scholarly journals The demographics and traumatic causes of spinal cord injury in Nepal: An observational study

Trauma ◽  
2020 ◽  
pp. 146040862094134
Author(s):  
Arran Willott ◽  
Raju Dhakal ◽  
Christine Groves ◽  
Julie Mytton ◽  
Matthew Ellis
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Young Adults ◽  
East Asia ◽  
Road Traffic ◽  
Spinal Injury ◽  
Age Groups ◽  
South East Asia ◽  
Rehabilitation Centre ◽  
Cord Injury

Introduction There has been little systematic study of the epidemiology of traumatic spinal cord injury (TSCI) in Nepal, South-East Asia, and low- and middle-income countries (LMICs) in general. One third of the global morbidity and mortality due to injuries is concentrated in South-East Asia. We need to better understand the circumstances leading to TSCI if we are to make progress with prevention. Method The Spinal Injury Rehabilitation Centre (SIRC) in Nepal systemically collected prospective data describing people with TSCI admitted between September 2015 and August 2016. Descriptive analyses of variables yielded demographic, aetiological and clinical descriptors of this cohort. Cross-tabulations were used to explore the associations between variables. Results Of 184 admissions over one year, males were admitted to SIRC almost 2.3 times more often than females. Young adults (21–30 years) were the largest age group (34%). The majority of TSCI resulted in paraplegia (67%) and was complete in nearly half (49%). Falls caused the majority of TSCI (69%), and falls from trees were the most common. Road traffic injuries (RTIs) were the second leading cause (29%); the majority involved two- or three-wheeled motorised vehicles and patients were most commonly driving. Conclusion Falls were the leading cause of TSCI across both genders and all age groups, followed by RTIs, which occurred most often in young adults and men. Injury surveillance and further research would provide a greater understanding of the pattern of TSCI and enable progress in TSCI prevention and rehabilitation.

scholarly journals Spinal Injury in Indian Children: Review of 204 Cases

2019 ◽  
Vol 10 (8) ◽  
pp. 1034-1039
Author(s):  
M. L. Bansal ◽  
Rajesh Sharawat ◽  
Rajat Mahajan ◽  
Hitesh Dawar ◽  
Bibhudendu Mohapatra ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Age Groups ◽  
Spine Injury ◽  
Fisher Exact Test ◽  
Injury Incidence ◽  
Age Group ◽  
Indian Children ◽  
Cord Injury

Study design: Retrospective study. Objective: The purpose of the study was to analyze the epidemiological parameters and associated factors after spinal cord injury (SCI) in children, in the last 14 years admitted at a tertiary care center (Indian Spinal Injury Centre [ISIC], New Delhi, India). Method: The demographic and injury-related data was analyzed descriptively. The incidence, type, and level of injury were compared across the age groups using a χ2 test. Wherever appropriate, Fisher exact test was used. Results: There were 1660 pediatric trauma cases admitted at ISIC from 2002 to 2015, where 204 cases presented with spine injuries. The average age of children sustaining spine injury was 15.69 years (3-18 years of range). There were 15 patients in the age group 0 to 9 years, 27 patients in the age group 10 to 14 years, and 162 patients in the age group 15 to 18 years. This difference in spine injury incidence among the age groups was statistically significant. Fall from height was a common mode of injury. In our sample, boys were 3 times more likely to be injured than girls. Burst fractures were common among the type of injuries. Conclusion: Our study confirms the predominance of cervical spine injury and the high incidence of multilevel contiguous with a lesser percentage of noncontiguous multilevel spinal involvement. SCIWORA (spinal cord injury without radiological abnormality) incidences were in a similar context to the literature available. There was a very low incidence of death. Neurological improvement was seen in 8 operated cases and 4 conservatively treated cases.

scholarly journals Demographic Profile of Spinal Cord Injury Patients Admitted in a Rehabilitation Centre: An Observational Study from Bangladesh

