The serum SIRT1 protein is associated with the severity of injury and neurological recovery in mice with traumatic spinal cord injury

OBJECTIVEThe objective of this prospective study was to determine the optimal timing for surgical decompression (SD) in patients with acute traumatic cervical spinal cord injury (tSCI) within the first 24 hours of injury.METHODSIn successive patients with fracture and/or dislocation of the subaxial cervical spine and American Spinal Injury Association Impairment Scale (AIS) grades A–C, receiver operating characteristic curve analysis was used to determine the optimal timing for SD within the first 24 hours of cervical tSCI to obtain a neurological recovery of at least two AIS grades. Multivariate logistic regression was used to model significant neurological recovery with time to SD, degree of spinal canal compromise (SCC), and severity of injury.RESULTSIn this cohort of 64 patients, the optimal timing for SD to obtain a significant neurological improvement was within 4 hours of injury (95% confidence interval 4–9 hours). Increasing the delay from injury to SD or the degree of SCC significantly reduced the likelihood of significant neurological improvement. Due to the strong correlation with SCC, the severity of injury was a marginally significant predictor of neurological recovery.CONCLUSIONSThese findings indicate that in patients with acute cervical tSCI and AIS grades A–C, the optimal timing for SD is within the first 4–9 hours of injury, depending on the degree of SCC and the severity of injury. Further studies are required to better understand the interrelationships among the timing of SD, injury severity, and degree of SCC in these patients.

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Epidemiological Characteristics of Traumatic Spinal Cord Injury in Shaanxi, China

10.21203/rs.3.rs-892532/v1 ◽

2021 ◽

Author(s):

Liang Yan ◽

Dong Wang ◽

Jinpeng Du ◽

Dingjun Hao ◽

Baorong He ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Medical Records ◽

Shaanxi Province ◽

Traumatic Spinal Cord Injury ◽

Diagnostic Code ◽

Female Ratio ◽

Severity Of Injury ◽

Cord Injury ◽

Epidemiological Characteristics

Abstract Study Design. A hospital-based retrospective epidemiological study.Summary of Background Data. TSCI is a highly disabling and deadly injury. Currently, there is little information regarding the epidemiological characteristics for TSCI in Shaanxi.Objective: To describe the demographic and epidemiological characteristics of patients with traumatic spinal cord injury (TSCI) in Shaanxi to help health-related institutions formulate corresponding measures.Methods. We retrospectively reviewed the medical records of the spine centers or orthopedic centers of the four cities in Shaanxi province according to the International Classification of Disease Version 10 (ICD-10) and diagnostic code of TSCI. Variables included gender, age, medical insurance, etiology, occupation, time of injury, level of injury, and severity of injury, multiple injury, treatment, and so on.Results: The study included the medical records of 694 patients with TSCI in 2018. The mean age of patients with TSCI was 48.4±14.9 years, and the male/female ratio was 3.45:1. The major causes of TSCI were high falls (40.2%) and low falls (26.7%). The most common injury site was the cervical spinal cord, accounting for 48.7%. The highest proportion of severity of injury was ASIA Grade D (37.8%). In addition, 74.6% of the patients had spinal fractures, the chest (38.0%) accounted for the highest proportion of all TSCI patients. Furthermore, 27.8% of the patients experienced clinical complications. 530 (76.4%) patients underwent surgery, 323 (46.5%) patients underwent inpatient rehabilitation.Conclusion: There are specific epidemiological characteristics of TSCI patients in Shaanxi, and preventive measures are suggested to be based on the characteristics of the different types of patients with TSCI and focused on high-risk groups.

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