal cord lesions that are created with a sharp instrument in NHP experiments may not replicate the clinical and pathological features of human spinal cord injury. Researchers should recognize the challenges associated with making clinical inferences in human SCIs based on NHP experiments that created experimental lesions with a sharp surgical instrument. PMID:23948598

Sledge, J; Andrew Graham, W; Westmoreland, S; Sejdic, E; Miller, A; Hoggatt, A; Nesathurai, S

2013-08-12

361

Assessment of autonomic dysfunction following spinal cord injury: Rationale for additions to International Standards for Neurological Assessment  

Microsoft Academic Search

We present a preliminary report of the discussion of the joint committee of the American Spinal Injury Associa- tion (ASIA) and the International Spinal Cord Society concern- ing the development of assessment criteria for general autonomic function testing following spinal cord injury (SCI). Elements of this report were presented at the 2005 annual meeting of the ASIA. To improve the

Andrei V. Krassioukov; Ann-Katrin Karlsson; Jill M. Wecht; Lisa-Anne Wuermser; Christopher J. Mathias; Ralph J. Marino

2007-01-01

362

Nerve root injury severity differentially modulates spinal glial activation in a rat lumbar radiculopathy model: considerations for persistent pain  

Microsoft Academic Search

Nerve root deformation magnitude affects behavioral sensitivity and spinal cytokine expression in a lumbar radiculopathy model. Despite evidence suggesting spinal glia play a role in persistent pain, no study has examined the relationship between injury severity in painful radiculopathy and spinal glial activation. This study quantified local in vivo biomechanics for nerve root injury, describing effects on temporal glial activation.

Beth A Winkelstein; Joyce A DeLeo

2002-01-01

363

The role of computed tomography in cervical spinal injury due to diving  

Microsoft Academic Search

We studied both the clinical features and computed tomography (CT) findings in 25 patients with a cervical spinal injury\\u000a related to diving. In all patients the X-rays, including anteroposterior, lateral and open mouth views, were normal. The clinical\\u000a features included headache, dizziness, without an alteration in the state of consciousness. In 5 patients, the CT spinal scan\\u000a revealed cervical spinal

M. Kligman; C. Vasili; M. Roffman

2001-01-01

364

Low-frequency H-reflex depression in trained human soleus after spinal cord injury  

Microsoft Academic Search

After spinal cord injury (SCI), widespread reorganization occurs within spinal reflex systems. Regular muscle activity may influence reorganization of spinal circuitry after SCI. The purpose of this study is to investigate the effects of long-term soleus training on H-reflex depression in humans after SCI. Seven subjects with acute (<7 weeks) SCI (AC group) underwent testing of H-reflex depression at several

Richard K. Shields; Shauna Dudley-Javoroski; Preeti Deshpande Oza

2011-01-01

365

Adenosine A1 receptor agonists reduce hyperalgesia after spinal cord injury in rats  

Microsoft Academic Search

Study design:An in vivo study using a spinal cord compression model in rats.Objectives:To evaluate the effect of adenosine on thermal hyperalgesia after spinal cord injury (SCI).Summary of background data:After SCI, some patients suffer dysesthesia that is unresponsive to conventional treatments. We previously established a rat thoracic spinal cord mild-compression model by which we were able to induce thermal hyperalgesia in

H Horiuchi; T Ogata; T Morino; H Yamamoto

2010-01-01

366

Quantification of Thyrotropin-Releasing Hormone Changes and Serotonin Content Changes Following Graded Spinal Cord Injury  

Microsoft Academic Search

Thyrotropin-releasing hormone (TRH) and serotonin (5-HT) are well known as neurotransmitters of descending bulbo-spinal tracts. 5-HT uptake caudal to (5-HT decreased) graded spinal lesions has been measured in rats and dogs and significantly correlated with the degree of cord injury. We studied 5-HT content via high-pressure liquid chromatography and radioimmunoassay measurements of TRH in dog spinal cord, both rostral and

Scott Shapiro; Mike Kubek; Eric Siemers; Edward Daly; Jim Callahan; Tim Putty

1995-01-01

367

Dyspnea During Daily Activities in Chronic Spinal Cord Injury  

PubMed Central

Objective To assess factors associated with breathlessness in chronic spinal cord injury (SCI) during daily activities. Design Cross-sectional survey. Settings Veterans Affairs SCI service and the community. Participants Four hundred forty-one participants 1 or more years post-SCI, and without acute illness, were recruited between 1994 and 2003 and were categorized according to their ability to walk unassisted, walk with an aid, or to move about by either hand-propelled wheelchair or motorized wheelchair (MWC). Interventions Assessment of injury extent, respiratory symptoms, cigarette smoking, comorbid medical conditions, and spirometry. Main Outcome Measures Breathlessness during talking, eating, or dressing. Results Breathlessness was more common in MWC users (20/85 users, 24%) than in nonusers (20/356, 6%). The main activity associated with breathlessness in 15 MWC users was talking (18%). In MWC users, the risk of breathlessness was related to lifetime cigarette smoking (odds ratio [OR]=1.02; 95% confidence interval [CI], 1.00–1.03 per pack year), and reports of chronic cough (OR=7.8; 95% CI, 2.0–32.7), and wheeze (OR=3.5; 95% CI, 1.04–13.6). SCI level, percentage of predicted forced vital capacity and forced expiratory volume in 1 second, and maximal inspiratory pressures were not related to breathlessness. Conclusions Breathlessness during selected daily activities (most commonly talking) was greatest in SCI participants who were most impaired with regard to mobility and was associated with reports of coughing, wheezing, and cigarette smoking.

Grandas, Noel F.; Jain, Nitin B.; Denckla, Joan B.; Brown, Robert; Tun, Carlos G.; Gallagher, Mary Ellen; Garshick, Eric

2005-01-01

368

Preserved corticospinal conduction without voluntary movement after spinal cord injury.  

PubMed

Study design:Case report.Objectives:To identify preserved corticomotor connection in chronic spinal cord injury (SCI) in the absence of clinically observable movement.Setting:Rehabilitation Hospital and Medical Research Institute, NY, USA.Methods:The motor-evoked potential (MEP) response to transcranial magnetic stimulation (TMS) was recorded using surface electromyography from the right biceps brachii, extersor carpi radialis (ECR), flexor carpi radialis (FCR) and abductor pollicis brevis (APB) muscles in a 31-year-old male traumatic SCI chronic patient-ASIA B, injury level C5. Motor power scores were additionally obtained from a clinician blinded to the results of TMS.Results:TMS could consistently elicit MEPs of normal latency, phase and amplitude, in the severely affected ECR muscle but not the similarly affected FCR muscle. The response in proximal and unaffected biceps muscle was larger than the healthy subject, whereas no response was obtained in the distal APB muscle as expected.Conclusion:TMS can identify residual pathways not apparent from clinical assessment alone, which may have prescriptive value for rehabilitation. PMID:23896664

Edwards, D J; Cortes, M; Thickbroom, G W; Rykman, A; Pascual-Leone, A; Volpe, B T

2013-07-30

369

PREDICTORS OF CARDIOPULMONARY HOSPITALIZATION IN CHRONIC SPINAL CORD INJURY  

PubMed Central

Objective We investigated longitudinal risk factors of hospitalization for circulatory and pulmonary diseases among veterans with chronic spinal cord injury (SCI). Circulatory and respiratory system illnesses are leading causes of death in chronic SCI patients, yet risk factors for related hospitalizations have not been characterized. Design Prospective cohort study. Setting Veterans Affairs (VA) Boston Healthcare System, Boston, Massachusetts. Participants / Data Source(s) 309 veterans ? 1 year post-SCI from the VA-Boston Chronic SCI cohort who completed a health questionnaire and underwent spirometry at study entry. Baseline data was linked to 1996–2003 hospitalization records from the VA National Patient Care Database. Interventions Not applicable. Main Outcome Measure(s) Cardiopulmonary hospital admissions, the predictors of which were assessed by Multivariate Cox regression. Results Of 1,478 admissions observed, 143 were due to cardiopulmonary (77 circulatory and 66 respiratory) illnesses. Independent predictors were greater age (3% increase /year), hypertension, and if in the lowest BMI quintile (<22.4 kg/m2). A greater %-predicted FEV1 was associated with reduced risk. SCI level and completeness of injury was not statistically significant after adjusting for these risk factors. Conclusion Cardiopulmonary hospitalization risk in persons with chronic SCI is related to greater age and medical factors that, if recognized, may result in strategies for reducing future hospitalizations.

