scholarly journals Integrative treatment of paralytic small intestine following acute cervical cord injury: A case report

2020 ◽  
Vol 11 ◽  
pp. 80
Author(s):  
Yoshitaka Hirano ◽  
Hideya Isai ◽  
Akinori Onuki ◽  
Kazuo Watanabe
Keyword(s):  
Spinal Cord ◽  
Small Intestine ◽  
Spinal Injury ◽  
Cervical Spinal Cord ◽  
Posterior Longitudinal Ligament ◽  
Neurological Status ◽  
Sensory Loss ◽  
Cervical Cord ◽  
Cord Injury ◽  
Cervical Cord Injury

Background: A patient developed paralysis of the small intestine following an acute traumatic hyperextension cervical spinal cord injury attributed to the ossification of the posterior longitudinal ligament (OPLL) C3–C6. The persistent ileus finally resolved utilizing Kampo medications (traditional Chinese therapy) consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16). Case Description: A 63-year-old male became acutely quadriplegic secondary to a hyperextension injury incurred during a fall. Radiographic studies confirmed mixed OPLL extending from C3–C6 resulting in marked cord compression, there was a clear spinal cord contusion. His neurological status using the American Spinal Injury Association (ASIA) Scale was Grade “A;” there were was complete motor and sensory loss below the C5 level. After a C3–C6 expansive laminoplasty, the ASIA scale improved to Grade B. However, he then developed a persistent small intestine ileus resulting in marked abdominal distention. When conventional therapies failed to resolve the problem, Kampo medicines, consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16), were administered. The ileus improved within 2 days and fully resolved within the 1st postoperative week. Conclusion: The utilization of Kampo medications, consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16), or the combined bukuryoingohangekobokuto (TJ-116) effectively resolved a postoperative paralytic small bowel ileus following a cervical laminoplasty performed in a quadriplegic patient. Keywords: Acute cervical cord injury, Cervical ossification of the posterior longitudinal ligamentOPLL, Complication management, Integrative medicine, Paralytic small intestine

Acute Cervical Cord Injury Associated with Ossification of the Posterior Longitudinal Ligament

Neurosurgery ◽  
2003 ◽  
Vol 53 (4) ◽  
pp. 887-892 ◽  
Author(s):  
Izumi Koyanagi ◽  
Yoshinobu Iwasaki ◽  
Kazutoshi Hida ◽  
Hiroyuki Imamura ◽  
Shin Fujimoto ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Magnetic Resonance ◽  
Posterior Longitudinal Ligament ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Cord Injury ◽  
Frankel Grade ◽  
Cervical Cord Injury

Abstract OBJECTIVE Patients with ossification of the posterior longitudinal ligament (OPLL) sometimes present with acute spinal cord injury caused by only minor trauma. In the present study, we reviewed our experience of acute cervical cord injury associated with OPLL to understand the pathomechanisms and to provide clinical information for management of this disorder. METHODS Twenty-eight patients were retrospectively analyzed. There were 26 men and 2 women, aged 45 to 78 years (mean, 63.0 yr). Most patients experienced incomplete spinal cord injury (Frankel Grade A, 3; B, 1; C, 15; and D, 9). RESULTS Radiological studies revealed continuous- or mixed-type OPLL in 14 patients and segmental-type OPLL in 14 patients. The sagittal diameter of the spinal canal was reduced to 4.1 to 10 mm at the narrowest level as a result of OPLL. Developmental size of the spinal canal was significantly smaller in the group with segmental OPLL. Magnetic resonance imaging scans revealed that spinal cord injury occurred predominantly at the caudal edge of continuous-type OPLL or at the disc levels. Surgery was performed in 24 patients either by posterior (18 patients) or anterior (6 patients) decompression at various time intervals after the trauma. Twenty patients (71%) displayed improvement in Frankel grade. CONCLUSION The present study demonstrates the preexisting factors and pathomechanisms of acute spinal cord injury associated with cervical OPLL. Magnetic resonance imaging is useful to understand the level and mechanism of injury. Further investigation will be needed to elucidate the role of surgical decompression.

