A Study of Critical Events That Lead to Spinal Cord Injury and the Importance of Rapid Reversal of Surgical Steps in Improving Neurological Outcomes

It is difficult to assess and monitor the spinal cord injury (SCI) because of its pathophysiology after injury, with different degrees of prognosis and various treatment methods, including laminectomy, durotomy, and myelotomy. Medical communication services with different factors such as time of surgical intervention, procedure choice, spinal cord perfusion pressure (SCPP), and intraspinal pressure (ISP) contribute a significant role in improving neurological outcomes. This review aims to show the benefits of communication services and factors such as ISP, SCPP, and surgical intervention time in order to achieve positive long-term outcomes after an appropriate treatment method in SCI patients. The SCPP was found between 90 and 100 mmHg for the best outcome, MAP was found between 110 and 130 mmHg, and mean ISP is ≤20 mmHg after injury. Laminectomy alone cannot reduce the pressure between the dura and swollen cord. Durotomy and duroplasty considered as treatment choices after severe traumatic spinal cord injury (TSCI).

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Prognostic utility of magnetic resonance imaging (MRI) in predicting neurological outcomes in patients with acute thoracolumbar spinal cord injury

European Spine Journal ◽

10.1007/s00586-019-06135-6 ◽

2019 ◽

Vol 29 (6) ◽

pp. 1227-1235

Author(s):

Ankith Naduvanahalli Vivekanandaswamy ◽

Muhil Kannan ◽

Vyom Sharma ◽

Ajoy Prasad Shetty ◽

Anupama Maheswaran ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Magnetic Resonance ◽

Resonance Imaging ◽

Neurological Outcomes ◽

Cord Injury ◽

Prognostic Utility ◽

Magnetic Resonance Imaging Mri

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Impact of multiple injuries on functional and neurological outcomes of patients with spinal cord injury

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/1757-7241-21-42 ◽

2013 ◽

Vol 21 (1) ◽

Cited By ~ 11

Author(s):

Giorgio Scivoletto ◽

Sara Farchi ◽

Letizia Laurenza ◽

Federica Tamburella ◽

Marco Molinari

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Multiple Injuries ◽

Neurological Outcomes ◽

Cord Injury

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Serum Albumin Predicts Long-Term Neurological Outcomes After Acute Spinal Cord Injury

Neurorehabilitation and Neural Repair ◽

10.1177/1545968317746781 ◽

2017 ◽

Vol 32 (1) ◽

pp. 7-17 ◽

Cited By ~ 7

Author(s):

Bobo Tong ◽

Catherine R. Jutzeler ◽

Jacquelyn J. Cragg ◽

Lukas Grassner ◽

Jan M. Schwab ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Clinical Trials ◽

Lower Extremity ◽

Serum Albumin ◽

Injury Severity ◽

International Standards ◽

Neurological Outcomes ◽

Cord Injury

Background. There is a need to identify reliable biomarkers of spinal cord injury recovery for clinical practice and clinical trials. Objective. Our objective was to correlate serum albumin levels with spinal cord injury neurological outcomes. Methods. We performed a secondary analysis of patients with traumatic spinal cord injury (n = 591) participating in the Sygen clinical trial. Serum albumin concentrations were obtained as part of routine blood chemistry analysis, at trial entry (24-72 hours), 1, 2, and 4 weeks after injury. The primary outcomes were “marked recovery” and lower extremity motor scores, derived from the International Standards for the Neurological Classification of Spinal Cord Injury. Data were analyzed with multivariable logistic and linear regression to adjust for potential confounders. Results. Serum albumin was significantly associated with spinal cord injury neurological outcomes. Higher serum albumin concentrations at 1, 2, and 4 weeks were associated with higher 52-week lower extremity motor score. Similarly, the odds of achieving “marked neurological recovery” was greater for individuals with higher serum albumin concentrations. The association between serum albumin concentrations and neurological outcomes was independent of initial injury severity, treatment with GM-1, and polytrauma. Conclusions. In spinal cord injury, serum albumin is an independent marker of long-term neurological outcomes. Serum albumin could serve as a feasible biomarker for prognosis at the time of injury and stratification in clinical trials.

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Use of Fidji Cervical Cage in the Treatment of Cervical Spinal Cord Injury without Radiographic Abnormality

BioMed Research International ◽

10.1155/2013/810172 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Sheng-Li Huang ◽

Hong-Wei Yan ◽

Kun-Zheng Wang

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Clinical Symptoms ◽

Cervical Spinal Cord ◽

Rare Condition ◽

X Rays ◽

Neurological Outcomes ◽

Radiographic Abnormality ◽

Cord Injury ◽

Disc Injury

Spinal cord injury without radiographic abnormality (SCIWORA) is a rare condition seen in adults. Many interbody fusion cages have been developed for its treatment, but clinical studies of Fidji cervical cage are still scarce. A total number of five patients (four male and one female) were reviewed. The ages of the patients ranged from 40 to 60 years. All the patients underwent neurological and radiological examinations. Neurological and functional outcomes were assessed on the basis of Frankel’s grade. Three of the patients were Frankel B, and the rest two were Frankel C. Magnetic resonance imaging was also performed for the evaluation of spinal cord and intervertebral disc injury. Anterior cervical discectomy and Fidji cervical cage fusion were performed for all. The fusion status was evaluated on the basis of X-rays. After surgical intervention, the clinical symptoms improved for all the patients. The disc interspaces in all the patients achieved solid union at final follow-up. Fidji cervical cage is very efficient in achieving cervical fusion in patients with SCIWORA. There are few complications associated with the use of this cage, and the functional and neurological outcomes are satisfactory.

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