Waddimba, Anthony C.; Jain, Nitin; Stolzmann, Kelly; Gagnon, David R.; Burgess, James F.; Kazis, Lewis E.; Garshick, Eric

2008-01-01

370

Specialized Respiratory Management for Acute Cervical Spinal Cord Injury:  

PubMed Central

Background: In individuals with cervical spinal cord injury (SCI), respiratory complications arise within hours to days of injury. Paralysis of the respiratory muscles predisposes the patient toward respiratory failure. Respiratory complications after cervical SCI include hypoventilation, hypercapnea, reduction in surfactant production, mucus plugging, atelectasis, and pneumonia. Ultimately, the patient must use increased work to breathe, which results in respiratory fatigue and may eventually require intubation for mechanical ventilation. Without specialized respiratory management for individuals with tetraplegia, recurrent pneumonias, bronchoscopies, and difficulty in maintaining a stable respiratory status will persist. Objective: This retrospective analysis examined the effectiveness of specialized respiratory management utilized in a regional SCI center. Methods: Individuals with C1-C4 SCI (N = 24) were the focus of this study as these neurological levels present with the most complicated respiratory status. Results: All of the study patients’ respiratory status improved with the specialized respiratory management administered in the SCI specialty unit. For a majority of these patients, respiratory improvements were noted within 1 week of admission to our SCI unit. Conclusion: Utilization of high tidal volume ventilation, high frequency percussive ventilation, and mechanical insufflation– exsufflation have demonstrated efficacy in stabilizing the respiratory status of these individuals. Optimizing respiratory status enables the patients to participate in rehabilitation therapies, allows for the opportunity to vocalize, and results in fewer days on mechanical ventilation for patients who are weanable.

Wong, Sandra Lynn; Shem, Kazuko; Crew, James

2012-01-01

371

A new minimally invasive experimental spinal cord injury model in rabbits.  

PubMed

The aim of this experimental study was to evaluate the effectivity of epidural microballoon inflation into the unroofed spinal column for the creation of a new experimental spinal cord injury model in rabbits. 10 New Zealand white rabbits were used for this study. Before operation and after anasthesia with 50 mg/kg ketamine and 8 mg/kg xylazine, spinal evoked potentials (SEP) were recorded in all rabbits. A midline skin incision was done on the lomber skin at the level of L1-L4. Paravertebral muscles were dissected bilaterally. A microhemilaminotomy was done in the right L3 lamina close to the midline by using Midas-rex micro-diamond drill instruments. The ligamentum flavum was opened and removed with microscissors. A microballoon was inserted into the spinal column between the bone and dura mater to the level of T12. The microballoon was inflated by using a pressure- and volume-controlled microballoon inflation device. Pre-injury and post-injury SEPs were recorded. The microballoon was deflated 15 minutes later and removed completely from the epidural space. 24 hours later the SEP study was repeated. Following microballoon inflation the SEP waves dropped to the basal level. All rabbits were paraplegic after the operation. In conclusion, this experimental study demonstrated that the microballoon inflation technique is a very successful method for the evaluation of spinal cord injury in rabbits. Unroofing of the spinal column is extremely important because decompression may be an effective treatment in spinal cord injury. Also the traumatic effect of aneurysm clips represents a different type of injury to the spinal cord. This new model may be used in experimental studies of spinal cord injury in rabbits. PMID:17882754

Baydin, A; Cokluk, C; Aydin, K

2007-06-01

372

Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: A multicenter trial  

Microsoft Academic Search

Wirz M, Zemon DH, Rupp R, Scheel A, Colombo G, Dietz V, Hornby TG. Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial. Arch Phys Med Rehabil 2005; 86:672–80.

Markus Wirz; David H. Zemon; Ruediger Rupp; Anke Scheel; Gery Colombo; Volker Dietz; T. George Hornby

2005-01-01

373

Longitudinal Change in FEV1 and FVC in Chronic Spinal Cord Injury  

Microsoft Academic Search

Presented in abstract form at the annual meeting of the American Spinal Injury Association, Tampa, Florida (June, 2007). Correspondence: Eric Garshick, MD, MOH VA Boston Healthcare System Pulmonary and Critical Care Medicine Section 1400 VFW Parkway West Roxbury, MA 02132

Kelly L Stolzmann; David R. Gagnon; Robert Brown; Carlos G. Tun; Eric Garshick

2008-01-01

374

Barriers to providing dual energy x-ray absorptiometry services to individuals with spinal cord injury.  

PubMed

To assess barriers to bone mineral density testing in individuals with chronic spinal cord injury, a cross-sectional study of 20 individuals with spinal cord injury was conducted with assessment of physical and logistical barriers to dual energy x-ray absorptiometry scanning. We identified several barriers, including scanner design and configuration in the scanning room that limited accessibility, increased typical scanning time, and made additional staff necessary. For dual energy x-ray absorptiometry to become a routine component of ongoing care in spinal cord injury medicine, we recommend the following changes: (1) install ceiling-mounted hydraulic lifts and grab bars to facilitate transfers in the scanning room; (2) increase staffing during scans; (3) increase time allotment for scans; (4) install the scanner in an adequately-sized room; and (5) partner with administrators and staff to raise awareness of access issues faced by individuals with spinal cord injury. PMID:18824888

Morse, Leslie R; Geller, Andrew; Battaglino, Ricardo A; Stolzmann, Kelly L; Matthess, Kirby; Lazzari, Antonio A; Garshick, Eric

2009-01-01

375

Home-Based Diagnosis and Management of Sleep-Related Breathing Disorders in Spinal Cord Injury.  

National Technical Information Service (NTIS)

Patients with spinal cord injury (SCI) commonly have sleep- disordered breathing due to obstructive sleep apnea (OSA) and/or nocturnal hypoventilation (NH) due to respiratory muscle weakness. In the general population, OSA has been linked to excess cardio...

R. G. Sitrin

2012-01-01

376

U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

377

Innovative Preventive and Treatment Techniques in Spinal Cord Injury Urologic Complications.  

National Technical Information Service (NTIS)

This project demonstrated the effectiveness and practicality of a new classification for neurogenic bladder following spinal cord injury and an algorithm for bladder care. By grouping the same type of bladder according to the 'residual ability' to achieve...

J. B. Nanninga Y. Wu

1981-01-01

378

Lower-Extremity Muscle Cross-Sectional Area After Incomplete Spinal Cord Injury  

Microsoft Academic Search

Shah PK, Stevens JE, Gregory CM, Pathare NC, Jayaraman A, Bickel SC, Bowden M, Behrman AL, Walter GA, Dudley GA, Vandenborne K. Lower-extremity muscle cross-sectional area after incomplete spinal cord injury.

Prithvi K. Shah; Jennifer E. Stevens; Chris M. Gregory; Neeti C. Pathare; Arun Jayaraman; Scott C. Bickel; Mark Bowden; Andrea L. Behrman; Glenn A. Walter; Gary A. Dudley; Krista Vandenborne

2006-01-01

379

Locomotor Training After Human Spinal Cord Injury: A Series of Case Studies  

Microsoft Academic Search

Many individuals with spinal cord injury (SCI) do not regain their ability to walk, even though it is a primary goal of rehabilitation. Mammals with thoracic spinal cord transection can relearn to step with their hind limbs on a treadmill when trained with sensory input associated with stepping. If humans have similar neural mechanisms for locomotion, then providing comparable training

Andrea L Behrman; Susan J Harkema

2000-01-01

380

Functional electrical stimulation after spinal cord injury: current use, therapeutic effects and future directions  

Microsoft Academic Search

Repair of the injured spinal cord by regeneration therapy remains an elusive goal. In contrast, progress in medical care and rehabilitation has resulted in improved health and function of persons with spinal cord injury (SCI). In the absence of a cure, raising the level of achievable function in mobility and self-care will first and foremost depend on creative use of

K T Ragnarsson

2008-01-01

381

BioMEMS Implants for neural Regeneration after a Spinal Cord Injury  

Microsoft Academic Search

Functional restoration is one of the major obstacles for spinal cord traumatic patient. Neural Regeneration is considered one of the strategies for functional recovery after spinal cord injury. Neurons can regenerate if they are provided with the favorable environment. Substantial efforts have been directed at understanding the central nervous system environment and the means of modifying it to an appropriate

Mohamed Badran; Medhat Moussa

2005-01-01

382

Evidence for spinal cord hypersensitivity in chronic pain after whiplash injury and in fibromyalgia  

Microsoft Academic Search

Patients with chronic pain after whiplash injury and fibromyalgia patients display exaggerated pain after sensory stimulation. Because evident tissue damage is usually lacking, this exaggerated pain perception could be explained by hyperexcitability of the central nervous system. The nociceptive withdrawal reflex (a spinal reflex) may be used to study the excitability state of spinal cord neurons. We tested the hypothesis

Borut Banic; Steen Petersen-Felix; Ole K. Andersen; Bogdan P. Radanov; P. M. Villiger; Lars Arendt-Nielsen; Michele Curatolo

2004-01-01

383

Gender differences in the interpersonal response to depression and spinal cord injury  

Microsoft Academic Search

Differential responses to depressed male and female spinal-cord-injured persons were assessed using an analogue model. Forty male and 53 female undergraduates listened to a scripted audiotape interview of either a male or a female individual with a spinal cord injury who was either depressed or not depressed. There were no significant effects for subject gender, and, regardless of the sex

Robert G. Frank; Timothy R. Elliott; Stephen A. Wonderlich; James R. Corcoran; Robert L. Umlauf; Glenn S. Ashkanazi

1987-01-01

384

Spinal Accessory Nerve Palsy as a Cause of Pain After Whiplash Injury  

Microsoft Academic Search

Spinal accessory nerve injury is most commonly reported following surgery in and around the posterior cervical triangle. Pain, impaired ability to raise the ipsilateral shoulder, and scapular winging on abduction of the arm are the most frequently noted clinical manifestations. We report the case of a collegiate swimmer who developed left-sided neck and shoulder pain secondary to a spinal accessory

Mark P. Bodack; Richard S. Tunkel; Steven G. Marini; Willibald Nagler

1998-01-01

385

Multipotent embryonic spinal cord stem cells expanded by endothelial factors and Shh\\/RA promote functional recovery after spinal cord injury  

Microsoft Academic Search

Cell transplantation is a promising way to treat spinal cord injury and neurodegenerative disorders. Neural stem cells taken from the embryonic spinal cord are an appealing source of cells for transplantation because these cells are committed to making spinal cord progeny. However these stem cells are rare and require expansion in tissue culture to generate sufficient cells for transplantation. We

Natalia Lowry; Susan K. Goderie; Matthew Adamo; Patricia Lederman; Carol Charniga; Jasrai Gill; Jerry Silver; Sally Temple

2008-01-01

386

Impact of injury level and self-monitoring on free time boredom of people with spinal cord injury  

Microsoft Academic Search

Purpose: The purpose of this study was to determine whether or not level of injury and personality characteristics creates an interaction effect that impacts the free time boredom of individuals with spinal cord injury (SCI). Method: Using a survey method, a packet containing a cover letter, a consent form, research questionnaires, and a self- addressed, stamped envelope was sent to

Youngkhill Lee; Robin Mittelstaedt

2004-01-01

387

Implanted electro-acupuncture electric stimulation improves outcome of stem cells' transplantation in spinal cord injury.  

