Pathophysiology, causes, and management of non-traumatic spinal injury

2016 ◽  
Author(s):  
Oliver Flower ◽  
Matthew Mac Partlin
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Wide Spectrum ◽  
Case Series ◽  
Developed Countries ◽  
Traumatic Spinal Cord Injury ◽  
Disc Disease ◽  
Delay In Diagnosis ◽  
Cord Injury

Non-traumatic spinal cord injury (NTSCI) is at least as common as traumatic spinal cord injury (TSCI). It affects both sexes equally and an older population than TSCI. It is a devastating condition with immense functional implications for the individuals involved. There is a wide spectrum of aetiologies with varying pathophysiology and knowledge of these is important to avoid delay in diagnosis and time-critical treatment. The most common causes described in case series in developed countries are degenerative disc disease, canal stenosis, tumours, vascular diseases and inflammatory conditions. History and examination may help direct investigations, but magnetic resonance imaging is usually required. Management of NTSCI focuses on diagnosing and treating the precipitating cause, supportive management, and preventing complications. The outcomes of non-traumatic spinal cord injury are similar to those of traumatic spinal cord injury and depend on the grade and level of injury, pre-morbid status, and concurrent co-morbidities.

Neurological Recovery in Traumatic Spinal Cord Injury Patient with Delayed Surgical Intervention

2018 ◽  
Vol 1 (2) ◽  
pp. 34
Author(s):  
Mochamad Targib Alatas
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Intervention ◽  
Case Series ◽  
Spinal Cord Injury Patient ◽  
Traumatic Spinal Cord Injury ◽  
Best Interest ◽  
Score Improvement ◽  
Cord Injury ◽  
Injury Patient

Early surgical treatment for traumatic spinal cord injury (SCI) patients has been proven to yield better improvement on neurological state, and widely practiced among surgeons in this field. However, it is not always affordable in every clinical setting. It is undeniable that surgery for chronic SCI has more challenges as the malunion of vertebral bones might have initiated, thus requires more complex operating techniques. In this case series, we report 7 patients with traumatic SCI whose surgical intervention is delayed due to several reasons. Initial motoric scores vary from 0 to 3, all have their interval periods supervised between outpatient clinic visits. On follow up they demonstrate significant neurological development defined by at least 2 grades motoric score improvement. Physical rehabilitation also began before surgery was conducted. These results should encourage surgeons to keep striving for the patient’s best interest, even when the injury has taken place weeks or even months before surgery is feasible because clinical improvement for these patients is not impossible. 

Influence of severity and level of injury on the occurrence of complications during the subacute and chronic stage of traumatic spinal cord injury: a systematic review

2021 ◽  
pp. 1-21
Author(s):  
Charlotte Y. Adegeest ◽  
Jort A. N. van Gent ◽  
Janneke M. Stolwijk-Swüste ◽  
Marcel W. M. Post ◽  
William P. Vandertop ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Chronic Phase ◽  
Autonomic Dysreflexia ◽  
Traumatic Spinal Cord Injury ◽  
Chronic Stage ◽  
Increased Risk ◽  
Cord Injury ◽  
Meta Analyses

OBJECTIVE Secondary health conditions (SHCs) are long-term complications that frequently occur due to traumatic spinal cord injury (tSCI) and can negatively affect quality of life in this patient population. This study provides an overview of the associations between the severity and level of injury and the occurrence of SHCs in tSCI. METHODS A systematic search was conducted in PubMed and Embase that retrieved 44 studies on the influence of severity and/or level of injury on the occurrence of SHCs in the subacute and chronic phase of tSCI (from 3 months after trauma). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. RESULTS In the majority of studies, patients with motor-complete tSCI (American Spinal Injury Association [ASIA] Impairment Scale [AIS] grade A or B) had a significantly increased occurrence of SHCs in comparison to patients with motor-incomplete tSCI (AIS grade C or D), such as respiratory and urogenital complications, musculoskeletal disorders, pressure ulcers, and autonomic dysreflexia. In contrast, an increased prevalence of pain was seen in patients with motor-incomplete injuries. In addition, higher rates of pulmonary infections, spasticity, and autonomic dysreflexia were observed in patients with tetraplegia. Patients with paraplegia more commonly suffered from hypertension, venous thromboembolism, and pain. CONCLUSIONS This review suggests that patients with a motor-complete tSCI have an increased risk of developing SHCs during the subacute and chronic stage of tSCI in comparison with patients with motor-incomplete tSCI. Future studies should examine whether systematic monitoring during rehabilitation and the subacute and chronic phase in patients with motor-complete tSCI could lead to early detection and potential prevention of SHCs in this population.

