scholarly journals Arrow-Shot Injury to Pediatric Spinal Cord

2021 ◽  
Author(s):  
Vijayveer Singh ◽  
Sharad Thanvi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Pediatric Population ◽  
Cervical Region ◽  
Cervical Cord ◽  
Cord Injury ◽  
Dural Suturing ◽  
Stab Injuries ◽  
Early Surgical Intervention

AbstractPenetrating spinal cord injuries (PSCI) in cervical region are extremely rare in pediatric population. Most injuries in pediatric population are accidental due to gunshot or a stab injury with a sharp or pointed object. Gun shots may result into a severe wound which is usually fatal and may result in death, quadriplegia, or serious long-term disability. Stab injuries are less severe and may result in neurological sequalae. In this paper, an unusual case of pediatric arrow shot partial cervical cord injury is reported which was managed by aggressive neurosurgical management. The arrow lodged in the cervical cord was very near to the vertebral artery leading to parapariesis which recovered well without any complications. Diagnostic imaging at admission included radiographs, computed tomography (CT), and CT angiography of the cervical region. The patient underwent early surgical intervention with removal of foreign body from the cord and subsequent dural suturing.

scholarly journals Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury

2020 ◽  
pp. 030802262097951
Author(s):  
Lizette Norin ◽  
Björn Slaug ◽  
Maria Haak ◽  
Susanne Iwarsson
Keyword(s):  
Older Adults ◽  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Occupational Performance ◽  
Environmental Barriers ◽  
Cord Injury ◽  
Long Term Follow Up ◽  
Societal Level ◽  
The Individual

Introduction Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grab bars (hygiene area) generated the most accessibility problems. Conclusion Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level.

Long-term outcome of paediatric spinal cord injury

Trauma ◽  
2017 ◽  
Vol 19 (1_suppl) ◽  
pp. 75-82 ◽  
Author(s):  
Richa Kulshrestha ◽  
Naveen Kumar ◽  
J Roy Chowdhury ◽  
Aheed Osman ◽  
W El Masri
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Social Outcomes ◽  
Long Term Outcomes ◽  
Cord Injury ◽  
Post Traumatic ◽  
Clinical Records

Background Spinal cord injuries are relatively uncommon in children and evidence about long-term outcomes is limited. This study was performed to determine the frequency of common long-term complications in patients sustaining spinal injury in childhood (0–18 years) and who were followed up at a single dedicated spinal injuries centre in the UK. Method A retrospective review of clinical records of all patients injured at or less than 18 years of age between 1971 and 1999. Complications studied were renal, bowel, musculoskeletal, pressure ulcers and post-traumatic syringomyelia. Long-term social outcomes of independence, employment and driving were also assessed. Results Of 69 individuals (47 males, 22 females) the median age at injury was 17 years (range 0–18 y); 68% were older than 13 years at injury and 74% had traumatic injuries. Patients had an average duration of 27 years (12–43 years) of spinal injury – half had a neurological level of T6 and above, 80% had paraplegia and 20% had quadriplegia. Discussion Patients with both complete and incomplete spinal cord injury have minimal neurological recovery. Managing medical complications is vital as only 11.5% had normal voiding and 10.6% had normal bowel function. The incidence of skin ulcers increases with duration of spinal cord injury and scoliosis is higher in the non-traumatic injury group. Spasticity is observed in 66.6% and post-traumatic syringomyelia in 11.7%. Long-term social outcomes are good with 75% patients able to do independent care, 46% could drive and 39% managed employment or higher education. Conclusions This study documents the long-term outcomes and complications of spinal cord injuries sustained in childhood. With initial active physiological conservative management of the majority of patients, patient education and ongoing support the majority of patients achieved long-term survival and led independent and productive lives.