PubMed

Spinal cord injury (SCI) is one of the most serious disorders in clinics, and the high disability rate and functional deficits are common issues in patients. Transplantation of bone-marrow-derived mesenchymal stromal cells (BMSCs) into the injured spinal cord is emerging as a novel method in the therapeutics of SCI; however, its application is limited by the poor survival rate of the transplanted cells and low differentiation rate into neurons. Our laboratory recently reported that electrical stimulation (ES) dramatically improves the survival rate of transplanted BMSCs and increases spinal cord functions in animals with spinal cord injury. In this paper, we asked whether implanted electro-acupuncture (iEA) can advance the beneficial effects from the ES treatment in animals with spinal cord injury. We showed that BMSCs transplantation alone resulted in significant functional recovery in animals. Interestingly, iEA with BMSCs treatment induced a significantly higher functional improvement in locomotor functions and SSEP compared to the BMSCs treatment alone. Additionally, we used molecular biology techniques and showed that BMSCs transplantation with iEA treatment significantly increased the number of surviving BMSCs compared to the BMSCs alone group. In conclusion, our experiment showed that the approach of coupling iEA electric stimulation and BMSCs transplantation remarkably promotes functional improvements in animals with spinal cord injury and holds promising potential to treat spinal cord injury in humans. PMID:22384853

Liu, Haichun; Yang, Kaiyun; Xin, Tao; Wu, Wenliang; Chen, Yunzhen

2012-03-02

388

Determinants of Lung Volumes in Chronic Spinal Cord Injury  

PubMed Central

Objective To characterize determinants of lung volumes in chronic spinal cord injury (SCI). Design Cross-sectional. Setting VA Boston Healthcare System. Participants White men (N=330) with chronic SCI. Interventions Not applicable. Main Outcome Measures Questionnaire responses and measurements of lung volumes. Results Adjusted for SCI severity and stature, greater body mass index (BMI) was associated (all P<.05) with lower total lung capacity (TLC) (?38.7mL·kg?1·m2), functional residual capacity (FRC) (?73.9mL·kg?1·m2), residual volume (RV) (?40.4mL·kg?1·m2), and expiratory reserve volume (ERV) (?32.2mL·kg?1·m2). The effect of BMI on RV was most pronounced in quadriplegia (?72mL·kg?1·m2). Lifetime smoking was associated with a greater FRC (5.3mL/pack a year) and RV (3.1mL/pack a year). The effects of lifetime smoking were also greatest in quadriplegia (11mL/pack a year for FRC; 7.8mL/pack a year for RV). Time since injury, independent of age, was associated with a decrease in TLC, FRC, ERV, and RV (P<.05). Age was not a predictor of TLC once time since injury was considered. Conclusions Determinants of FRC, TLC, ERV, and RV in chronic SCI include factors related and unrelated to SCI. The mechanisms remain to be determined but likely involve the elastic properties and muscle function of the respiratory system and perhaps the effects of systemic inflammation related to adiposity. Addressing modifiable factors such as obesity, muscle stiffness, and smoking may improve respiratory morbidity and mortality in SCI by improving pulmonary function.

Stepp, Evan L.; Brown, Robert; Tun, Carlos G.; Gagnon, David R.; Jain, Nitin B.; Garshick, Eric

2008-01-01

389

Overview of Psychosocial Health Among Youth with Spinal Cord Injury  

PubMed Central

Background: Psychosocial health can be conceptualized as being mentally, emotionally, and socially well. Little is known about normative psychosocial development among children and adolescents with spinal cord injury (SCI). Objective: To provide a comprehensive overview of psychosocial health of 410 youth with SCI from ages 2 to 18 years. To understand developmental trends, data are presented separately for ages 2-5, 6-12, 13-15, and 16-18 years. Methods: Youth with SCI were recruited from 1 of 3 pediatric specialty hospitals within a single hospital system. Structured surveys assessing community participation, quality of life (QOL), and mental health (including anxiety and depression) were completed by youth with SCI (for ages 6-18) or their primary caregivers (for ages 2-5). Descriptive statistics were used to assess how patients scored on all standardized measures. Results: Of the 410 participants, 56% were male, 64% were Caucasian, 66% had paraplegia, and 55% had complete injuries. On average, the participants were 12 years old (SD 4.87) at interview and 7.26 years old (SD 5.97) at injury. Psychosocial health outcomes were described for each of the 4 age groups: 2-5 years (n = 52), 6-12 (n = 142), 13-15 (n = 82), and 16-18 (n = 134) years. Conclusions: As compared to published norms, this sample of youth with SCI seemed to be experiencing decreased levels of community participation and QOL, but also decreased levels of anxiety and depression. These data provide needed information to clinicians regarding how youth with SCI may typically experience psychosocial health and where their patients fit into that typical experience.

2013-01-01

390

Bone Loss following Spinal Cord Injury in a Rat Model  

PubMed Central

Abstract The current study was undertaken to follow the time course of bone loss in the proximal tibia of rats over several weeks following thoracic contusion spinal cord injury (SCI) of varying severity. It was hypothesized that bone loss would be more pronounced in the more severely injured animals, and that hindlimb weight bearing would help prevent bone loss. Twenty-six female Sprague-Dawley rats (200–225?g, 6–7 weeks old) received standard thoracic (T9) injuries at energies of 6.25, 12.5, 25, or 50?g-cm. The rats were scored weekly for hindlimb function during locomotion. At 0, 2 or 3, and 8 weeks, high-resolution micro-CT images of each right tibia were obtained. Mechanical indentation testing was done to measure the compressive strength of the cancellous bone structure. The 6.25?g-cm group showed near normal locomotion, the 12.5 and 25?g-cm groups showed the ability to frequently or occasionally generate weight-supported plantar steps, respectively, and the 50?g-cm group showed only movement without weight-supported plantar stepping. The 6.25, 12.5 and 25?g-cm groups remained at the same level of bone volume fraction (cancBV/TV=0.24±0.07), while the 50?g-cm group experienced severe bone loss (67%), resulting in significantly lower (p<0.05) bone volume fraction (cancBV/TV=0.11±0.05) at 8 weeks. Proximal tibia cancellous bone strength was reduced by approximately 50% in these severely injured rats. Instead of a linear proportionality between injury severity and bone loss, there appears to be a distinct functional threshold, marked by occasional weight-supported stepping, above which bone loss does not occur.

Brown, Edward H.; Xu, Qian; Waddell, Seid W.; Burden, Robert L.; Burke, Darlene A.; Magnuson, David S.K.

2012-01-01

391

Pitfall in insertion of suprapubic catheter in patients with spinal cord injuries  

Microsoft Academic Search

Objective: To report an unusual presentation of a misplaced suprapubic catheter (SPC) in a spinal cord injury (SCI) patient.Design: A case report of a SCI patient in whom a SPC was `partially misplaced' in an emergency.Setting: London Spinal Injuries Unit, Stanmore, UK.Subject: A 33-year-old man who sustained a C5 SCI in a road traffic accident 6 months ago. He had

R Hamid; J Peters; PJR Shah

2002-01-01

392

Functional magnetic stimulation for conditioning of expiratory muscles in patients with spinal cord injury  

Microsoft Academic Search

Lin VW, Hsiao IN, Zhu E, Perkash I. Functional magnetic stimulation for conditioning of expiratory muscles in patients with spinal cord injury. Arch Phys Med Rehabil 2001;82:162-6. Objective: To evaluate the effectiveness of functional magnetic stimulation (FMS) in conditioning expiratory muscles patients with spinal cord injury (SCI). Design: A prospective before-after trial. Setting: The Functional Magnetic Stimulation Laboratory of the

Vernon W. Lin; Ian N. Hsiao; Ercheng Zhu; Inder Perkash

2001-01-01

393

Can We Use Human Embryonic Stem Cells to Treat Brain and Spinal Cord Injury and Disease?  