scholarly journals Selenium-Binding Protein 1 (SELENBP1) as Biomarker for Adverse Clinical Outcome After Traumatic Spinal Cord Injury

2021 ◽  
Vol 15 ◽  
Author(s):  
Julian Seelig ◽  
Raban Arved Heller ◽  
Patrick Haubruck ◽  
Qian Sun ◽  
Jochen Georg Klingenberg ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Cell Damage ◽  
Cell Activity ◽  
Mechanical Trauma ◽  
Specific Cell ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury ◽  
Sensory Functions

Graphical AbstractThe pathophysiology of traumatic spinal cord injury (TSCI) can be divided into two major phases. (A) The mechanical trauma is followed within minutes by a secondary phase consisting of local complex and intertwined acute responses, intercellular signaling and cell activity regulating pathways. Inflammatory processes, oxidative stress and hypoxia, leading to cell damage and death, and specific cell contents are released into the circulation (B). The motor and sensory deficits upon TSCI are assessed by using the American Spinal Injury Association (ASIA) impairment scale (AIS), ranging from AIS A as a complete absence of any motor and sensory functions under the lesion site, to AIS E with complete preservation of motor and sensory functions. (C) The concentrations of serum SELENBP1 were elevated in patients classified as AIS A as compared to less severely affected patients classified as AIS B, C or D. A cut-off was deduced [(SELENBP1) > 30.2 μg/L], reliably predicting whether a patient belongs to the group showing neurological recovery (G1) or not (G0) within 3 months after the trauma. The figure was created by using https://biorender.com.

Understanding the factors that influence social and community participation as perceived by people with non-traumatic spinal cord injury

2017 ◽  
Vol 80 (10) ◽  
pp. 577-586 ◽  
Author(s):  
Linda Barclay ◽  
Primrose Lentin ◽  
Rachael McDonald ◽  
Helen Bourke-Taylor
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lived Experience ◽  
Community Participation ◽  
Institutional Environment ◽  
Developed Countries ◽  
Traumatic Spinal Cord Injury ◽  
Age Related ◽  
The Social ◽  
Cord Injury

Introduction The number of people with non-traumatic spinal cord injury is rising in developed countries such as Australia and Great Britain. People with non-traumatic spinal cord have different gender, injury and age-related profiles compared to those with traumatically acquired spinal cord injury; therefore, their lived experience is likely to be different. However, the specific issues and challenges that this group faces have not been well investigated. Method Semi-structured in-depth interviews were conducted with 17 adults with non-traumatic spinal cord injury. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Findings The factors that influenced the social and community participation of people with non-traumatic spinal cord injury were grouped into three broad areas: person factors, factors in the physical and institutional environment, and factors in the social or cultural environment. Conclusion The findings from this study inform the understanding of occupational therapists regarding the social and community participation of people with non-traumatic spinal cord injury and how this can be facilitated. Assisting people with non-traumatic spinal cord injury to participate in meaningful social and community-based activities is important to maximise their quality of life.

scholarly journals Spinal Cord Injury Rehabilitation in Nepal

2013 ◽  
Vol 52 (190) ◽  
Author(s):  
Nabina Shah ◽  
Binav Shrestha ◽  
Kamana Subba
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Developed Countries ◽  
Successful Implementation ◽  
Injury Rehabilitation ◽  
Rehabilitation Care ◽  
Cord Injury ◽  
The Developed Countries

Spinal cord injury is a major trauma, with its short and long term effects and consequences to the patient, his friends and family. Spinal cord injury is addressed in the developed countries with standard trauma care system commencing immediately after injury and continuing to the specialized rehabilitation units. Rehabilitation is important to those with spinal injury for both functional and psychosocial reintegration. It has been an emerging concept in Nepal, which has been evident with the establishment of the various hospitals with rehabilitation units, rehabilitation centres and physical therapy units in different institutions. However, the spinal cord injury rehabilitation setting and scenario is different in Nepal from those in the developed countries since spinal cord injury rehabilitation care has not been adequately incorporated into the health care delivery system nor its importance has been realized within the medical community of Nepal. To name few, lack of human resource for the rehabilitation care, awareness among the medical personnel and general population, adequate scientific research evidence regarding situation of spinal injury and exorbitant health care policy are the important hurdles that has led to the current situation. Hence, it is our responsibility to address these apparent barriers to successful implementation and functioning of rehabilitation so that those with spinal injury would benefit from enhanced quality of life.Keywords: rehabilitation; spinal injury.

