scholarly journals Comparison of urodynamic parameters with respect to neurological levels in post-traumatic spinal cord injury patients

2020 ◽  
Vol 8 (4) ◽  
pp. 1320
Author(s):  
Rohit Ramesh Gaikar ◽  
Anil Kumar Gaur ◽  
Sumedh Narayan More ◽  
Vaibhav Shivram Lokhande ◽  
Amol Babanrao Khade
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Traumatic Spinal Cord Injury ◽  
Leak Point Pressure ◽  
Injury Group ◽  
Significant Difference ◽  
Cord Injury ◽  
Point Pressure ◽  
Mean Compliance ◽  
Urodynamic Parameters

Background: Urodynamic evaluation is mandatory in order to correctly assess and classify bladder dysfunction in spinal cord injury (SCI) patients. Study investigated patterns of neurogenic bladder dysfunction in patients with post traumatic spinal cord injury and assessed the relationship of detrusor leak point pressure with compliance, post void residual urine volume and maximum cystometric capacity.Methods: Eighty six patients with neurogenic bladder secondary to traumatic spinal cord injury (SCI) underwent cystometry with electromyography (EMG). T-test was used to compare detrusor leak point pressure (LPP) between complete and incomplete injury groups. Pearson correlation test was used to seek correlation between detrusor LPP and compliance, post void residual volume (PRV) and maximum cystometric capacity (MCC).Results: Mean detrusor LPP in suprasacral complete injury group, suprasacral incomplete injury group and sacral complete injury was 52±21 cm of H2O, 53±18 cm of H2O and 16±9 cm of H2O respectively. No significant difference in detrusor LPP was found between suprasacral complete and incomplete group on t-Test (p= 0.571068). Significant difference in detrusor LPP was found between suprasacral and sacral group (p= 5.71891E-12). Mean compliance in sacral injury group was 24±16 and in suprasacral complete injury group was 5±6. Mean compliance in suprasacral incomplete injury group was 4±2. Pearson correlation showed negative correlation (r = -0.6918934) between detrusor leak point pressure and compliance (p= 1.2744E-13). Negative correlation (r = -0.311409922) was observed between detrusor leak point pressure and post leak/ void residual urine volume (p= 0.003335033) and between detrusor LPP and maximum cystometric capacity (r = -0.31354), (p= 0.003115).Conclusions: Significant difference in urodynamic parameters exists between sacral and suprasacral injury patients. However there is no significant difference in urodynamic parameters between complete and incomplete injury at suprasacral level.

Synergistic effect of basic fibroblast growth factor and methylprednisolone on neurological function after experimental spinal cord injury

1995 ◽  
Vol 83 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Richard Baffour ◽  
Kranthi Achanta ◽  
Jeffrey Kaufman ◽  
Joel Berman ◽  
Jane L. Garb ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Growth Factor ◽  
Capillary Density ◽  
Neurological Function ◽  
Fibroblast Growth ◽  
Injury Group ◽  
Significant Difference ◽  
Cord Injury ◽  
Over Time

✓ The authors evaluated the effects of exogenous basic fibroblast growth factor (bFGF) in combination with intravenous methylprednisolone on neurological function and cord angiogenesis in a model of spinal cord injury. Cord injury was produced by extradural clip compression through a T-1 laminectomy. Rats were randomized to one of six groups. Group A was given sham laminectomy without cord injury or treatment. The remaining animals were divided into five groups: untreated injury (Group B); injury treated with methylprednisolone (Group C); combined methylprednisolone and 1 µ bFGF administered locally at the site of injury (Group D); methylprednisolone and 3 µg bFGF (Group E); or methylprednisolone and 3 µg heated bFGF (Group F). Groups C through F received treatment 1 hour after cord injury. At 1, 2, 3, and 4 weeks after surgery, neurological function of hindlimbs was assessed by blinded observers using an established multiple test method (toe spread, reflexes to extension, pain, and pressure as well as inclined plane and swim test) with tests graded and results expressed as a combined behavioral score. Animals were killed to study spinal cord angiogenesis in cord samples (2-mm sections proximal and distal to the injury site) by capillary density determination. Behavioral scores over time showed a significant difference among Groups B, C, D, E, and F (p = 0.0044), with Groups E and B maintaining highest and lowest scores, respectively. There was a linear dose effect of bFGF over time (p = 0.0187). At 4 weeks, scores showed a difference among the five groups (p = 0.006), with Group E showing higher scores than any other treatment group (for example, vs. group F: p = 0.035). There was a significant difference among the groups in gray matter capillary density counts: proximal (p = 0.0192) and distal (p = 0.024), whereas white matter capillary counts were similar across treatment groups. These results show: 1) possible synergism exists between methylprednisolone and bFGF, such that combinations of these drugs significantly enhance neurological recovery, 2) bFGF exhibits a dose—response effect in function but not in capillary density, and 3) heated, inactivated bFGF is not therapeutically effective.

scholarly journals Traumatic versus non traumatic spinal cord injury: Characteristics and functional outcome in a Tunisian rehabilitation centre

2018 ◽  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Functional Outcome ◽  
Considerable Proportion ◽  
Traumatic Spinal Cord Injury ◽  
Physical Medicine ◽  
Injury Characteristics ◽  
Injury Group ◽  
Cord Injury

Background: Understanding of the underlying mechanisms of Spinal cord injury (SCI) would help in the development of treatment strategies and enhance neurological recovery. Aim: The aim of this study was to describe clinical and demographic data of SCI in a physical medicine department and to compare neurological and functional outcome in Traumatic Spinal Cord Injury group (TSCI) and Non Traumatic Spinal Cord Injury group (NTSCI) during two years of follow up. Materials and methods: This study was conducted in a physical medicine and rehabilitation department of a tertiary hospital (January 2008-December 2014). Medical records of 177 patients with spinal cord injury (SCI) were reviewed. Two groups were defined: traumatic (TSCI) and non-traumatic (NTSCI) spinal cord injury. Characteristics and functional outcome were analyzed and compared. Results: Patients of NT group were significantly older. Most of injuries in both groups had a cervical level. ASIA scale scores and MIF scales were significantly higher in NT group at admission and after two years of follow up. The impairment was more remarkable in this group. Conclusions: Our study suggests that non traumatic SCI represent a considerable proportion of SCI rehabilitation admissions. Although different characteristics and injury patterns, functional outcomes maybe comparable to traumatic SCI. Key words: spinal cord injury, epidemiology, etiology, rehabilitation

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. 

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