Microsoft Academic Search

The potential use of human embryonic stem cells for the treatment of neurological disease and injury is discussed from the\\u000a perspectives of two common disease scenarios. Spinal cord injury and diseases such as multiple sclerosis that affect specific\\u000a cell types in the spinal cord represent a substantial proportion of all neuropathologies and are among the most heavily targeted\\u000a by efforts

Joel C. Glover

394

Depression after spinal cord injury: Relation to gender, ethnicity, aging, and socioeconomic indicators  

Microsoft Academic Search

Krause JS, Kemp B, Coker J. Depression after spinal cord injury: relation to gender, ethnicity, aging, and socioeconomic indicators. Arch Phys Med Rehabil 2000;81:1099-1109. Objective: To investigate the relation among aging, gender, ethnicity, socioeconomic indicators, and depressive symptoms after spinal cord injury (SCI). Design: Survey was done to collect cross-sectional data. A mediational model was used to analyze the interrelationships

James S. Krause; Bryan Kemp; Jennifer Coker

2000-01-01

395

Pseudo-tumours of the urinary tract in patients with spinal cord injury\\/spina bifida  

Microsoft Academic Search

Objective: To raise awareness of pseudo-tumours of urinary tract, as pseudo-tumours represent benign mass lesions simulating malignant neoplasms. Accurate diagnosis helps to avoid unnecessary surgery in spinal cord injury patients.Setting: Regional Spinal Injuries Centre, Southport, UKCase reports:Pseudo-tumour of kidney: A 58-year-old man with tetraplegia developed a right perirenal haematoma while taking warfarin; ultrasound and CT scanning showed no evidence of

S Vaidyanathan; P L Hughes; P Mansour; B M Soni; Gurpreet Singh; J W H Watt; T Oo; P Sett

2004-01-01

396

Clinical significance of detrusor sphincter dyssynergia type in patients with post-traumatic spinal cord injury  

Microsoft Academic Search

Objectives. To investigate the significance of categorizing detrusor sphincter dyssynergia (DSD) by type in patients with chronic spinal cord injury.Methods. A retrospective review of the charts, video-urodynamic studies, and upper tract radiographic studies of 269 patients with post-traumatic, suprasacral spinal cord injuries was performed. The patients were categorized according to the DSD type (intermittent or continuous), level and completeness of

Kyle J Weld; Marshall J Graney; Roger R Dmochowski

2000-01-01

397

Antegrade continence enema for the treatment of neurogenic constipation and fecal incontinence after spinal cord injury  

Microsoft Academic Search

Objective: To describe the effects of an antegrade continence enema stoma formed in a paraplegic man with intractable constipation and fecal incontinence.Design: Case report.Setting: Spinal cord injury unit, Veterans Affairs hospital.Participants: Spinal cord injury (SCI) patient with T12 paraplegia.Intervention: Surgical formation of antegrade continence enema stoma.Main Outcome Measures: Time of bowel program care, ease of fecal elimination, safety of procedure.Results:

Claire C. Yang; Steven A. Stiens

2000-01-01

398

Functional magnetic stimulation of the colon in persons with spinal cord injury  

Microsoft Academic Search

Lin VW, Nino-Murcia M, Frost F, Wolfe V, Perkash I. Functional magnetic stimulation of the colon in persons with spinal cord injury. Arch Phys Med Rehabil 2001;82:167-73. Objective: To evaluate the usefulness of functional magnetic stimulation (FMS) as a noninvasive method to stimulate the colon in individuals with spinal cord injury (SCI). Design: A prospective before-after trial consisting of 2

Vernon W. Lin; Matilda Nino-Murcia; Frederick Frost; Vickie Wolfe; Ian Hsiao; Inder Perkash

2001-01-01

399

Home aids and personal assistance 10–45 years after spinal cord injury  

Microsoft Academic Search

Objective:Assessment of home aids, adaptations and personal assistance received after traumatic spinal cord injury (SCI).Setting:Clinic for Spinal Cord Injuries, Denmark. Uptake area, 2.5 million inhabitants.Study design and methods:Cross-sectional follow-up with retrospective data from medical files.Materials:Individuals with traumatic SCI before 1 January 1991, still in regular follow-up and with sufficient medical record. In all, 279 were included, and 236 answered the

T Biering-Sørensen; R B Hansen; F Biering-Sørensen

2009-01-01

400

Employment outcomes of adults who sustained spinal cord injuries as children or adolescents  

Microsoft Academic Search

Anderson CJ, Vogel LC. Employment outcomes of adults who sustained spinal cord injuries as children or adolescents. Arch Phys Med Rehabil 2002;83:791-801. Objectives: To determine employment outcomes of adults with pediatric-onset spinal cord injury (SCI) and factors associated with those outcomes. Design: Structured interview, including standardized measures. Setting: Community. Participants: Individuals who sustained an SCI at age 18 years or

Caroline J. Anderson; Lawrence C. Vogel

2002-01-01

401

Levels of brain wave activity (8–13 Hz) in persons with spinal cord injury  

Microsoft Academic Search

Study design: Brain wave activity in people with spinal cord injury (SCI) was compared to brain wave activity in able-bodied controls.Objectives: To investigate whether a spinal injury results in changes in levels of brain wave activity in the 8–13 Hz spectrum of the electroencephalography (EEG).Setting: Sydney, Australia.Methods: Monopolar, multichannel EEG assessment was completed for 20 persons with SCI and 20

Y Tran; P Boord; J Middleton; A Craig

2004-01-01

402

Effects of an exercise program on the rehabilitation of patients with spinal cord injury  

Microsoft Academic Search

Salinas Dur[aacute]n F, Lugo L, Ram[iacute]rez L, Eusse E. Effects of an exercise program on the rehabilitation of patients with spinal cord injury. Arch Phys Med Rehabil 2001;82:1349-54. Objectives: To evaluate the impact of directed physical exercise in patients with spinal cord injury (SCI) and to measure functional independence before and after an exercise program. Design: Case series. Setting: Tertiary

Luz Lugo; Edgar Eusse Lic

2001-01-01

403

Beneficial effects of secretory leukocyte protease inhibitor after spinal cord injury  

PubMed Central

Secretory leukocyte protease inhibitor is a serine protease inhibitor produced by various cell types, including neutrophils and activated macrophages, and has anti-inflammatory properties. It has been shown to promote wound healing in the skin and other non-neural tissues, however, its role in central nervous system injury was not known. We now report a beneficial role for secretory leukocyte protease inhibitor after spinal cord injury. After spinal cord contusion injury in mice, secretory leukocyte protease inhibitor is expressed primarily by astrocytes and neutrophils but not macrophages. We show, using transgenic mice over-expressing secretory leukocyte protease inhibitor, that this molecule has an early protective effect after spinal cord contusion injury. Furthermore, wild-type mice treated for the first week after spinal cord contusion injury with recombinant secretory leukocyte protease inhibitor exhibit sustained improvement in locomotor control and reduced secondary tissue damage. Recombinant secretory leukocyte protease inhibitor injected intraperitoneally localizes to the nucleus of circulating leukocytes, is detected in the injured spinal cord, reduces activation of nuclear factor-?B and expression of tumour necrosis factor-?. Administration of recombinant secretory leukocyte protease inhibitor might therefore be useful for the treatment of acute spinal cord injury.

Ghasemlou, Nader; Bouhy, Delphine; Yang, Jingxuan; Lopez-Vales, Ruben; Haber, Michael; Thuraisingam, Thusanth; He, Guoan; Radzioch, Danuta; Ding, Aihao

2010-01-01

404

Serum Leptin Levels Following Acute Experimental Spinal Cord Injury  

PubMed Central

Background/Objective: Spinal cord injury influences many hormones that are known to be involved in the modulation of neurotrophic, neurogenic, and neuroprotective events. Recent studies showed that leptin could be neuroprotective, enhancing neuronal survival in vitro and in vivo. The objective of this study was to evaluate the pattern of the serum leptin levels in rats during acute traumatic SCI. Methods: Forty male Sprague-Dawley rats were divided randomly into 4 groups. In the control group, neither laminectomy nor SCI was performed; only laminectomy was performed without SCI in the sham group. In the cervical and thoracic spinal trauma groups, laminectomies were performed following the same trauma procedure. Blood samples were drawn 2, 6, 12, and 24 hours after the procedures and assayed immediately. Results: In the first 2 hours, levels of leptin were similar in control and sham-operated groups and higher in neurotrauma groups (P < 0.05). At the sixth hour, leptin levels increased in the sham-operated group, decreased in the neurotrauma groups (P < 0.05), and did not change in the control group (P > 0.05). At the 12th hour, the levels of leptin increased in all groups (P > 0.05). At the 24th hour, they decreased in the control, sham-operated, and cervical groups (P < 0.05); levels did not change in the thoracic group (P > 0.05). The decrease was higher in the control group than in the other groups (P < 0.05). Conclusions: Activation of endogenous leptin secretion started immediately after the SCI. The level of neurologic lesion (either cervical or thoracic regions) affected the levels of serum leptin differently, but with the exception of the first 12-hour period, this difference did not reach a statistically significant level.

