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.

A study of burden of care and its correlates among family members supporting relatives and loved ones with traumatic spinal cord injuries

2017 ◽  
Vol 31 (7) ◽  
pp. 948-956 ◽  
Author(s):  
Carmina Castellano-Tejedor ◽  
Pilar Lusilla-Palacios
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Life Satisfaction ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Burden Of Care ◽  
Zarit Burden Interview ◽  
Resilience Scale ◽  
Cord Injury ◽  
The Future

Objective: To understand and describe in a sample of caregivers of persons with spinal cord injury, their burden of care, resilience and life satisfaction and to explore the relationship between these variables. Design: Cross-sectional design. Setting: One Spinal Cord Injury Acute Inpatient Unit from a general hospital. Subjects: Seventy-five relatives of persons with spinal cord injuries (84% women) with a mean age of 48.55 ( SD = 12.55) years. Interventions: None. Measures: Demographics (neurological loss and severity according to the American Spinal Injury Association criteria), the Zarit Burden Interview, the Resilience Scale and the Life Satisfaction Checklist. Results: All caregivers experienced feelings of different intensities of burden (52% mild-to-moderate, 43% moderate-to-severe and 5% severe), and none of them expressed little or no burden at the assessment moment. Caregivers’ main worries were “dependence” and “the future of the injured.” Resilience was medium-to-high (mean = 141.93, SD = 23.44) for the whole sample with just a minority of them revealing low (15%) or very low resilience (7%). The highest scores were obtained in relation to “caregivers’ independence” and “meaning of their lives.” Life satisfaction scores were medium-to-high (mean = 36.6, SD = 6). These scores were not related to demographics or the severity of the injury. Zarit Burden Interview scores were negatively correlated to Resilience Scale ( r = −.370, P = .001) and Life Satisfaction Checklist scores ( r = −.412, P < .001). Conclusion: More resilient and satisfied caregivers experienced lower burden. Burden is moderate-to-high and mainly related to uncertainty about the future, caregivers’ insecurity with caregiving and dependence of the injured.

Pediatric spinal injury: the very young

1988 ◽  
Vol 68 (1) ◽  
pp. 25-30 ◽  
Author(s):  
John R. Ruge ◽  
Grant P. Sinson ◽  
David G. McLone ◽  
Leonard J. Cerullo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Causative Factor ◽  
Important Variable ◽  
Neurological Injury ◽  
Content Type ◽  
Significant Difference ◽  
Cord Injury

✓ Maturity of the spine and spine-supporting structures is an important variable distinguishing spinal cord injuries in children from those in adults. Cinical data are presented from 71 children aged 12 years or younger who constituted 2.7% of 2598 spinal cord-injured patients admitted to the authors' institutions from June, 1972, to June, 1986. The 47 children with traumatic spinal cord injury averaged 6.9 years of age and included 20 girls (43%). The etiology of the pediatric injuries differed from that of adult injuries in that falls were the most common causative factor (38%) followed by automobile-related injuries (20%). Ten children (21.3%) had spinal cord injury without radiographic abnormality (SCIWORA), whereas 27 (57%) had evidence of neurological injury. Complete neurological injury was seen in 19% of all traumatic pediatric spinal cord injuries and in 40% of those with SCIWORA. The most frequent level of spinal injury was C-2 (27%, 15 cases) followed by T-10 (13%, seven cases). Upon statistical examination of the data, a subpopulation of children aged 3 years or younger emerged. These very young children had a significant difference in level of injury, requirement for surgical stability, and sex distribution compared to 4- to 12-year-old children.

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.

scholarly journals International Standards for Neurological Classification of Spinal Cord Injuries (ASIA/ISNCSCI scale, revised 2015) 67

2016 ◽  
Vol 4 (2) ◽  
pp. 67-72 ◽  
Author(s):  
Sergei V Vissarionov ◽  
Alexei G Baindurashvili ◽  
Irina A Kryukova
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Neurological Status ◽  
International Standards ◽  
American Spinal Injury Association ◽  
Cord Injury ◽  
Important Challenge

Standardization of neurological examination and diagnosis in the case of spinal injury is currently an important challenge in neurotraumatology. At present, most organizations, worldwide, that are involved with spinal injuries, apply the International Standards for Neurological Classifications of Spinal Cord Injury (ISNCSCI), drafted by American Spinal Injury Association (ASIA) and approved in 1992. The ASIA/ISNCSCI scale is a quantitative system for estimation of the neurological status of spinal cord injury patients. The ASIA/ISNCSCI scale has been repeatedly updated and revised since 1992. The 2015 version of the ISNCSCI on the American Spinal Injury Association website is demonstrated in this study, and the form and testing instruction are translated into Russian.