2018 ◽  
pp. e000111 ◽  
Author(s):  
Ziniya Mustary Rahman ◽  
S. M. Alam ◽  
Md. Shujayt Goni ◽  
Faruq Ahmed ◽  
A K M Tawhid ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Demographic Data ◽  
Rehabilitation Centre ◽  
Demographic Profile ◽  
The Road ◽  
Cord Injury ◽  
Fall From Height

Background:  Spinal cord injury (SCI) is a life threating condition which has a profound impact in the morbidity and mortality. SCI causes lifetime sufferings and mostly occur among the young adults. Not only in Bangladesh but also worldwide, SCI is a devastating and burdensome condition. This research was conducted to see the demographic profile of SCI patients in Bangladesh. Methods and Materials: This is a retrospective analysis where data was collected from medical records of all SCI patients admitted in between January 2012 to December 2014 from Centre for the Rehabilitation of the Paralysed (CRP), Savar. Results: A total of 1172 SCI patients were analyzed. Most of the patients were in their second to third decade of life which consisted 28.8% (n=338). Among total respondents, 86.2% (n=1010) were male and 13.8% (n=162) were female. Most of the participants 61.1% (n=716) were from rural area. The main cause of SCI was fall from height (FFH) {45.8% (n = 537)} followed by the road traffic accidents (RTA) {24.7% (n = 288)}. Overall, 52.3% (n = 613) of participants suffered from traumatic paraplegia while 60.9% (n = 714) had complete lesion. Among the total participants, 30.70% (n = 359) of participants had skeletal level C1-C7 injury. Division-wise distribution shows that FFH is a major cause of SCI {14.84% (n = 174)} followed by the RTA which is a second most common cause in 8.95% (n = 105) of participants in Dhaka division while SCI due to bull attacks and bullet injury are a major cause in Khulna division {1.02% (n = 12)} and Chittagong division respectively. Conclusion: The data is collected from a tertiary level of rehabilitation centre where extensive demographic data was not previously represented. In many developing countries SCI is neglected, poorly managed and deprived from society. In addition, the present study suggests that demographic factors may affect the characteristics of SCI.

Rehabilitation of the canine patient following spinal cord injury: a practical guide

2021 ◽  
Vol 26 (1) ◽  
pp. 1-6
Author(s):  
Cheryl Corral
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Neurological Deficits ◽  
Practical Guide ◽  
Cord Injury ◽  
Physical Therapies

This article forms part of a series exploring the rehabilitation of the canine shoulder, elbow, back, hip and stifle following injury or disease. Discussed here are different rehabilitation techniques used to address neurological deficits, pain and weakness following spinal injury, including physical therapies, electrotherapies and acupuncture.

Clinical and Radiological Differences in Patients Following Traumatic SCI at Different Ages

2021 ◽  
Vol 23 (4) ◽  
pp. 305-314
Author(s):  
Thalia Saraiva Mendonça ◽  
Vitor Dias de Arruda Andrade ◽  
Pedro Nogarotto Cembraneli ◽  
Julia Brasileiro de Faria Cavalcante ◽  
André Salotto Rocha ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Young Adults ◽  
Compression Fracture ◽  
Facial Trauma ◽  
Traumatic Spinal Cord Injury ◽  
Elderly Adults ◽  
Middle Aged ◽  
Cord Injury ◽  
Middle Aged Adults