Gezici, Ali Riza; Ergun, Ruchan; Karakas, Alper; Gunduz, Bulent

2009-01-01

405

Predicting “charge outliers” after spinal cord injury: A multicenter analysis of demographics, injury characteristics, outcomes, and rehabilitation charges  

Microsoft Academic Search

Burnett DM, Cifu DX, Kolakowsky-Hayner S, Kreutzer JS. Predicting “charge outliers” after spinal cord injury: a multicenter analysis of demographics, injury characteristics, outcomes, and rehabilitation charges. Arch Phys Med Rehabil 2001;82:114-9. Objective: To describe the distribution of charges, to distinguish between “charge outliers” and nonoutliers, and to identify a model that uses demographics and injury characteristics to predict charge outlier

Derek M. Burnett; David X. Cifu; Stephanie Kolakowsky-Hayner; Jeffrey S. Kreutzer

2001-01-01

406

Effect of nationwide injury prevention programme on serious spinal injuries in New Zealand rugby union: ecological study  

Microsoft Academic Search

Objective To investigate the effect of RugbySmart, a nationwide educational injury prevention programme, on the frequency of spinal cord injuries.Design Ecological study.Setting New Zealand rugby union. Participants Population at risk of injury comprised all New Zealand rugby union players. Intervention From 2001, all New Zealand rugby coaches and referees have been required to complete RugbySmart, which focuses on educating rugby

Kenneth L Quarrie; Simon M Gianotti; Will G Hopkins; Patria A Hume

2007-01-01

407

Rugby injuries to the cervical spine and spinal cord: a 10-year review.  

PubMed

A 10-year review (1987-1996) of injuries sustained to the spine and spinal cord in rugby players with resultant paralysis has been undertaken. This article reviews that the incidence of serious rugby spine and spinal cord injuries in South Africa has increased over the 10-year period reviewed, despite stringent new rules instituted in an attempt to decrease the incidence of these injuries. The mechanisms of injury, as previously reported, remain the same as well as the phases of game responsible for injury of the tight scrum, tackle, rucks, and mauls. Two new observations are reported: the first is related to the occurrence of spinal cord concussion with transient paralysis, and the second is related to the increased incidence of osteoarthritis of the cervical spine in rugby players. PMID:9475983

Scher, A T

1998-01-01

408

Prevention of urinary tract infections in persons with spinal cord injury in home health care.  

PubMed

More than 250,000 persons in the United States live with spinal cord injury (SCI), and 10,000 to 12,000 new injuries occur each year. Of these spinal cord injured persons, 53% have tetraplegia, 46% have paraplegia, and less than 1% experience complete neurologic recovery. About 48% have complete injuries (i.e., full quadriplegia) and 52% have incomplete injuries (; ). Almost all persons with neurologic impairment related to SCI have voiding dysfunction. Urinary tract infections (UTIs) have long been problematic for those living with SCI. Once the leading cause of death, urinary complications remain the leading cause of morbidity and the most common infection in persons with SCI (). This article provides a brief overview of spinal cord injuries and the effect of SCI on the urinary system. Factors that increase the risk for UTI will also be described. PMID:20520263

Eves, Faith J; Rivera, Natacha

2010-04-01

409

Partial Peripheral Nerve Injury Promotes a Selective Loss of GABAergic Inhibition in the Superficial Dorsal Horn of the Spinal Cord  

Microsoft Academic Search

To clarify whether inhibitory transmission in the superficial dor- sal horn of the spinal cord is reduced after peripheral nerve injury, we have studied synaptic transmission in lamina II neu- rons of an isolated adult rat spinal cord slice preparation after complete sciatic nerve transection (SNT), chronic constriction injury (CCI), or spared nerve injury (SNI). Fast excitatory trans- mission remains

Kimberly A. Moore; Tatsuro Kohno; Laurie A. Karchewski; Joachim Scholz; Hiroshi Baba; Clifford J. Woolf

2002-01-01

410

Effects of Rolipram on Adult Rat Oligodendrocytes and Functional Recovery after Contusive Cervical Spinal Cord Injury  

PubMed Central

Traumatic human spinal cord injury causes devastating and long-term hardships. These are due to the irreparable primary mechanical injury and secondary injury cascade. In particular, oligodendrocyte cell death, white matter axon damage, spared axon demyelination, and the ensuing dysfunction in action potential conduction lead to the initial deficits and impair functional recovery. For these reasons, and that oligodendrocyte and axon survival may be related, various neuroprotective strategies after SCI are being investigated. We previously demonstrated that oligodendrocytes in the adult rat epicenter ventrolateral funiculus express 3?-5?-cyclic adenosine monophosphate-dependent phosphodiesterase 4 subtypes and that their death was attenuated up to 3 days after contusive cervical spinal cord injury when rolipram, a specific inhibitor of phosphodiesterase 4, was administered. Here, we report that 1) there are more oligodendrocyte somata in the adult rat epicenter ventrolateral funiculus, 2) descending and ascending axonal conductivity in the ventrolateral funiculus improves, and that 3) there are fewer hindlimb footfall errors during grid-walking at 5 weeks after contusive cervical spinal cord injury when rolipram is delivered for 2 weeks. This is the first demonstration of improved descending and ascending long-tract axonal conductivity across a spinal cord injury with this pharmacological approach. Since descending long-tract axonal conductivity did not return to normal, further evaluations of the pharmacokinetics and therapeutic window of rolipram as well as optimal combinations are necessary before consideration for neuroprotection in humans with spinal cord injury.

Beaumont, Eric; Whitaker, Christopher M.; Burke, Darlene A.; Hetman, Michal; Onifer, Stephen M.

2009-01-01

411

Licofelone modulates neuroinflammation and attenuates mechanical hypersensitivity in the chronic phase of spinal cord injury.  

PubMed

Inflammation is a major factor shaping outcome during the early, acute phase of traumatic spinal cord injury (SCI). It is known that pro-inflammatory signaling within the injured spinal cord drives pathological alterations in neurosensory processing and shapes functional outcome early after injury. However, it is unclear whether inflammation persists into the chronic phase of injury or shapes sensory processing long after injury. To investigate these possibilities, we have performed biochemical and behavioral assessments 9 months after moderate thoracic spinal contusion injury in the rat. We have found that levels of the pro-inflammatory lipid mediators leukotriene B4 and prostaglandin E2 are elevated in the chronic spinal cord lesion site. Additionally, using metabolomic profiling, we have detected elevated levels of pro-oxidative and inflammatory metabolites, along with alterations in multiple biological pathways within the chronic lesion site. We found that 28 d treatment of chronically injured rats with the dual COX/5-LOX inhibitor licofelone elevated levels of endogenous anti-oxidant and anti-inflammatory metabolites within the lesion site. Furthermore, licofelone treatment reduced hypersensitivity of hindpaws to mechanical, but not thermal, stimulation, indicating that mechanical sensitivity is modulated by pro-inflammatory signaling in the chronic phase of injury. Together, these findings provide novel evidence of inflammation and oxidative stress within spinal cord tissue far into the chronic phase of SCI, and demonstrate a role for inflammatory modulation of mechanical sensitivity in the chronic phase of injury. PMID:23303944

Dulin, Jennifer N; Karoly, Edward D; Wang, Ying; Strobel, Henry W; Grill, Raymond J

2013-01-01

412

NEURONAL PROGENITOR TRANSPLANTATION AND RESPIRATORY OUTCOMES FOLLOWING UPPER CERVICAL SPINAL CORD INJURY IN ADULT RATS  

PubMed Central

Despite extensive gray matter loss following spinal cord injury (SCI), little attention has been given to neuronal replacement strategies and their effects on specific functional circuits in the injured spinal cord. In the present study, we assessed breathing behavior and phrenic nerve electrophysiological activity following transplantation of microdissected dorsal or ventral pieces of rat fetal spinal cord tissue (FSCD or FSCV, respectively) into acute, cervical (C2) spinal hemisections. Transneuronal tracing demonstrated connectivity between donor neurons from both sources and the host phrenic circuitry. Phrenic nerve recordings revealed differential effects of dorsally- vs. ventrally-derived neural progenitors on ipsilateral phrenic nerve recovery and activity. These initial results suggest that local gray matter repair can influence motoneuron function in targeted circuits following spinal cord injury and that outcomes will be dependent on the properties and phenotypic fates of the donor cells employed.

White, Todd E.; Lane, Michael A.; Sandhu, Milapjit S.; O'Steen, Barbara E.; Fuller, David D.; Reier, Paul J.

2010-01-01

413

Information Needs of People With Spinal Cord Injuries  

PubMed Central

Background/Objective: To determine the information needs, level of Internet access, and current and preferred formats and sources of information of adults with spinal cord injuries (SCIs). Individuals with SCIs have a high lifetime risk for medical complications and other health conditions secondary to their injury. Many secondary conditions can be prevented or mitigated through appropriate self-care and/or self-management. People with SCIs need timely, high-quality information about health and medical issues after discharge and throughout their lifetime to improve self-care and maximize quality of life. Methods: A survey was administered as part of the third time point of a longitudinal research study on individuals with SCI. Results: A total of 80.2% of the 277 respondents reported having Internet access. The most frequently selected format used currently and preferred by respondents for receiving SCI information was “Web pages/Internet.” The top-ranked current and preferred source of SCI information was from a “Physician: SCI Expert/ Rehabilitation Specialist.” Respondents reported needing information on medical issues the most. Significantly higher percentages of individuals identified as “white” and with higher education levels had access to the Internet and ranked the selection of Web pages/Internet as their top choice. Conclusions: Results confirm that, although people with SCI prefer to receive SCI information from SCI experts, the Internet is a more accessible and more currently used source. Educational level and race predicted current and preferred use of the Internet for obtaining SCI information, suggesting that Internet distribution of SCI information will exclude subgroups.