Neurological Recovery in Traumatic Spinal Cord Injury Patient with Delayed Surgical Intervention

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Mochamad Targib Alatas
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Intervention ◽  
Case Series ◽  
Spinal Cord Injury Patient ◽  
Traumatic Spinal Cord Injury ◽  
Best Interest ◽  
Score Improvement ◽  
Cord Injury ◽  
Injury Patient

Early surgical treatment for traumatic spinal cord injury (SCI) patients has been proven to yield better improvement on neurological state, and widely practiced among surgeons in this field. However, it is not always affordable in every clinical setting. It is undeniable that surgery for chronic SCI has more challenges as the malunion of vertebral bones might have initiated, thus requires more complex operating techniques. In this case series, we report 7 patients with traumatic SCI whose surgical intervention is delayed due to several reasons. Initial motoric scores vary from 0 to 3, all have their interval periods supervised between outpatient clinic visits. On follow up they demonstrate significant neurological development defined by at least 2 grades motoric score improvement. Physical rehabilitation also began before surgery was conducted. These results should encourage surgeons to keep striving for the patient’s best interest, even when the injury has taken place weeks or even months before surgery is feasible because clinical improvement for these patients is not impossible.

scholarly journals Paired associative stimulation improves hand function after non-traumatic spinal cord injury: A case series

2019 ◽  
Vol 4 ◽  
pp. 178-183 ◽  
Author(s):  
Aleksandra Tolmacheva ◽  
Sarianna Savolainen ◽  
Erika Kirveskari ◽  
Nina Brandstack ◽  
Jyrki P. Mäkelä ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hand Function ◽  
Case Series ◽  
Traumatic Spinal Cord Injury ◽  
Paired Associative Stimulation ◽  
Cord Injury

scholarly journals Clinical Characteristics and Challenges of Management of Traumatic Spinal Cord Injury in a Trauma Center of a Developing Country

2019 ◽  
Vol 10 (03) ◽  
pp. 393-399
Author(s):  
Ayodeji Salman Yusuf ◽  
Muhammad Raji Mahmud ◽  
Dumura Jeneral Alfin ◽  
Samue Isa Gana ◽  
Samaila Timothy ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Trauma Center ◽  
Spinal Injury ◽  
Cervical Spinal Cord ◽  
Prehospital Care ◽  
Insurance Coverage ◽  
Traumatic Spinal Cord Injury ◽  
Optimal Care ◽  
Cord Injury

Abstract Background Traumatic spinal cord injury (TSCI) is a major burden in trauma care worldwide. Most victims are young, and the injury results in economic loss and psychological and social burden on the individual and the society. The outcome depends on the severity of primary spinal cord injury, interventions to prevent secondary insults to the damaged cord, and access to a specialized care. The lack of standard prehospital care and dedicated facilities for spine care coupled with challenges of inadequate health insurance coverage impact negatively on the outcome of care in patients with spinal cord injury in our practice. Objectives This study was performed to determine the clinical profile of patients with TSCI and to highlight the factors that determine the early outcome in a resource-constrained trauma center. Materials and Methods  This study was a retrospective review of trauma registry and medical records of all the patients with acute TSCI at the National Trauma Center Abuja from September 2014 to December 2016. Results A total of 133 patients with TSCI were studied. Most of these patients were young men with a mean age of 36 years. Most injury (72.2%) occurred following motor vehicular crash affecting mainly the cervical spinal cord (62.0%). None of the patients received standard prehospital care. Only 41.4% of the patients were transported to the hospital in an ambulance. About half (52.6%) of the patients suffered complete spinal cord injury (the American Spinal Injury Association [ASIA] A), and pressure ulcer was the most common complication (23.3%). Only 42% of the patients that needed surgical intervention were operated, mainly due to the inability to pay for the service. The ASIA grade on admission was the most significant determinant factor of morbidity and mortality. Conclusion Optimal care of patients with TSCI was hindered by inadequate facilities and economic constraints.

scholarly journals The effects of early or direct admission to a specialised spinal injury unit on outcomes after acute traumatic spinal cord injury

Spinal Cord ◽  
2016 ◽  
Vol 55 (5) ◽  
pp. 518-524 ◽  
Author(s):  
M M Maharaj ◽  
R E Stanford ◽  
B B Lee ◽  
R J Mobbs ◽  
O Marial ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury ◽  
Direct Admission
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