scholarly journals Classifications Used in Spinal Cord Injuries

2021 ◽  
Author(s):  
Erek Öztürk ◽  
Yener Akyuva ◽  
Erdinç Çivelek
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Functional Independence ◽  
International Standards ◽  
Data Set ◽  
Multidimensional Pain Inventory ◽  
Cord Injury

Creating a common language allows information to be shared well/wholesome/healthily. Classifications have a important role in the formation of this language, which provides many benefits such as follow-up of the clinical course. Classifications in spinal cord injuries are based on examination, so the results of different treatments can be revealed more clearly with a standardized examination and registration. The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) which is the most sensitive and common classification was developed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS), although its foundations were laid in 1969 by Frankel. Apart from neurological evaluation, there are scales such as Functional Independence Scale, Modified Barthel Index, Spinal Cord Independence Scale, Quadriplegia Functional Index, Walking Index for Spinal Cord Injury, Spinal Cord Injury Functional Ambulation Inventory to determine the functional status in spinal cord injuries. Additionally scales such as Assessment of Spinal Cord Injury Basic Pain Data Set, Multidimensional Pain Inventory, DN4 (DouleurNeuropathique DN4) can be used for pain assessment in a patient with spinal cord injury.

Active physiological conservative management in traumatic spinal cord injuries – an evidence-based approach

Trauma ◽  
2017 ◽  
Vol 19 (1_suppl) ◽  
pp. 10-22 ◽  
Author(s):  
W El Masri ◽  
Naveen Kumar
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Conservative Management ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Surgical Decompression ◽  
The Body ◽  
Prognostic Indicators ◽  
Number Of Patients ◽  
Cord Injury

The management of the traumatic spinal cord injury remains controversial. Guttmann demonstrated that with simultaneous attention to all medical and non-medical effects of the spinal cord injury, a significant number of patients recovered motor and sensory functions to ambulate and the majority were pain-free following conservative management. Active physiological conservative management of the spinal injury requires simultaneous scrupulous care of the injured spine together with; the multisystem neurogenic effects of the spinal cord injury on the respiratory, cardiovascular, urinary, gastrointestinal, dermatological, sexual and reproductive functions; the management of the associated psychological effects of paralysis from the early hours or days of injury as well as; the physical rehabilitation and modification of the environment. To date, there is no evidence to suggest that the surgical decompression and/or stabilisation of the neurologically impaired spinal cord injury patient is advantageous. This article considers the debates and evidence of surgical management including the effects of timing of the surgical decompression. Also addressed are the factors influencing decisions on management, prognostic indicators of recovery and natural history of complete and incomplete cord injuries. Traumatic biomechanical instability of the spine, physiological instability of the spinal cord, traumatic spinal canal encroachment and traumatic cord compression are also discussed. Early mobilisation, indications for surgery at the RJAH and economic considerations of spinal cord injuries are presented. The ultimate goals of the active physiological conservative management are to ensure maximum neurological recovery and independence, a pain-free and flexible spine, safe and convenient functioning of the various systems of the body with minimal inconvenience to patients and the prevention of complications.

Consequences of Delayed Surgical Treatment of Traumatic Spinal Cord Injuries: Tertiary Centre Experience

2021 ◽  
pp. 5
Author(s):  
Abdulrahman Alhabeeb
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Spinal Injury ◽  
Healthcare Providers ◽  
Tertiary Hospital ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury

Introduction: Owing to its disabling consequences, spinal cord injury is devastating for both patients and their healthcare providers. There are many causes of spinal cord injury, the most common by far being motor vehicle accident (MVA). Unfortunately, in neglected injuries, many complications and poor outcomes could be encountered. This research aimed to assess the causes, consequences, and outcomes of neglected traumatic spinal cord injuries. Methodology: Out of the 750 cases reviewed between February 2016 and February 2021, 18 cases matched our inclusion criteria which was any Traumatic Spinal Cord Injury (TSCI) with neurological deficit requiring surgical intervention more than 14 days from the index trauma. The following variables were measured: patients’ demographics, injury, management, delay, complication, and hospital course characteristics. American Spinal Injury Association (ASIA) Impairment Scale scores were recorded at presentation and final follow-up. Result: Out of the 18 neglected TSCI patients, 72.2% were male. Patients’ mean age at the time of injury was 36.8 years, and 77.8% of them were from outside Riyadh. The mechanism of injury was MVA in all patients. Delay in referral to a tertiary hospital was the main cause accounting for 88.9%. The mean duration of neglect was 43 days. Improvement in ASIA score was found in two patients. Bedsores and DVT were found in 55.5% and 27.8%, respectively. Postoperatively, 77% of the patients were admitted to the ICU. Most patients (12) were unable to join a specialized spinal cord injury rehabilitation center postoperatively. Conclusion: Early referral of all traumatic spinal cord injury patients is highly encouraged to prevent short- and long-term complications.

