Pathology of spinal cord lesions caused by ossification of the posterior longitudinal ligament, with special reference to reversibility of the spinal cord lesion

Objective: Patients with nontraumatic spinal cord lesions account for between one fourth and one half of all spinal cord injuries. In the management of this group of patients, an understanding of factors influencing functional improvement is essen tial to help define the most appropriate rehabilitation programme. Although it is pos sible to predict accurately the functional outcome for an individual patient with a com plete traumatic spinal cord injury, few studies have looked at prognostic factors in patients with nontraumatic spinal cord disease. The aim of this study was to determine which, and how well, factors assessed on admission to a rehabilitation unit relate to functional improvement in this group. Methods: The study sample consists of 100 patients with an incomplete nontraumatic spinal cord lesion who underwent inpatient neurorehabilitation. Possible prognostic factors were sought by identifying those vari ables with a significant difference in the Functional Independence Measure (FIM) motor change score above and below the median. A step-wise multiple regression analysis was then performed to determine which variables influenced functional out come. Results: Patients with larger functional gains had significantly lower disability scores on admission, a shorter time between symptom onset and rehabilitation, and a longer length of stay. They were more likely to have a cervical lesion and evidence of neurologic recovery. Multiple regression analysis demonstrated that the FIM motor score on admission and the time between symptom onset and rehabilitation predicted 54% of the variance of the FIM motor score gain. Conclusions: This finding suggests that early rehabilitation is an important factor in securing a good outcome. Key Words: Rehabilitation-Spinal cord lesion-Functional outcome.

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Electromyography in spinal cord lesion with special reference to the sphincters

Spinal Cord ◽

10.1038/sc.1966.32 ◽

1967 ◽

Vol 4 (4) ◽

pp. 240-244 ◽

Cited By ~ 3

Author(s):

Alex Chantraine ◽

Leo Timmermans

Keyword(s):

Spinal Cord ◽

Special Reference ◽

Spinal Cord Lesion ◽

Cord Lesion

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The Correlation of High Signal Intensity Spinal Cord Lesion in MRI T2-weighted Image and Neurological Symptom : The Experience of Operated 78 Cases of Cervical Spondylosis and Ossified Posterior Longitudinal Ligament

Spinal Surgery ◽

10.2531/spinalsurg.14.193 ◽

2000 ◽

Vol 14 (3) ◽

pp. 193-200

Author(s):

Hirofumi Oyama ◽

Akira Ikeda ◽

Shigeo Inoue ◽

Hiroshi Iizuka ◽

Otone Endoh ◽

...

Keyword(s):

Spinal Cord ◽

Neurological Symptom ◽

Signal Intensity ◽

Cervical Spondylosis ◽

Posterior Longitudinal Ligament ◽

High Signal Intensity ◽

Spinal Cord Lesion ◽

High Signal ◽

Ossified Posterior Longitudinal Ligament ◽

Cord Lesion

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Treatment of wrist deformities in children with arthrogryposis multiplex congenita

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors4126-36 ◽

2016 ◽

Vol 4 (1) ◽

pp. 26-36

Author(s):

Evgeniya A Kochenova ◽

Olga E Agranovich ◽

Margarita V Savina

Keyword(s):

Spinal Cord ◽

Hand Function ◽

Flexion Contracture ◽

Spinal Cord Lesion ◽

Wedge Osteotomy ◽

Arthrogryposis Multiplex Congenita ◽

Spinal Cord Lesions ◽

Ulnar Deviation ◽

Tendon Transfers ◽

Cord Lesion

Introduction: Treatment of wrist contractures in children with arthrogryposis multiplex congenita (AMC) is extremely problematic because of the high incidence of recurrence. This study aimed to improve the outcome of wrist contracture treatment in children with AMC.Materials and Methods: A total of 90 patients (162 wrists) were examined and treated. Patients were assessed using a number of clinical, radiological, and electrophysiological examinations. There are several different clinical variants of wrist contracture, including flexion contracture of the wrist, flexion contracture associated with ulnar deviation, and isolated ulnar deviation of the wrist. Patients were divided into three groups according to the level of spinal cord lesion: С6-С7, С5-С8, and С5-Th1. As the number of damaged spinal cord segments increased, the amplitude of passive and active movements, degree of passive correction, muscle power, and wrist function decreased. Surgical treatment involved the following three approaches: tendon transfers, tendon transfers and carpal wedge osteotomy, and tendon transfers with carpal wedge osteotomy and shortened osteotomy of the forearm.Results: Analysis of treatment results showed that patients with segmental spinal cord lesions at the С6-С7 and С5-С8 level were mostly associated with a good outcome, whereas patients with lesions at the С5-Th1 level achieved satisfactory outcomes.Conclusions: Patients with segmental lesions of the spinal cord at the С6-С7 and С5-С8 level were associated with restoration of active wrist extension up to the neutral position or more and were expected to achieve significant improvement of hand function. Patients with spinal cord lesions at the C5-Th1 level exhibited significant lesions of the muscles, along with bone deformities. Consequently, surgical treatment could only achieve functional wrist position with minimal improvement of hand function. Using differential approaches in the treatment of wrist contracture that are selected by determining the level of spinal cord lesion will enable physicians to predict the outcome and improve the function and appearance of the wrist.

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