Traumatic brain and spinal cord injury

2020 ◽  
pp. 397-406
Author(s):  
Alice Theadom ◽  
Kelly M Jones
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Injury Risk ◽  
Spinal Cord Injuries ◽  
Epidemiological Methods ◽  
Increased Risk ◽  
Cord Injury ◽  
Poor Outcomes ◽  
Brain And Spinal Cord

Incidence of traumatic brain injury and spinal cord injury ranges between 45–790 per 100,000 and 1–6 per 100,000 respectively, with mortality rates ranging between 1–35%. The epidemiological evidence on traumatic brain (TBI) and spinal cord injuries (SCI) including definitions, injury classifications, and international reports of prevalence, are presented. Mortality figures, mechanisms of injury, risk factors, personal and societal costs, and acute and long-term outcomes are also reviewed. The influence of definitions, inclusion criteria, and recruitment sources on estimates and the need for standardization of epidemiological methods is also considered. Population groups most at risk of sustaining traumatic brain or spinal cord injuries are identified as well as highlighting those at increased risk of poor outcomes in the longer term. Traumatic brain and spinal cord injuries are explored separately, before briefly exploring the evidence of concurrent traumatic brain and spinal cord injury.

The Damaged Spinal Cord Is a Suitable Target for Stem Cell Transplantation

2020 ◽  
Vol 34 (8) ◽  
pp. 758-768
Author(s):  
Armin Curt ◽  
Jane Hsieh ◽  
Martin Schubert ◽  
Markus Hupp ◽  
Susanne Friedl ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Stem Cells ◽  
Cell Transplantation ◽  
Adult Stem Cells ◽  
Structural Changes ◽  
Tumor Formation ◽  
Cervical Cord ◽  
Cord Injury ◽  
Short And Long Term

Background. Given individuals with spinal cord injury (SCI) approaching 2 million, viable options for regenerative repair are desperately needed. Human central nervous system stem cells (HuCNS-SC) are self-renewing, multipotent adult stem cells that engraft, migrate, and differentiate in appropriate regions in multiple animal models of injured brain and spinal cord. Preclinical improved SCI locomotor function provided rationale for the first-in-human SCI clinical trial of HuCNS-SC cells. Evidence of feasibility and long-term safety of cell transplantation into damaged human cord is needed to foster translational progression of cellular therapies. Methods. A first-ever, multisite phase I/IIa trial involving surgical transplantation of 20 million HuCNS-SC cells into the thoracic cord in 12 AIS A or B subjects (traumatic, T2-T11 motor-complete, sensory-incomplete), aged 19 to 53 years, demonstrated safety and preliminary efficacy. Six-year follow-up data were collected (sensory thresholds and neuroimaging augmenting clinical assessments). Findings. The study revealed short- and long-term surgical and medical safety (well-tolerated immunosuppression in population susceptible to infections). Preliminary efficacy measures identified 5/12 with reliable sensory improvements. Unfortunately, without thoracic muscles available for manual muscle examination, thoracic motor changes could not be measured. Lower limb motor scores did not change during the study. Cervical cord imaging revealed, no tumor formation or malformation of the lesion area, and secondary supralesional structural changes similar to SCI control subjects. Interpretation. Short- and long-term safety and feasibility support the consideration of cell transplantation for patients with complete and incomplete SCI. This report is an important step to prepare, foster, and maintain the therapeutic development of cell transplantation for human SCI.

scholarly journals Use of glucocorticoids in acute spinal cord injuries: a last decade analysis

2021 ◽  
Author(s):  
Guilherme Dantas Campos Pinto ◽  
Gabriela Arcoverde Wanderley ◽  
Gustavo Sales Santa Cruz ◽  
Luís Eduardo Nobrega Nogueira Alves ◽  
Wagner Gonçalves Horta
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Meta Analysis ◽  
Safety Margin ◽  
Canadian Study ◽  
Neurological Outcomes ◽  
Cord Injury ◽  
Early Use ◽  
American Academy Of Neurology