Matter, Becky; Feinberg, Melanie; Schomer, Katherine; Harniss, Mark; Brown, Pat; Johnson, Kurt

2009-01-01

414

[Lampreys as an animal model in regeneration studies after spinal cord injury].  

PubMed

Spinal cord injuries are an important sanitary and economical problem for the society. In mammals, including humans, a traumatic injury to the spinal cord leads to a loss of motor and sensorial function, which is irreversible due to the low regenerative ability of the central nervous system. In contrast to mammals, functional recovery occurs spontaneously after a complete spinal cord transection in lampreys. Functional recovery occurs because in these animals about 50% of the reticulospinal axons regenerate after injury and also because of the occurrence of processes of reorganization and plasticity of the spinal circuits. In this review, we first analyze the characteristics and regeneration ability of lampreys as compared to mammals. Then, we compile the knowledge about the process of recovery after a spinal cord injury acquired in studies using the lampreys as animal model and finally we provide some general perspectives about the molecular processes implicated in regeneration that can be investigated in a very advantageous way in this animal model and which knowledge could allow to develop new therapies for patients suffering spinal cord injury. PMID:22825976

Rodicio, María Celina; Barreiro-Iglesias, Antón

2012-08-01

415

A demographic profile of traumatic and non-traumatic spinal injury cases: a hospital-based study from India  

Microsoft Academic Search

Study design and subjects:Retrospective descriptive analysis of data of patients with spinal injuries admitted to a tertiary referral medical center from January 1, 2003 to December 31, 2004.Objectives:To identify the demographic profile of patients with spinal injuries admitted in this hospital.Setting:Medical records department, Kasturba Hospital, Manipal, Karnataka, India.Methods:A total of 207 patients with traumatic and non-traumatic spinal injuries were included

P Agarwal; P Upadhyay; K Raja

2007-01-01

416

Spinal cord stimulation: a new method to produce an effective cough in patients with spinal cord injury.  

PubMed

Patients with spinal cord injury have an increased risk of developing respiratory tract infections as the result of expiratory muscle paralysis and consequent inability to cough. We have developed a method by which the expiratory muscles can be activated via lower thoracic and upper lumbar spinal cord stimulation to produce an effective cough mechanism. In a tetraplegic patient who required frequent (8.57+/-2.3 times per week [mean+/-SEM]) caregiver assistance to facilitate airway clearance and expectoration of secretions, three epidural electrodes were applied in the T9, T11, and L1 spinal cord regions. During stimulation at the T9 and L1 levels, airway pressures were 90 and 82 cm H2O, respectively. Peak expiratory flow rates were 6.4 L/s and 5.0 L/s; respectively. During combined (T9+L1) stimulation, airway pressure and expiratory flow rate increased to 132 cm H2O and 7.4 L/s, respectively. Addition of the third lead did not result in further increases in pressure generation. These values are characteristic of those observed with a normal subject. Because the patient is able to trigger the device independently, he no longer requires caregiver support for airway management. If confirmed in additional patients, spinal cord stimulation may be a useful method to restore an effective cough mechanism in patients with spinal cord injury. PMID:16543552

DiMarco, Anthony F; Kowalski, Krzysztof E; Geertman, Robert T; Hromyak, Dana R

2006-03-16

417

Risk of hospitalizations after spinal cord injury: Relationship with biographic, injury, educational, and behavioral factors  

PubMed Central

Objectives To assess the risk factors associated with hospitalization and the relationship of individual health behaviors with hospitalizations following spinal cord injury (SCI). Study Design Cross-sectional survey. Setting A large specialty hospital in the Southeastern USA. Methods Persons with SCI responded (n=1386) to a mail survey assessing various aspects of their health including health behaviors and number of hospitalizations in the past year. Logistic regression was used to assess the relationships between biographic, injury, educational, and health behavior factors with hospitalization in the past year. Results Overall, 36.6% of participants were hospitalized on at least one occasion during the previous year. Two biographic and injury characteristics were associated with hospitalization: race and SCI severity. Specifically, minorities and persons with non-motor functional high cervical or non-cervical SCI (ASIA grades A–C) were more likely to be hospitalized. Three behavioral factors were significantly associated with hospitalization after controlling for biographic and injury characteristics. Persons who used prescription medications, those who engaged more in smoking behaviors, and persons who reported more SCI specific health behaviors were more likely to be hospitalized. Conclusion Specific health behaviors are associated with increased hospitalization among persons with SCI. Future research is needed to assessing the time-sequence of these relationships.

Krause, James S.; Saunders, Lee L.

2008-01-01

418

Regional cortical and trabecular bone loss after spinal cord injury.  

PubMed

Spinal cord injury (SCI) triggers rapid loss of trabecular bone mineral density (BMD) in bone epiphyses and a loss of cortical cross-sectional area (CSA) in bone diaphyses, increasing fracture risk for people with SCI. The purpose of this study was to measure trabecular BMD and cortical CSA loss at several previously unexamined lower-limb sites (4% fibula, 12% femur, 86% tibia, cortical) in individuals with SCI. Using peripheral quantitative computed tomography, we scanned 13 participants with SCI longitudinally and 16 on one occasion; 21 participants without SCI served as controls. In the first year post-SCI, 15% to 35% of BMD was lost at the distal femur, proximal tibia, and distal fibula. Bone loss at the distal fibula accelerated between 1 and 2 years post-SCI. BMD at these sites reached a steady state value of ~50% of the non-SCI value 4 years post-SCI. At the tibia diaphysis, cortical CSA decline was slower, eventually reaching 65% of the non-SCI value. Because of the extensive loss of bone observed at these sites, careful consideration needs to be given to the dose of musculoskeletal stress delivered during rehabilitation interventions like standing, muscle electrical stimulation, and aggressive stretching of spastic muscles. PMID:23408218

Dudley-Javoroski, Shauna; Shields, Richard K

2012-12-01

419

Colonoscopic lesions in veterans with spinal cord injury.  

PubMed

The overall goal of this observational study was to determine the type and prevalence of colonoscopic lesions encountered in veterans with traumatic spinal cord injury (SCI) and to examine their relationship to lesion level, completeness, and duration postinjury. We retrospectively reviewed the electronic charts of veterans with SCI who are regularly followed in our SCI clinic. Colonoscopy in veterans with SCI was undertaken for their gastrointestinal (GI) complaints. Of the 87 veterans with SCI, 71 who were 50 years of age or older were included in this study. Of these 71, 28 underwent colonoscopies (39.4%). Demographic variables were matched between patients who underwent colonoscopies and those who did not for age, sex, race/ethnicity, age of onset of SCI, and duration of SCI (p > 0.05). The colonoscopic lesions seen in 26 (93%) of the 28 veterans with SCI who underwent colonoscopies included diverticulae, internal hemorrhoids, and polyps. No relationship was found between colonoscopic lesion type and SCI lesion location or severity. A relationship was found between total colonoscopic lesions and duration of SCI (p < 0.001). Age-, sex-, and race/ethnicity-matched veterans without SCI (controls) who underwent colonoscopy for their GI complaints had more colonoscopic lesions than the veterans with SCI who underwent colonoscopies (p < 0.001). PMID:22773527

Rabadi, Meheroz H; Vincent, Andrea S

2012-01-01

420

Regional cortical and trabecular bone loss after spinal cord injury  

PubMed Central

Spinal cord injury (SCI) triggers rapid loss of trabecular bone mineral density (BMD) in bone epiphyses and a loss of cortical cross-sectional area (CSA) in bone diaphyses, increasing fracture risk for people with SCI. The purpose of this study was to measure trabecular BMD and cortical CSA loss at several previously unexamined lower-limb sites (4% fibula, 12% femur, 86% tibia, cortical) in individuals with SCI. Using peripheral quantitative computed tomography, we scanned 13 participants with SCI longitudinally and 16 on one occasion; 21 participants without SCI served as controls. In the first year post-SCI, 15% to 35% of BMD was lost at the distal femur, proximal tibia, and distal fibula. Bone loss at the distal fibula accelerated between 1 and 2 years post-SCI. BMD at these sites reached a steady state value of ~50% of the non-SCI value 4 years post-SCI. At the tibia diaphysis, cortical CSA decline was slower, eventually reaching 65% of the non-SCI value. Because of the extensive loss of bone observed at these sites, careful consideration needs to be given to the dose of musculoskeletal stress delivered during rehabilitation interventions like standing, muscle electrical stimulation, and aggressive stretching of spastic muscles.

Dudley-Javoroski, Shauna; Shields, Richard K.