scholarly journals Spinal Injuries Due To Hockey

1984 ◽  
Vol 11 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Charles H. Tator ◽  
Chris E.U. Ekong ◽  
David W. Rowed ◽  
Michael L. Schwartz ◽  
Virginia E. Edmonds ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Cervical Spinal Cord ◽  
Burst Fracture ◽  
Spinal Injuries ◽  
Acute Spinal Cord Injury ◽  
Sensory Loss ◽  
Recreational Activities ◽  
Cord Injury

SUMMARYAlthough many types of sports and recreational activities have been identified as common causes of acute spinal cord injury, hockey has been a rare cause of acute cord injury in Canada or elsewhere. For example, from 1948 to 1973 there were no patients with cord injuries due to hockey in a series of 55 patients with acute cord injuries due to sports or other recreational activities admitted to two Toronto hospitals. In contrast, between 1974 and 1981, the Acute Spinal Cord Injury Unit, Sunnybrook Medical Centre treated six patients with cervical spinal injury due to hockey, five of whom were seen during a 13 month period from September, 1980 to October, 1981. Five of the six sustained a severe acute cervical spinal cord injury, and one a cervical root injury. The cord injury was complete in two cases, while three had complete motor loss but incomplete sensory loss below the level of the lesion. All were males aged 15 to 26 years. Of the players with cord injury, four struck the boards with the neck flexed, and one struck another player with the neck flexed. The one player without cord injury struck the boards with his neck extended. The commonest bony injury was a burst fracture of C5 or C6. One of the patients with a complete cord injury died three months later of a pulmonary embolus, and the other patients with cord injury showed some recovery of root function, but little or no cord recovery. The reasons for the increase in spinal injuries in hockey are unknown.

scholarly journals Impact of cervical spinal cord contusion on the breathing pattern across the sleep-wake cycle in the rat

2019 ◽  
Vol 126 (1) ◽  
pp. 111-123 ◽  
Author(s):  
Kun-Ze Lee
Keyword(s):  
Spinal Cord ◽  
Tidal Volume ◽  
Spinal Injury ◽  
Cervical Spinal Cord ◽  
Minute Ventilation ◽  
Respiratory Frequency ◽  
Breathing Patterns ◽  
Cord Injury ◽  
Spinal Contusion ◽  
Cervical Spinal Injury

The present study was designed to investigate breathing patterns across the sleep-wake state following a high cervical spinal injury in rats. The breathing patterns (e.g., respiratory frequency, tidal volume, and minute ventilation), neck electromyogram, and electroencephalography of unanesthetized adult male rats were measured at the acute (i.e., 1 day), subchronic (i.e., 2 wk), and/or chronic (i.e., 6 wk) injured stages after unilateral contusion of the second cervical spinal cord. Cervical spinal cord injury caused a long-term reduction in the tidal volume but did not influence the sleep-wake cycle duration. The minute ventilation during sleep was usually lower than that during the wake period in uninjured animals due to a decrease in respiratory frequency. However, this sleep-induced reduction in respiratory frequency was not observed in contused animals at the acute injured stage. By contrast, the tidal volume was significantly lower during sleep in contused animals but not uninjured animals from the acute to the chronic injured stage. Moreover, the frequency of sigh and postsigh apnea was elevated in acutely contused animals. These results indicated that high cervical spinal contusion is associated with exacerbated sleep-induced attenuation of the tidal volume and higher occurrence of sleep apnea, which may be detrimental to respiratory functional recovery after cervical spinal cord injury. NEW & NOTEWORTHY Cervical spinal injury is usually associated with sleep-disordered breathing. The present study investigated breathing patterns across sleep-wake state following cervical spinal injury in the rat. Unilateral cervical spinal contusion significantly impacted sleep-induced alteration of breathing patterns, showing a blunted frequency response and exacerbated attenuated tidal volume and occurrence of sleep apnea. The result enables us to investigate effects of cervical spinal injury on the pathogenesis of sleep-disordered breathing and evaluate potential therapies to improve respiration.

scholarly journals Analysis of myelomalacia and posterior longitudinal Ligament ossification as prognostic factors in patients with cervical spondylotic myelopathy submitted to laminoplasty