Microangiographic study of experimental spinal cord injuries

1971 ◽  
Vol 35 (3) ◽  
pp. 277-286 ◽  
Author(s):  
David J. Fairholm ◽  
Ian M. Turnbull
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Axonal Degeneration ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Degenerative Changes ◽  
Injured Spinal Cord ◽  
Content Type ◽  
Cord Injury ◽  
Fine Print

✓ The pathology of spinal cord injury has been studied in 34 rabbits and 5 dogs with attention focused on the condition of the microvasculature during the evolution of neuronal and axonal degeneration and necrosis. The animals were killed and perfused arterially with colloidal barium from 10 min to 14 days after a controlled spinal injury. Microradiographs of the injured tissues were obtained and compared with corresponding histological sections. Microangiography at 7 to 14 days defines two zones in the injured spinal cord. Zone 1 is located in the posterocentral part of the cord. Capillaries in this region progressively lose their ability to conduct blood and perfusate over the first 4 hours. Degenerative changes in neurons are visible by 1 hour after injury. Necrosis of all elements including capillaries ensues. Zone 2 surrounds Zone 1. Microvascular patterns are normal in Zone 2 although neuronal and axonal degeneration is severe. Pericapillary hemorrhages which occur as early as 10 min after injury in Zone 1 and become progressively larger over the first 4 hours seldom are seen in Zone 2. The evidence indicates that at all times in the pathogenesis of spinal cord injury the microvasculature in Zone 2 is capable of perfusion. Degeneration of neural structures either precedes microvascular breakdown (Zone 1) or occurs in the absence of microvascular disruption (Zone 2). Recovery of damaged neurons and axons depends upon a preserved microcirculation.

scholarly journals Spinal Cord Injuries in Emergency Medicine

2021 ◽  
pp. 8-16
Author(s):  
Hisham Mohammed Sonbul ◽  
Razan Mohammad N. Aljohani ◽  
Abdullah Sulaiman Alqefari ◽  
Zahra Ahmed Alasfoor ◽  
Noor Ayman Adel Abualsaud ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Spinal Column ◽  
Surgical Removal ◽  
Trauma Victim ◽  
Concomitant Injuries ◽  
Cord Injury ◽  
Bone Fragments

Spinal cord injury is a serious medical disorder that frequently leads in significant morbidity and permanent impairment. Direct damage to the spinal cord or compression owing to broken vertebrae or masses such as epidural hematomas or abscesses are the most common causes of spinal cord injury. When examining a blunt trauma victim, medical professionals are taught to presume the patient has a spinal column damage unless it is proven otherwise. The early examination of a patient with a suspected cervical spinal injury in the emergency department (ED) is no different than that of any other trauma patient. The ABCs, or airway, breathing, and circulation, procedures are being taken into consideration. In acute spinal cord damage, hypotension can be hemorrhagic or neurogenic. Because of the high prevalence of concomitant injuries and vital sign confusion in acute spinal cord injury, a thorough search for hidden sources of bleeding is required. Surgical removal of bone fragments, foreign objects, herniated discs, or broken vertebrae that appear to be compressing the spine is frequently required. In order to avoid future discomfort or deformity, surgery may be required to stabilize the spine. In this review we’ll be looking at spinal cord injury, it’s diagnosis and treatment.

Cognitive-behavioral pain management during pediatric spinal cord injury rehabilitation

2013 ◽  
Author(s):  
Kimberly P. Raghubar ◽  
Adrianna Amari ◽  
Meg Nicholl ◽  
Valerie Paasch ◽  
Daniel Becker ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pain Management ◽  
Cognitive Behavioral ◽  
Injury Rehabilitation ◽  
Cord Injury ◽  
Pediatric Spinal Cord Injury
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