2013-01-01

421

Vena Cava Filters in Spinal Cord Injuries: Evolving Technology  

PubMed Central

Background: Asymptomatic deep venous thrombosis (DVT) has been reported in 60% to 100% of persons with spinal cord injury (SCI). Several guidelines have been published detailing recommended venous thromboembolism (VTE) prophylaxis after acute SCI. Low-molecular-weight heparin, intermittent pneumatic compression (IPC) devices, and/or graduated compression stockings are recommended. Vena cava filters (VCFs) are recommended for secondary prophylaxis in certain situations. Objective: To clarify the use of vena cava filters in patients with SCI. Methods: Literature review. Results: Prophylactic use of vena cava filters has expanded in trauma patients, including individuals with SCI. Filter placement effectively prevents pulmonary emboli and has a low complication rate. Indications include pulmonary embolus while on anticoagulant therapy, presence of pulmonary embolus and contraindication for anticoagulation, and documented free-floating ileofemoral thrombus. VCFs should be considered in patients with complete motor paralysis caused by lesions in the high cervical cord (C2 and C3), with poor cardiopulmonary reserve, or with thrombus in the inferior vena cava despite anticoagulant prophylaxis. Three optional retrievable filters that are approved for use are discussed. Conclusion: Retrievable VCFs are a safe, feasible option for secondary prophylaxis of VTE in patients with SCI. Objective criteria for temporary and permanent placement need to be defined.

Johns, Jeffery S; Nguyen, Conner; Sing, Ronald F

2006-01-01

422

Expanding health promotion to individuals with spinal cord injuries.  

PubMed

Health promotion and preventive health services, though related, are not synonymous. Unlike preventive services, health promotion reaches beyond a specific action or inaction and nurtures a positive lifestyle. Many nurses believe in providing preventive health services to clients with spinal cord injuries (SCI) but describe them as clients who "will never get well." Nurses then question the relevance of health promotion services to those with SCI. This limited perspective fails to acknowledge that many individuals with physical disabilities perceive themselves as healthy. They know how to manage their disabilities and want to learn more about how they can actualize their potential in the context of their physical disabilities. Attitudes, overt or covert, that fail to recognize these individuals potential for health add to the disenfranchisement that they experience daily from society. This disenfranchisement often leads to hopelessness, anger, and depression. None of these emotions fosters health or happiness. The nurse who forges into health promotion expands his/her practice beyond the traditional "fix a problem" role. In the health promotion setting, the nurse's influence must move beyond preventing a specific complication and impact the more global outcome of promoting lifestyle choices, habits, and attitudes. PMID:10855210

Allen-Wright, S

1999-09-01

423

Cell Transplantation for Spinal Cord Injury: A Systematic Review  

PubMed Central

Cell transplantation, as a therapeutic intervention for spinal cord injury (SCI), has been extensively studied by researchers in recent years. A number of different kinds of stem cells, neural progenitors, and glial cells have been tested in basic research, and most have been excluded from clinical studies because of a variety of reasons, including safety and efficacy. The signaling pathways, protein interactions, cellular behavior, and the differentiated fates of experimental cells have been studied in vitro in detail. Furthermore, the survival, proliferation, differentiation, and effects on promoting functional recovery of transplanted cells have also been examined in different animal SCI models. However, despite significant progress, a “bench to bedside” gap still exists. In this paper, we comprehensively cover publications in the field from the last years. The most commonly utilized cell lineages were covered in this paper and specific areas covered include survival of grafted cells, axonal regeneration and remyelination, sensory and motor functional recovery, and electrophysiological improvements. Finally we also review the literature on the in vivo tracking techniques for transplanted cells.

Li, Jun; Lepski, Guilherme

2013-01-01

424

Gastrointestinal involvement in spinal cord injury: a clinical perspective.  

PubMed

Bowel problems occur in 27% to 62% of patients with spinal cord injuries (SCI), most commonly constipation, distention, abdominal pain, rectal bleeding, hemorrhoids, bowel accidents, and autonomic hyperreflexia. The acute abdomen, with a mortality of 9.5%, does not present with rigidity or absent bowel sounds but rather with dull/poorly-localized pain, vomiting, or restlessness, with tenderness, fever, and leukocytosis in up to 50% of patients. Fecal impaction may present with anorexia and nausea. Methods used for bowel care include laxatives, anal massage, manual evacuation, and enemas. Randomized, double-blind studies demonstrated the effectiveness of neostigmine, which increases cholinergic tone, combined with glycopyrrolate, an anticholinergic agent with minimal activity in the colon that reduces extracolonic side-effects. Improved bowel function occurs with anterior sacral root stimulators which may be combined with an S2 to S4 posterior sacral rhizotomy which interrupts the reflex arc by cutting the posterior roots carrying the spasticity-causing sensory nerves. For severe constipation, a colostomy reduces time for bowel care, providing a clean environment so decubitus ulcers may heal. Gallstones occur in 17% to 31% of patients, and acalculous cholecystitis in 3.7% of patients with acute SCI. A high index of suspicion is needed to properly diagnose bowel problems in SCI. PMID:22457863

Ebert, Ellen

2012-03-01

425

Body machine interface: remapping motor skills after spinal cord injury.  

PubMed

The goal of a body-machine interface (BMI) is to map the residual motor skills of the users into efficient patterns of control. The interface is subject to two processes of learning: while users practice controlling the assistive device, the interface modifies itself based on the user's residual abilities and preferences. In this study, we combined virtual reality and movement capture technologies to investigate the reorganization of movements that occurs when individuals with spinal cord injury (SCI) are allowed to use a broad spectrum of body motions to perform different tasks. Subjects, over multiple sessions, used their upper body movements to engage in exercises that required different operational functions such as controlling a keyboard for playing a videogame, driving a simulated wheelchair in a virtual reality (VR) environment, and piloting a cursor on a screen for reaching targets. In particular, we investigated the possibility of reducing the dimensionality of the control signals by finding repeatable and stable correlations of movement signals, established both by the presence of biomechanical constraints and by learned patterns of coordination. The outcomes of these investigations will provide guidance for further studies of efficient remapping of motor coordination for the control of assistive devices and are a basis for a new training paradigm in which the burden of learning is significantly removed from the impaired subjects and shifted to the devices. PMID:22275588

Casadio, M; Pressman, A; Acosta, S; Danzinger, Z; Fishbach, A; Mussa-Ivaldi, F A; Muir, K; Tseng, H; Chen, D

2011-01-01

426

Cell transplantation for spinal cord injury: a systematic review.  

PubMed

Cell transplantation, as a therapeutic intervention for spinal cord injury (SCI), has been extensively studied by researchers in recent years. A number of different kinds of stem cells, neural progenitors, and glial cells have been tested in basic research, and most have been excluded from clinical studies because of a variety of reasons, including safety and efficacy. The signaling pathways, protein interactions, cellular behavior, and the differentiated fates of experimental cells have been studied in vitro in detail. Furthermore, the survival, proliferation, differentiation, and effects on promoting functional recovery of transplanted cells have also been examined in different animal SCI models. However, despite significant progress, a "bench to bedside" gap still exists. In this paper, we comprehensively cover publications in the field from the last years. The most commonly utilized cell lineages were covered in this paper and specific areas covered include survival of grafted cells, axonal regeneration and remyelination, sensory and motor functional recovery, and electrophysiological improvements. Finally we also review the literature on the in vivo tracking techniques for transplanted cells. PMID:23484157

Li, Jun; Lepski, Guilherme

2013-01-15

427

Combination Drug Therapy for Pain following Chronic Spinal Cord Injury  

PubMed Central

A number of mechanisms have been elucidated that maintain neuropathic pain due to spinal cord injury (SCI). While target-based therapeutics are being developed based on elucidation of these mechanisms, treatment for neuropathic SCI pain has not been entirely satisfactory due in part to the significant convergence of neurological and inflammatory processes that maintain the neuropathic pain state. Thus, a combination drug treatment strategy, wherein several pain-related mechanism are simultaneously engaged, could be more efficacious than treatment against individual mechanisms alone. Also, by engaging several targets at once, it may be possible to reduce the doses of the individual drugs, thereby minimizing the potential for adverse side effects. Positive preclinical and clinical studies have demonstrated improved efficacy of combination drug treatment over single drug treatment in neuropathic pain of peripheral origin, and perhaps such combinations could be utilized for neuropathic SCI pain. At the same time, there are mechanisms that distinguish SCI from peripheral neuropathic pain, so novel combination therapies will be needed.

Hama, Aldric; Sagen, Jacqueline

2012-01-01

428

Functional Electrical Stimulation in Spinal Cord Injury Respiratory Care  

PubMed Central

The management of chronic respiratory insufficiency and/or long-term inability to breathe independently has traditionally been via positive-pressure ventilation through a mechanical ventilator. Although life-sustaining, it is associated with limitations of function, lack of independence, decreased quality of life, sleep disturbance, and increased risk for infections. In addition, its mechanical and electronic complexity requires full understanding of the possible malfunctions by patients and caregivers. Ventilator-associated pneumonia, tracheal injury, and equipment malfunction account for common complications of prolonged ventilation, and respiratory infections are the most common cause of death in spinal cord–injured patients. The development of functional electric stimulation (FES) as an alternative to mechanical ventilation has been motivated by a goal to improve the quality of life of affected individuals. In this article, we will review the physiology, types, characteristics, risks and benefits, surgical techniques, and complications of the 2 commercially available FES strategies – phrenic nerve pacing (PNP) and diaphragm motor point pacing (DMPP).

Jarosz, Renata; Littlepage, Meagan M.; Creasey, Graham; McKenna, Stephen L.