2021 ◽  
Vol 32 (2) ◽  
pp. 297-301
Author(s):  
Desirée Elizabeth Pasqualetto Antikievicz ◽  
Giulio Bartié Rossi ◽  
Marcos Vinicius Calfatt Maldaun ◽  
Paulo Henrique Pires de Aguiar ◽  
Daniel Gripp ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Prognostic Factors ◽  
Cervical Spondylotic Myelopathy ◽  
Cervical Spinal Cord ◽  
Posterior Longitudinal Ligament ◽  
The Elderly ◽  
Cervical Canal ◽  
Open Door ◽  
Cord Injury ◽  
Posterior Longitudinal Ligament Ossification

Background: Cervical spondylotic myelopathy is a degenerative disease of the intervertebral disc and vertebral body of the spine that causes cervical spinal cord injury due to central vertebral canal stenosis. Its prevalence is higher in the elderly. Treatment is usually surgical when the spinal cord is affected either clinically with pyramidal release or radiologically with the altered spinal cord. Objective: The rationale of this study is to analyze the myelomalacia and the ossification of posterior longitudinal ligament as prognostic factors in the postoperative evolution of patients with cervical canal compression who underwent laminoplasty by open-door or french-door techniques. Methods: We performed a retrospective analysis of 18 surgical cases of spondylotic cervical myelopathy of the same senior neurosurgeon, using the chi-square test to analyze prognostic factors for patients’ postoperative evolution in the Nurick scale, after open-door or french-door laminoplasty. Results: The comparison between pre and postoperative showed an improvement of 71.43% of cases that did not have ligament ossification compared to 45.45% of cases that presented posterior longitudinal ligament ossification. Also, there was a better prognosis in patients without myelomalacia, as 71.43% of them improved their condition against only 45.45% improvement in those with myelomalacia. Conclusion: There is a need for further studies with larger samples to expressively prove that the presence of longitudinal ligament ossification and the previous presence of myelomalacia are factors of worse prognosis in the postoperative evolution of patients with cervical spondylotic myelopathy submitted to laminoplasty.

scholarly journals Multivariate Analysis of Acute Magnetic Resonance Imaging Predicts Neurological Improvements in Patients With Cervical Spinal Cord Injury After Early Surgical Decompression

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Tomoo Inoue ◽  
Toshiki Endo ◽  
Shinsuke Suzuki ◽  
Hiroshi Uenohara ◽  
Teiji Tominaga
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Spinal Injury ◽  
Cervical Spinal Cord ◽  
Principal Component ◽  
Surgical Decompression ◽  
Cervical Spinal Cord Injury ◽  
Cord Injury

Abstract INTRODUCTION Patients with cervical spinal cord injury (SCI) show different clinical outcomes. There is a significant association between the acute magnetic resonance (MR) imaging of cervical SCI and neurological recovery of cervical SCI. We speculated that principal component analysis (PCA), a dimension reduction procedure, would detect clinically predictive patterns in complex MR imaging and predict neurological improvements assessed by the American Spinal Injury Association Impairment Scale (AIS) and Japanese Orthopaedic Association (JOA) score. METHODS We performed a retrospective analysis of 50 patients with cervical SCI who underwent early surgical decompression less than 48 h after the trauma. We analyzed 7 types of MR imaging assessments: axial grade assessed by the Brain and Spinal Injury Center score (BASIC), longitudinal intramedurallry lesion length, spinal cord signal intensity on T1 and T2 weighted image, maximum canal compromise, maximum spinal cord compression, Subaxial Cervical Spine Injury Classification System. PCA was applied on these multivariate data to identify factors that contribute to recovery after cervical SCI following surgery. AIS conversion was evaluated at 6 mo. RESULTS Nonlinear principal component (PC) evaluation detected 2 features of MR imaging. PCA revealed PC 1 (40.6%) explaining the intramedullary signal abnormalities that were negatively associated with postoperative AIS conversion. PC2 (18.5%) suggested extrinsic morphological variables, but did not predict outcomes. The BASIC score revealed the significant overall predictive value for AIS conversion at six months (AUC 0.86). This result suggested that the intramedullary signal abnormalities reflect delayed neurological improvements even after early surgical decompressions in patients with cervical SCI. CONCLUSION PCA could be a useful data-mining tool to show the complex relationships between acute MR imaging findings in cervical SCI. This study emphasized the importance of multivariable intramedullary MR imaging as clinical outcome predictors.

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