Background. Traumatic spinal cord injury (SCI) is a lesion that can affect several spinal structures, including the vertebrae, spinal cord, ligaments, and other adjacent parts of the spine. Traumatic spinal cord injury (SCI) can cause functional changes in patients of different ages. Material and methods. The study aims to determine whether there are social, clinical, and radiological differences between young, middle-aged, and elderly adults with SCI caused by a ground-level fall. This retrospective study analyzed the records of patients with a clinical diagnosis of SCI. It enrolled patients with traumatic spinal cord injury after a ground-level fall divided as follows: young aged adults 18–35 years of age (G1); middle-aged adults aged 36–60 years (G2); and elderly adults aged over 60 years (G3). Their clinical, social, and radiological variables were analyzed. Results. It is observed that low schooling level, being widowed, and being a homemaker were more frequently encountered among elderly adults, whereas being single was more common in middle-aged adults. The morphologic diagnosis of compression fracture and the associated injury of facial trauma occurred more frequently in elderly adults, with an increasing tendency with age. Conservative therapeutic management was most commonly encountered in elderly adults, compared to surgery from a posterior approach in middle-aged adults. Listhesis was better identified in middle-aged adults by computed tomography (CT). Spinal cord contusion and injury to the C1 vertebra were demonstrated in young adults by magnetic resonance imaging (MRI). Conclusions. 1. Elderly adults with low education level, widowed, and homemakers were more susceptible to SCI caused by a fall. 2. Single marital status was more frequently noted in young adults. 3. The most frequent clinical aspects were the morphological aspect of compression fracture and fa­cial trauma as an associated injury in elderly adults, with the occurrence of facial trauma increasing with age. 4. Conservative therapeutic management was more common in elderly adults than surgery from a po­sterior approach in middle-aged adults. 5. Re­garding the radiological aspects of CT, listhesis was better identified in middle-aged adults. Spi­nal cord contusions and C1 vertebra lesions were better identified in young adults by MRI.

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 Olfactory ensheathing cell transplantation for chronic spinal cord injury: A long-term follow-up study

2021 ◽  
Vol 9 (2) ◽  
pp. 94-105
Author(s):  
Naifeng Kuang ◽  
Xiaoyu Wang ◽  
Yuexia Chen ◽  
Guifeng Liu ◽  
Fan’e Kong ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Autonomic Function ◽  
Spinal Injury ◽  
International Standards ◽  
Olfactory Ensheathing Cell ◽  
Cord Injury ◽  
Long Term Follow Up

Spinal cord injury is a serious disabling condition. Transplantation of olfactory ensheathing cells (OECs) is one of the most promising treatments for spinal cord injury (SCI). Thirty-nine patients with chronic SCI received OEC transplantation and completed long-term follow-up, with a minimum follow-up of 7 years. We assessed sensorimotor function with the American Spinal Injury Association (ASIA) Impairment Scale (AIS) and autonomic nervous function by the International Standards to document remaining Autonomic Function after Spinal Cord Injury (ISAFSCI), and sympathetic skin responses (SSR). The scores of each group were significantly higher after OECs transplantation than before treatment. SSR latencies were shorter and response amplitudes increased after treatment. Long-term follow-up showed further improvement only in motor function and autonomic function compared with 3 months postoperatively. No complications occurred in any patient during long-term follow-up. The results indicate that the transplantation of OECs in spinal cord restored function without serious side effects.

scholarly journals SOME ASPECTS OF PEDIATRIC SPINAL CORD INJURY

2005 ◽  
pp. 015-019
Author(s):  
Igor Ivanovich Larkin ◽  
Valery Ivanovich Larkin
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Radiological Diagnostics ◽  
Cord Injury ◽  
Pediatric Spinal Cord Injury ◽  
Mri Changes

Objective. To analyse the possibility of diagnostics improvement in children with spinal cord injuries. Material and Methods. The observations of 147 cases of various spinal cord injuries in children at the age of 11 months to 15 years have been analyzed. Causes of trauma, age peculiarities of spinal injury manifestations, and difficulties of clinical and radiological diagnostics are discussed. Results. Most cases of spinal cord injury in children could be revealed and adequately managed at a prehospital stage. It should be noted that the spine lesion and MRI changes do not always accompany spinal cord injury in children. This observation must be taken into account while making diagnosis. Conclusion. Electromyography is an important examination confirming spinal cord injury without radiographic abnormalities (SCIWORA syndrome) in children.

