Spinal Cord Injury During Spinal Surgery

Spinal cord injury (SCI) is a common disease in spinal surgery. SCI affects the metabolism of patients and changes their lifestyle. Nutritional problems may occur, which may be manifested as insufficient or overnutrition. Nutrition status is related to many complications and final outcome after SCI. In this paper, the nutritional status of patients with SCI and the progress of nutritional intervention were reviewed by comprehensive domestic and foreign literature. Medical staff should routinely screen and evaluate the nutrition of patients after SCI operation, and provide comprehensive nutritional intervention such as diet, exercise and dietary supplement.

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Protocol for rapid onset of mobilisation in patients with traumatic spinal cord injury (PROMPT-SCI) study: a single-arm proof-of-concept trial of early in-bed leg cycling following acute traumatic spinal cord injury

BMJ Open ◽

10.1136/bmjopen-2021-049884 ◽

2021 ◽

Vol 11 (11) ◽

pp. e049884

Author(s):

Jean-Marc Mac-Thiong ◽

Andreane Richard-Denis ◽

Yvan Petit ◽

Francis Bernard ◽

Dorothy Barthélemy ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Patient Outcomes ◽

Spinal Surgery ◽

Rapid Onset ◽

Traumatic Spinal Cord Injury ◽

Proof Of Concept ◽

Historical Cohort ◽

Cord Injury ◽

Leg Cycling

IntroductionActivity-based therapy (ABT) is an important aspect of rehabilitation following traumatic spinal cord injury (SCI). Unfortunately, it has never been adapted to acute care despite compelling preclinical evidence showing that it is safe and effective for promoting neurological recovery when started within days after SCI. This article provides the protocol for a study that will determine the feasibility and explore potential benefits of early ABT in the form of in-bed leg cycling initiated within 48 hours after the end of spinal surgery for SCI.Methods and analysisPROMPT-SCI (protocol for rapid onset of mobilisation in patients with traumatic SCI) is a single-site single-arm proof-of-concept trial. Forty-five patients aged 18 years or older with a severe traumatic SCI (American Spinal Injury Association Impairment Scale grade A, B or C) from C0 to L2 undergoing spinal surgery within 48 hours of the injury will be included. Participants will receive daily 30 min continuous sessions of in-bed leg cycling for 14 consecutive days, initiated within 48 hours of the end of spinal surgery. The feasibility outcomes are: (1) absence of serious adverse events associated with cycling, (2) completion of 1 full session within 48 hours of spinal surgery for 90% of participants and (3) completion of 11 sessions for 80% of participants. Patient outcomes 6 weeks and 6 months after the injury will be measured using neurofunctional assessments, quality of life questionnaires and inpatient length of stay. Feasibility and patient outcomes will be analysed with descriptive statistics. Patient outcomes will also be compared with a matched historical cohort that has not undergone in-bed cycling using McNemar and Student’s t-tests for binary and continuous outcomes, respectively.Ethics and disseminationPROMPT-SCI is approved by the Research Ethics Board of the CIUSSS NIM. Recruitment began in April 2021. Dissemination strategies include publications in scientific journals and presentations at conferences.Trial registration numberNCT04699474.

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Complications of spinal surgery in acute spinal cord injury

Spinal Cord ◽

10.1038/sc.1994.65 ◽

1994 ◽

Vol 32 (6) ◽

pp. 389-395 ◽

Cited By ~ 8

Author(s):

J E Carvell ◽

D J Grundy

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Spinal Surgery ◽

Acute Spinal Cord Injury ◽

Cord Injury

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Spinal Cord Injury During Spinal Surgery

Essentials of Neurosurgical Anesthesia & Critical Care ◽

10.1007/978-0-387-09562-2_29 ◽

2011 ◽

pp. 283-287 ◽

Cited By ~ 1

Author(s):

Masahiko Kawaguchi

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Spinal Surgery ◽

Cord Injury

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Early Spinal Surgery Following Thoracolumbar Spinal Cord Injury

Spine ◽

10.1097/brs.0000000000001903 ◽

2017 ◽

Vol 42 (10) ◽

pp. E617-E623 ◽

Cited By ~ 8

Author(s):

Jacqui Agostinello ◽

Camila R. Battistuzzo ◽

Peta Skeers ◽

Stephen Bernard ◽

Peter E. Batchelor

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Spinal Surgery ◽

Cord Injury

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Full-Endoscopic Decompression with the Application of an Endoscopic-Matched Ultrasonic Osteotome for Removal of Ossification of the Thoracic Ligamentum Flavum

January 2018 - Pain Physician ◽

10.36076/ppj.2021/24/275 ◽

2021 ◽

pp. 275-281

Author(s):

Yuan-Ting Zhao

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Spinal Surgery ◽

Ligamentum Flavum ◽

Japanese Orthopaedic Association ◽

Thoracic Myelopathy ◽

Improvement Rate ◽

Cord Injury ◽

Endoscopic Spinal Surgery

Background: Resection of the ossification of the thoracic ligamentum flavum (OTLF) with a high-speed burr may cause a high rate of perioperative complications, such as dural laceration and/or iatrogenic spinal cord injury. Objectives: The aim of this study was to investigate the safety and feasibility of the endoscopicmatched ultrasonic osteotome in full-endoscopic spinal surgery for direct removal of OTLF. Study Design: Retrospective study. Setting: All data were from Honghui Hospital in Xi’an. Methods: This study conducted between December 2017 and December 2018, included 27 consecutive patients who met the study criteria, had single-level OTLF, and underwent fullendoscopic decompression under local anesthesia. The postoperative follow-up was scheduled at 1, 3, 6, and 12 months postoperatively. Outcomes evaluations included the Visual Analog Scale (VAS) score for lower extremity pain and the modified Japanese Orthopaedic Association (mJOA) score and improvement rate for the assessment of thoracic myelopathy. Removal of OTLF was measured by comparing the pre- and postoperative computed tomography (CT) and magnetic resonance imaging (MRI) scans. Results: The operation was completed in all patients without conversion to open surgery. The operation time ranged from 65 to 125 minutes (average, 83.7 ± 12.3 minutes). All patients were followed up for 12 to 18 months, with an average follow-up of 14.3 ± 1.3 months. Satisfactory neurologic decompression was confirmed by postoperative CT and MRI, and no revision surgery was required. The VAS and mJOA scores showed statistically higher improvement at the 1-month follow-up and the last follow-up compared with the preoperative assessment (P < 0.05). According to the improvement rate at the final follow-up, 20 cases were classified as good, 6 cases were fair, and 1 case remained unchanged. Limitations: A single-center, noncontrol study. Conclusions: The endoscopic-matched ultrasonic osteotome can be considered quite safe and feasible for direct removal of OTLF during full-endoscopic spinal surgery in strictly selected patients, as this allows for effective direct decompression of OTLF while minimizing trauma and instability. In addition, because of the design characteristics of the ultrasonic osteotome, surgical complications, especially dural tears and spinal cord injury, can also be effectively controlled. Key words: Percutaneous endoscopic spinal surgery, ultrasonic osteotome, ossification of thoracic ligamentum flavum, microsurgery, thoracic myelopathy, minimally invasive procedures

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