Introduction: The early use of methylprednisolone (MP) pulse represents the only treatment suggested to stop neurological outcomes in non-operable acute spinal cord injuries (ASCI). The protocol of the drug use dates from the 1990s and results of the NASCIS 2 randomized clinical trial. However, such conduct is still an issue for discussion, due to limited evidence. Objective: To compare the results of the main studies about the use of MP in the ASCI published in the last decade. Methods: This is a narrative review of the use of MP in the ASCI. A search was carried out using the keywords “acute spinal cord injury” and “methylprednisolone” on PubMed and Cochrane, in April 2021. Indexed meta- analysis from 2011 to 2020 were used as filters. All studies (3) were selected for analysis and comparison of their results. Results: Cochrane meta-analysis, in 2012 concluded that MP administration results in an improvement of the neurological outcome and presents good safety margin. Although it agrees with the drug harmless, a Canadian study in 2017 pointed out the MP offers a poor motor function benefit in the long term. Recently, in 2019, a meta-analysis from the American Academy of Neurology, did not recommend the use of MP in the ASCI, because of the lack of benefit in neurological function and increased occurrence of complications after the adoption of the therapy. Conclusion: Data from the last ten years of analysis demonstrates a progressive decrease in the evidence in favor of the use of MP in the ASCI.

Value of gas myelography in early management of acute cervical spinal cord injuries

1975 ◽  
Vol 42 (3) ◽  
pp. 330-337 ◽  
Author(s):  
Alain B. Rossier ◽  
Jean Berney ◽  
Arthur E. Rosenbaum ◽  
Jurg Hachen
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord ◽  
Cord Compression ◽  
Cervical Cord ◽  
Valuable Contribution ◽  
Early Management ◽  
Specific Patient ◽  
Content Type ◽  
Cord Injury

✓ Gas myelography was carried out in 22 patients with acute cervical spinal cord injuries in whom oily contrast media seemed contraindicated. The authors believe this technique makes a valuable contribution to the basic decision regarding the surgical versus medical treatment of a specific patient with a cervical cord injury. They emphasize the importance of visualizing cord compression due to disc herniation in these cases and conclude that gases are the optimal contrast agents for visualization of the entire circumference of the spinal cord.

Catastrophic Football Injuries: 1977–1998

Neurosurgery ◽  
2000 ◽  
Vol 47 (3) ◽  
pp. 673-677 ◽  
Author(s):  
Robert C. Cantu ◽  
Frederick O. Mueller
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Axial Loading ◽  
Spinal Fracture ◽  
Cerebral Injury ◽  
Cervical Region ◽  
Direct Result ◽  
Cervical Cord ◽  
Cord Injury ◽  
Cervical Injuries

ABSTRACT THE PRIMARY PURPOSE of this study was to investigate the occurrence of catastrophic football head and spine injuries, in an attempt to reduce their frequency. We analyzed epidemiological and medical data from 1977 through 1998. Catastrophic football injuries are defined as football injuries that result in death, brain or spinal cord injury, or cranial or spinal fracture. All studied cord injuries involved the cervical region. During the period covered by this study, 118 athletes died as a direct result of participation in the skills of football, 200 football players received a permanent cervical cord injury, and 66 sustained a permanent cerebral injury. Most cervical injuries occurred to defensive players during the act of tackling. The axial loading mechanism of spinal cord injury was identified in 27% of tackling injuries. To further reduce catastrophic injuries, players must stop tackling with the head down and using the head as a battering ram; instead, players should use the shoulder for blocking and tackling. Other recommendations for reducing catastrophic injuries are presented.

scholarly journals Acupuncture's Effects in Treating the Sequelae of Acute and Chronic Spinal Cord Injuries: A Review of Allopathic and Traditional Chinese Medicine Literature

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Peter T. Dorsher ◽  
Peter M. McIntosh
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Spinal Cord Injuries ◽  
The United States ◽  
Sensory Loss ◽  
Term Survival ◽  
Cord Injury

