THE EFFICIENCY OF THE CENTRALIZED SYSTEM FOR DELIVERY OF SPECIALIZED MEDICAL CARE TO VICTIMS WITH ACUTE SPINAL CORD INJURY IN A MODERN METROPOLIS

Objective.To perform comparative assessment and identification of determinants of efficiency of the centralized system for delivery of specialized medical care to victims with acute spinal cord injury in the modern metropolis.Material and Methods.The results of specialized medical care delivered to 2283 victims with acute spinal cord injuries were studied. The comparison group (decentralized system: treatment in several multidisciplinary hospitals in St. Petersburg) included 306 patients, and study group (centralized system: treatment in a specialized urban center for emergency spinal surgery) – 1977. Comparative analysis of the results of surgical treatment included 44 patients from comparison group and 223 patients from the study group (p> 0.05). The methods of non-parametric statistics were used.Results.The centralized treatment system is characterized by a statistically significant increase in the rate of surgical activity, a manifold increase in the proportion of emergency spinal surgery (p < 0.01) and the mandatory use of modern technologies for surgical stabilization of the spine, shortening the hospital stay, as well as higher values of all indicators characterizing the results of treatment (p < 0.01).Conclusion.In a large city, the centralized system of treating victims with spinal cord injury is characterized by more efficient use of urban health resources and better treatment outcomes. The key to its successful creation and subsequent operation, in addition to the centralization of medical care with the reasonable formation and distribution of the incoming patient flow, adequate logistic support for the treatment process and the presence of highly qualified medical personnel, is the availability of modern surgical technologies in delivering specialized emergency care.

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Complications of spinal surgery in acute spinal cord injury

Spinal Cord ◽

10.1038/sc.1994.65 ◽

1994 ◽

Vol 32 (6) ◽

pp. 389-395 ◽

Cited By ~ 8

Author(s):

J E Carvell ◽

D J Grundy

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Spinal Surgery ◽

Acute Spinal Cord Injury ◽

Cord Injury

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Mobilization of Patients After Spinal Surgery for Acute Spinal Cord Injury

Spine ◽

10.1097/00007632-200110150-00022 ◽

2001 ◽

Vol 26 (20) ◽

pp. 2278-2282 ◽

Cited By ~ 8

Author(s):

Dajue Wang ◽

Peter J. Teddy ◽

Nigel J. Henderson ◽

Brian S. F. Shine ◽

Brian P. Gardner

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Spinal Surgery ◽

Acute Spinal Cord Injury ◽

Cord Injury

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Epidemiology of acute spinal cord injuries in the Groote Schuur Hospital Acute Spinal Cord Injury (GSH ASCI) Unit, Cape Town, South Africa, over the past 11 years

South African Medical Journal ◽

10.7196/samjnew.8072 ◽

2015 ◽

Vol 105 (10) ◽

pp. 835 ◽

Cited By ~ 11

Author(s):

Johan Sothmann ◽

Juliette Stander ◽

Nicolas Kruger ◽

Robert Dunn

Keyword(s):

South Africa ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Spinal Cord Injuries ◽

Cape Town ◽

Acute Spinal Cord Injury ◽

The Past ◽

Cord Injury

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THE RESULTS OF EXAMINATION OF MEDICAL CARE QUALITY FOR ASSOCIATED VERTEBRO-SPINAL-CORD INJURY

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2010-0-1-102-105 ◽

2010 ◽

Vol 16 (1) ◽

pp. 102-105

Author(s):

V. V. Shchedrenok ◽

I. V. Yakovenko ◽

S. V. Orlov ◽

I. A. Simonova ◽

P. V. Krasnoshlyk ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Medical Care ◽

Emergency Service ◽

Injury Severity ◽

Spinal Cord Injuries ◽

Care Quality ◽

Cord Injury ◽

Neuro Imaging ◽

Surgical Operations

Medical care quality assessment for patients with vertebro-spinal-cord injury at different stages in St.-Petersburg during year was performed. The first aid in the most cases (74,8%) was rendered by emergency service. A vertebro-spinal-cord injuries were not diagnosed by a staff of line and special medical aid brigades in 31,6-51,9%. The causes of incorrect diagnostics at hospital stage: insufficient and delayed patient examination, underestimation of injury severity in consequence of delayed use of neuro-imaging methods. Surgical operations for vertebro-spinal-cord injuries were performed in 59 (8%) cases. 43 (73%) patients needed in vertebral fixation.

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Incidence of acute spinal cord injury in South Korea does not reflect a sizable number of traumatic spinal cord injuries

Spinal Cord ◽

10.1038/s41393-020-0475-x ◽

2020 ◽

Vol 58 (8) ◽

pp. 939-940 ◽

Cited By ~ 1

Author(s):

Ja-Ho Leigh ◽

Han-Kyoul Kim ◽

Moon Suk Bang

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

South Korea ◽

Spinal Cord Injuries ◽

Acute Spinal Cord Injury ◽

Cord Injury ◽

Sizable Number

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EFEKTIVITAS PEMBERIAN DOSIS TINGGI METHYLPREDNISOLONE PADA TRAUMA SPINAL CORD AKUT

Jurnal Ilmiah Kesehatan Media Husada ◽

10.33475/jikmh.v2i1.112 ◽

2013 ◽

Vol 2 (1) ◽

pp. 81-85

Author(s):

Abdul Qodir

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Additional Data ◽

Spinal Cord Injuries ◽

Acute Spinal Cord Injury ◽

High Dose ◽

High Dose Methylprednisolone ◽

Cord Injury ◽

Methylprednisolone Treatment ◽

Language Data

Acute spinal cord injury is a devastating condition typically affecting young people, mostly males. High-Dose Methylprednisolone treatment in the early hours after the injury is aimed at reducing the extent of permanent paralysis during the rest of the patient’s life. The aim To review randomized trials of High-Dose Methylprednisolone in Acute Spinal Cord Injuries. All randomized controlled trials of steroid treatment for acute spinal cord injury in any language. Data have been extracted from original trial reports. For the NASCIS, Japanese and French trials, additional data (e.g. SDs) have been obtained from the original authors. The evidence produced by this systematic review support the use of high dose methylprednisolone in acute spinal cord injury to improve neurological recovery. Patients who received high-dose methylprednisolone therapy should be observed with intensive in order to reduce complications from such therapy.

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Spinal Cord Injury in Pregnancy

10.1093/med/9780190667351.003.0029 ◽

2018 ◽

Author(s):

Kathryn J. Drennan ◽

Maria Vanushkina

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Urinary Tract ◽

Spinal Cord Injuries ◽

Acute Spinal Cord Injury ◽

Autonomic Dysreflexia ◽

Health Maintenance ◽

Proactive Management ◽

Cord Injury ◽

In Pregnancy

Spinal cord injury is an uncommon complication of pregnancy. But women with spinal cord injuries should be counseled that successful pregnancy is possible. Pregnancies should be planned once the patient has reached optimal functional status. At the outset of pregnancy, complications should be planned for, and an overall functional and routine health maintenance assessment should be evaluated. Providers should pay particular attention to voiding and elimination management, prevention of urinary tract infection, respiratory complications, and autonomic dysreflexia. Urinary complications can be decreased by maintaining a low pressure voiding system as well as addressing urinary tract bacterial colonization. When autonomic dysreflexia is encountered, the source should be identified and eliminated. Proactive management of potential complications leads to successful pregnancies with neonatal outcomes indistinguishable from the general population. The management of acute spinal cord injury should emphasize maternal stabilization. If an acute spinal cord injury occurs in pregnancy, any steps needed to improve the outcome should be undertaken.

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