scholarly journals Management of Sacral Pressure Sore by Clinically Isolated Superior Gluteal Artery Perforator-based Fasciocutaneus Flap in Patients with Spinal Cord Injury

2016 ◽  
Vol 27 (1) ◽  
pp. 14-18
Author(s):  
S P Das ◽  
Mamtamanjari Sahu ◽  
Pramod Kumar Parida
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Constant Pressure ◽  
Spinal Injury ◽  
Wound Dehiscence ◽  
Pressure Sore ◽  
Superior Gluteal Artery ◽  
Doppler Probe ◽  
Cord Injury ◽  
Artery Perforator

Abstract Prolong confinement to bed in spinal injury patients imparts constant pressure on bony prominences resulting impairment of blood flow to local tissue. Constant pressure of 2 hours or more produces irreversible changes leading to tissue necrosis and development of pressure sore. Sacrum encounters highest pressure in supine position and is the commonest site of pressure sore in spinal cord injury patients followed by trochanter and heel. Objective of the study Observation on management of sacral pressure sore by superior gluteal arterial perforatorbased flap using anatomical land marks in the absence of facility of Doppler probe for isolation of superior gluteal arterial perforators. Materials and methods Thirteen patients of spinal cord injury presented with sacral pressure sore were managed surgically using superior gluteal artery perforator-based flap coverage. The location of the artery was identifi ed using anatomical land marks. In 10 patients the flap was heeled uneventfully, one had signifi cant complication with wound dehiscence. Conclusions Management of sacral pressure sore by superior gluteal arterial perforator-based flap using anatomical land marks is a simple and reliable procedure. The learning curve is not that stiff. Sophisticated instruments are not required for this procedure.

scholarly journals Spinal Cord Injury With Tetraplegia in Young Persons After Diving Into Shallow Water: What Has Changed in the Past 10 to 15 Years?

2020 ◽  
pp. 219256822094412
Author(s):  
Christopher Ull ◽  
Emre Yilmaz ◽  
Oliver Jansen ◽  
Sebastian Lotzien ◽  
Thomas A. Schildhauer ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Shallow Water ◽  
Spinal Injury ◽  
Care Center ◽  
Risk Groups ◽  
Young Person ◽  
Health Care Center ◽  
Neurological Improvement ◽  
Cord Injury

Study Design: Retrospective, monocentric, observational study in a tertiary health care center. Objectives: To analyze prehospital and clinical findings, complications, neurological improvement and follow-up in a young person cohort with spinal cord injury (SCI) and tetraplegia according to the American Spinal Injury Association (ASIA) Impairment Scale (AIS) A to D after diving into shallow water. Methods: Included were all persons younger than 50 years with SCI after head-first diving into shallow water between June 2001 and June 2019. All persons with SCI were divided into complete tetraplegia (AIS A) and incomplete tetraplegia (AIS B, C, and D) to test differences. Results: A total of 59 males (98.7%) and 1 female with a mean age of 27.7 years suffered an SCI. Alcohol use was documented in 25 cases (41.7%). At the time of admission, 33 people (55%) showed a complete tetraplegia (AIS A) and 27 showed an incomplete tetraplegia with 8 AIS B (13.3%), 15 AIS C (25%), and 4 AIS D (6.7%). At the time of discharge, people with initially complete tetraplegia showed a significant improvement from admission to discharge ( P ≤ .004). Persons with incomplete tetraplegia were more likely to improve their neurological status compared with complete tetraplegia patients ( P ≤ .001). Especially persons with complete tetraplegia suffered from typical SCI-related problems and complications. Conclusions: People with SCI and tetraplegia at the time admission show neurological improvement in 50% of the cases with an overall better outcome in persons with incomplete tetraplegia. The surgical treatment of SCI within 24 hours seems to be associated with a better neurological outcome and a lower level of tetraplegia. The incidence of SCI caused by diving into shallow water remains stable without a significant change, especially in high-risk groups. More education and prevention programs are necessary to avoid these injuries.

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