Each year, there are an estimated 12 000 individuals who sustain a spinal cord injury (SCI) in the United States. Improved understanding of the pathophysiology of SCI and its sequelae has over the past 50 years led to the development of medical treatments (especially urologic) that have enhanced short- and long-term survival from these injuries. The prevalence of individuals with SCI in this country is ~250 000 individuals; and beyond the incalculable personal consequences of these devastating neurologic injuries, substantial direct and indirect societal costs result from the sequelae of SCI including paralysis, sensory loss, chronic pain, decubiti and bladder and/or bowel incontinence. The purpose of this treatise is to review the allopathic and traditional Chinese medicine (TCM) literature available through MEDLINE, PubMed and eCAM search engines that discuss the potential uses of acupuncture to treat acute and chronic spinal cord injuries and their sequelae, and present the neurophysiologic mechanisms for acupuncture's beneficial effects. There is evidence that use of electroacupuncture in acute SCI may significantly improve long-term neurologic recovery from these injuries both in terms of motor, sensory and bowel/bladder function with essentially no risk. Acupuncture may even improve neurourologic function in individuals with chronic SCI, and help with management with chronic pain associated with these injuries.

scholarly journals Spinal Cord Injuries Among Genders; Psychological Well- Being

2021 ◽  
Vol 8 (3) ◽  
pp. 9-14
Author(s):  
Samir Khan Kabir ◽  
Akhlaq Wazir ◽  
Naseer Hassan ◽  
Ihsan Ullah ◽  
Raza Hassan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Well Being ◽  
Total Sample ◽  
Anxiety And Depression ◽  
Psychological Well Being ◽  
Orthopaedic Department ◽  
Cord Injury ◽  
Male Patients

OBJECTIVES: The aim of this study was to analyse the psychological wellbeing among gender suffering from spinal cord injury (SCI). METHODOLOGY: This was a comparative study. It was conducted from January-March 2020 in Hayatabad Medical Complex (HMC), Peshawar. This study compares the psychological well being in terms of their stress, anxiety, and depression. A questionnaire DASS-42 was used to collect the data from both genders. The inclusion criteria comprise of patients who came for the treatment of their spinal cord injury to the orthopaedic department. Those patients having severe physical and comorbid psychiatric illness were excluded. The data was collected and analysed on SPSS 26. RESULTS: The total sample of 127 in which male were 83 and female were 44. The results were significant according to stress, anxiety, and depression. The level of stress was more in male patients, whereas anxiety results were insignificant among gender and depression were high in females respectively. CONCLUSION: Our results revealed, SCI patients have a high risk of anxiety or depression in among male and female. This information could help physicians understand the long-term risk of new-onset anxiety or depression in SCI patients .  

scholarly journals Level-Specific Differences in Systemic Expression of Pro- and Anti-Inflammatory Cytokines and Chemokines after Spinal Cord Injury

2018 ◽  
Vol 19 (8) ◽  
pp. 2167 ◽  
Author(s):  
James Hong ◽  
Alex Chang ◽  
Mohammad-Masoud Zavvarian ◽  
Jian Wang ◽  
Yang Liu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Vascular Supply ◽  
Thoracic Injury ◽  
Cervical Region ◽  
Cytokines And Chemokines ◽  
Markers Of Inflammation ◽  
Cord Injury ◽  
Anti Inflammatory ◽  
Splenic Atrophy

While over half of all spinal cord injuries (SCIs) occur in the cervical region, the majority of preclinical studies have focused on models of thoracic injury. However, these two levels are anatomically distinct—with the cervical region possessing a greater vascular supply, grey-white matter ratio and sympathetic outflow relative to the thoracic region. As such, there exists a significant knowledge gap in the secondary pathology at these levels following SCI. In this study, we characterized the systemic plasma markers of inflammation over time (1, 3, 7, 14, 56 days post-SCI) after moderate-severe, clip-compression cervical and thoracic SCI in a rat model. Using high-throughput ELISA panels, we observed a clear level-specific difference in plasma levels of VEGF, leptin, IP10, IL18, GCSF, and fractalkine. Overall, cervical SCI had reduced expression of both pro- and anti-inflammatory proteins relative to thoracic SCI, likely due to sympathetic dysregulation associated with higher level SCIs. However, contrary to the literature, we did not observe level-dependent splenic atrophy with our incomplete SCI model. This is the first study to compare the systemic plasma-level changes following cervical and thoracic SCI using level-matched and time-matched controls. The results of this study provide the first evidence in support of level-targeted intervention and also challenge the phenomenon of high SCI-induced splenic atrophy in incomplete SCI models.

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