2012-01-01

429

Dysphagia and Associated Respiratory Considerations in Cervical Spinal Cord Injury  

PubMed Central

Background: Dysphagia is a relatively common secondary complication that occurs after acute cervical spinal cord injury (SCI). The detrimental consequences of dysphagia in SCI include transient hypoxemia, chemical pneumonitis, atelectasis, bronchospasm, and pneumonia. The expedient diagnosis of dysphagia is imperative to reduce the risk of the development of life-threatening complications. Objective: The objective of this study was to identify risk factors for dysphagia after SCI and associated respiratory considerations in acute cervical SCI. Methods: Bedside swallow evaluation (BSE) was conducted in 68 individuals with acute cervical SCI who were admitted to an SCI specialty unit. Videofluroscopy swallow study was conducted within 72 hours of BSE when possible. Results: This prospective study found dysphagia in 30.9% (21 out of 68) of individuals with acute cervical SCI. Tracheostomy (P = .028), ventilator use (P = .012), and nasogastric tube (P = .049) were found to be significant associated factors for dysphagia. Furthermore, individuals with dysphagia had statistically higher occurrences of pneumonia when compared with persons without dysphagia (P < .001). There was also a trend for individuals with dysphagia to have longer length of stay (P = .087). Conclusion: The role of respiratory care practitioners in the care of individuals with SCI who have dysphagia needs to be recognized. Aggressive respiratory care enables individuals with potential dysphagia to be evaluated by a speech pathologist in a timely manner. Early evaluation and intervention for dysphagia could decrease morbidity and improve overall clinical outcomes.

Chaw, Edward; Shem, Kazuko; Castillo, Kathleen; Wong, Sandra Lynn; Chang, James

2012-01-01

430

Controversies in the Surgical Management of Spinal Cord Injuries  

PubMed Central

Traumatic spinal cord injury (SCI) affects over 200,000 people in the USA and is a major source of morbidity, mortality, and societal cost. Management of SCI includes several components. Acute management includes medical agents and surgical treatment that usually includes either all or a combination of reduction, decompression, and stabilization. Physical therapy and rehabilitation and late onset SCI problems also play a role. A review of the literature in regard to surgical management of SCI patients in the acute setting was undertaken. The controversy surrounding whether reduction is safe, or not, and whether prereduction magnetic resonance (MR) imaging to rule out traumatic disc herniation is essential is discussed. The controversial role of timing of surgical intervention and the choice of surgical approach in acute, incomplete, and acute traumatic SCI patients are reviewed. Surgical treatment is an essential tool in management of SCI patients and the controversy surrounding the timing of surgery remains unresolved. Presurgical reduction is considered safe and essential in the management of SCI with loss of alignment, at least as an initial step in the overall care of a SCI patient. Future prospective collection of outcome data that would suffice as evidence-based is recommended and necessary.

Raslan, Ahmed M.; Nemecek, Andrew N.

2012-01-01

431

Care of post-traumatic spinal cord injury patients in India: An analysis  

PubMed Central

Background: The spinal cord injured patients if congregated early in spinal units where better facilities and dedicated expert care exist the outcome of treatment and rehabilitation, can be improved. The objective of this study is to find out the various factors responsible for a delay in the presentation of spinal injury patients to the specialized spinal trauma units and to suggest steps to improve the quality of care of the spinal trauma patients in the Indian setup. Materials and Methods: Sixty patients of traumatic spinal cord injury admitted for rehabilitation between August 2005 and May 2006 were enrolled into the study and their data was analyzed. Results: Eighty-five per cent of the spinal cord injured patients were males and the mean age was 34 years (range 13-56 years). Twenty-nine (48.33%) of the spinal injuries occurred due to fall from height. There was an average of 45 days (range 0-188 days) of delay in presentation to a specialized spinal unit and most of the time the cause for the delay was unawareness on the part of patients and/or doctors regarding specialized spinal units. In 38 (62.5%) cases the mode of transportation of the spinal cord injured patient to the first visited hospital was by their own conveyance and the attendants of the patients did not have any idea about precautions essential to prevent neurological deterioration. Seventeen (28.33%) patients were given injection solumedrol with conservative treatment, 35 (60%) patients were given only conservative treatment and seven patients were operated (11.66%) upon at initially visited hospital. Of the seven patients operated five were fixed with posterior Harrington instrumentation (71.42%) and two (28.57%) were operated by short segment posterior pedicle screw fixation. None of the patients were subjected to physiotherapy-assisted transfers or wheel chair skills or even basic postural training, proper bladder/ bowel training program and sitting balance. Conclusion: Awareness on the part of the general population, attendants of the patients, clinical and paraclinical team regarding spinal cord injury needs to be addressed. Safe mode of transportation of spinal cord injured patient and early presentation at tertiary spinal care center with comprehensive spinal trauma care team should be stressed upon.

Pandey, VK; Nigam, V; Goyal, T D; Chhabra, HS

2007-01-01

432

The incidence of neurogenic shock in patients with isolated spinal cord injury in the emergency department  

Microsoft Academic Search

Summary Background: Spinal cord injury (SCI) is recognised to cause hypotension and bradycardia (neu- rogenic shock). Previous studies have shown that the incidence of this in the emergency department (ED) may be low. However these studies are relatively small and have included a mix of blunt and penetrating injuries with measurements taken over different time frames. The aim was to

H. R. Gul; O. Bouamra; F. E. Leck

433

Analysis of 139 spinal cord injuries due to accidents in water sports  

Microsoft Academic Search

Between 1967 and 1978, a total of 2587 patients received primary treatment in the Spinal Cord Injury Centre at the University of Heidelberg. In 212 cases the paralysis was caused by sports or diving accidents. Injuries resulting from accidents in water sports totalled 139, 131 (61.7 per cent) of which could be classified as actual diving accidents. These 131 cases

K Steinbrück; V Paeslack

1980-01-01

434

DEATH ANXIETY AS A PREDICTOR OF POSTTRAUMATIC STRESS LEVELS AMONG INDIVIDUALS WITH SPINAL CORD INJURIES  

Microsoft Academic Search

Because the onset of a spinal cord injury may involve a brush with death and because serious injury and disability can act as a reminder of death, death anxiety was examined as a predictor of posttraumatic stress levels among individuals with disabilities. This cross-sectional study used multiple regression and multivariate multiple regression to examine whether death denial and death awareness

ERIN MARTZ

2004-01-01

435

Gabapentin for spasticity and autonomic dysreflexia after severe spinal cord injury  

Microsoft Academic Search

Study design:Using a complete transection spinal cord injury (SCI) model at the fourth thoracic vertebral level in adult rats, we evaluated whether blocking noxious stimuli below the injury diminishes abnormal somatic and autonomic motor reflexes, manifested in muscular spasticity and hypertensive autonomic dysreflexia, respectively. Gabapentin (GBP) is well tolerated and currently used to manage neuropathic pain in the SCI population;

A G Rabchevsky; S P Patel; H Duale; T S Lyttle; C R O'Dell; P H Kitzman

2011-01-01

436

Metabolic and Endocrine Changes in Persons Aging with Spinal Cord Injury  

Microsoft Academic Search

Persons with spinal cord injury (SCI) have secondary medical disabilities that impair their ability to function. With paralysis, dramatic deleterious changes in body composition occur acutely with further adverse changes ensuing with increasing duration of injury. Lean mass, composed of skeletal muscle and bone, is lost and adiposity is relatively increased. The body composition changes may be further exacerbated by

William A. Bauman; Ann M. Spungen; Rodney H. Adkins; Bryan J. Kemp

1999-01-01

437

Evoked potentials and quantitative thermal testing in spinal cord injury patients with chronic neuropathic pain  

Microsoft Academic Search

ObjectiveNeuropathic pain (NP) is a common symptom following spinal cord injury (SCI). NP may be associated with altered processing of somatosensory pathways in dermatomes rostral to the injury level. To explore this possibility, the characteristics of contact heat evoked potentials (CHEPs) and quantitative thermal testing (QTT) were studied at and above the lesion level in SCI patients with NP. The

Hatice Kumru; Dolors Soler; Joan Vidal; Josep Maria Tormos; Alvaro Pascual-Leone; Josep Valls-Sole

438

Antinociceptive effect of ambroxol in rats with neuropathic spinal cord injury pain  

Microsoft Academic Search

Symptoms of neuropathic spinal cord injury (SCI) pain include evoked cutaneous hypersensitivity and spontaneous pain, which can be present below the level of the injury. Adverse side-effects obtained with currently available analgesics complicate effective pain management in SCI patients. Voltage-gated Na+ channels expressed in primary afferent nociceptors have been identified to mediate persistent hyperexcitability in dorsal root ganglia (DRG) neurons,

Aldric T. Hama; Ann Woodhouse Plum; Jacqueline Sagen

2010-01-01

439

Excitotoxic spinal cord injury: behavioral and morphological characteristics of a central pain model  

Microsoft Academic Search

Intraspinal injections of the AMPA-metabotropic receptor agonist quisqualic acid (QUIS) were made in an effort to simulate injury induced elevations of excitatory amino acids (EAAs), a well documented neurochemical change following spinal cord injury (SCI). The progressive pathological sequela associated with QUIS injections closely resembles the cascade of events described following ischemic and traumatic SCI and the pathogenesis of cavities

R. P Yezierski; S Liu; G. L Ruenes; K. J Kajander; K. L Brewer

1998-01-01

440