scholarly journals Outcome in patients undergoing surgery for spinal injury in an Ethiopian hospital

2015 ◽  
Vol 23 (6) ◽  
pp. 772-779 ◽  
Author(s):  
Martin Andreas Lehre ◽  
Lars Magnus Eriksen ◽  
Abenezer Tirsit ◽  
Segni Bekele ◽  
Saba Petros ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Treatment ◽  
Motor Vehicle ◽  
Spinal Injury ◽  
Addis Ababa ◽  
Cord Injury ◽  
Spine Injuries ◽  
Tract Infections

OBJECT The objective of this study was to investigate epidemiology and outcome after surgical treatment for spinal injuries in Ethiopia. METHODS Medical records of patients who underwent surgery for spine injuries at Myungsung Christian Medical Center in Addis Ababa, Ethiopia, between January 2008 and September 2012 were reviewed retrospectively. Assessment of outcome and complications was determined from patient consultations and phone interviews. RESULTS A total of 146 patients were included (129 males, 17 females). Their mean age was 31.7 years (range 15–81 years). The leading cause of injury was motor vehicle accidents (54.1%), and this was followed by falls (26.7%). The most common injury sites were lumbar (41.1%) and cervical (34.2%) regions of the spine. In 21.2% of patients, no neurological deficit was present before surgery, 46.6% had incomplete spinal cord injury (American Spinal Injury Association [ASIA] Impairment Scale [AIS] Grade B-D), and 32.2% had complete spinal cord injury (AIS Grade A). Follow-up was hampered by suboptimal infrastructure, but information regarding outcome was successfully obtained for 110 patients (75.3%). At follow-up (mean 22.9 months; range 2–57 months), 25 patients (17.1%) were confirmed dead and 85 patients (58.2%) were alive; 49 patients (33.6%) underwent physical examination. At least 8 of the 47 patients (17.0%) with a complete injury and 29 of the 68 patients (42.6%) with an incomplete injury showed neurological improvement. The reported incidences of pressure wounds, recurrent urinary tract infections, pneumonia, and thromboembolic events were 22.5%, 13.5%, 5.6%, and 1.1%, respectively. CONCLUSIONS Patients showed surprisingly good recovery considering the limited resources. Surgical treatment for spine injuries in Ethiopia is considered beneficial.

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.

Neurological prognosis after traumatic quadriplegia

1979 ◽  
Vol 50 (5) ◽  
pp. 611-616 ◽  
Author(s):  
Frederick M. Maynard ◽  
Glenn G. Reynolds ◽  
Steven Fountain ◽  
Conal Wilmot ◽  
Richard Hamilton
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Head Injuries ◽  
Gunshot Wounds ◽  
Neurological Impairment ◽  
Treatment Protocols ◽  
Content Type ◽  
Cord Injury

✓ Between January, 1974, and December, 1976, 123 patients with traumatic quadriplegia were admitted to the California Regional Spinal Cord Injury Care System. The spinal cord injury resulted from gunshot wounds in five, from a stab wound in one, from neck injuries with no bone damage seen on x-ray studies in 10, and from fracture dislocations of the cervical spine in 107. One-year follow-up information was available on 114 patients. Neurological impairment using the Frankel classification system was compared at 72 hours postinjury to the 1-year follow-up examination. Fifty of 62 patients with complete injury at 72 hours were unchanged at 1 year. Five of these 62 patients had developed motor useful function in the legs or became ambulatory by 1 year, but all had sustained serious head injuries at the time of their trauma making initial neurological assessment unreliable. Ten percent of all cases had combined head injury impairing consciousness. Among 103 cognitively intact patients, none with complete injury at 72 hours were walking at 1 year. Of patients with sensory incomplete function at 72 hours postinjury, 47% were walking at 1 year; 87% of patients with motor incomplete function at 72 hours postinjury were walking at 1 year. Spinal surgery during the first 4 weeks postinjury did not improve neurological recovery. A method of analyzing neurological and functional outcomes of spinal cord injury is presented in order to more accurately evaluate the results of future treatment protocols for acute spinal injury.

Long-Term Follow-up of Patients with Spinal Cord Injury

2005 ◽  
Vol 19 (4) ◽  
pp. 332-337 ◽  
Author(s):  
Figen Yilmaz ◽  
Fusun Sahin ◽  
Semra Aktug ◽  
Banu Kuran ◽  
Adem Yilmaz
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
American Spinal Injury Association ◽  
Cord Injury ◽  
Long Term Follow Up

Objective. The aim of this study was to evaluate the motor, sensory, and functional recovery in patients with spinal cord injury (SCI). Methods. Forty-one patients with SCI participated in this study. Twenty patients were evaluated after discharge. Each patient was evaluated by the American Spinal Injury Association (ASIA) impairment scale and the Functional Independence Measure (FIM) at admission, before discharge, and at least at 6 months after discharge. Friedman, Dunn, and Mann-Whitney U tests were used for statistical analysis. Results. There were 17 male and 3 female patients. Seven patients had complete SCI, and 13 patients had incomplete SCI. The evaluation of motor, sensory, and FIM scores at admission showed significant improvement in all of the patients during the follow-up period (P < 0.0001). Five incompletely injured cases improved with regard to ASIA staging. Motor and FIM scores significantly increased at follow-up for converted and unconverted patients. All parameters increased at follow-up in patients who were complete and incomplete. Motor scores significantly increased at discharge and at follow-up. FIM scores also increased significantly at follow-up in incomplete patients. Conclusion. Motor, sensory, and FIM scores increased in patients with SCI after a follow-up period of 18 months. Improvement to a higher ASIA stage could be accomplished by 25% of the patients. Although both complete and incomplete patients recovered significantly at the follow-up period, only incompletely injured cases could convert to a higher ASIA stage.

Incidence and severity of acute complications after spinal cord injury

2012 ◽  
Vol 17 (Suppl1) ◽  
pp. 119-128 ◽  
Author(s):  
Robert G. Grossman ◽  
Ralph F. Frankowski ◽  
Keith D. Burau ◽  
Elizabeth G. Toups ◽  
John W. Crommett ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Trials ◽  
Motor Vehicle ◽  
Spinal Injury ◽  
Vehicle Accidents ◽  
The North ◽  
Treatment And Prevention ◽  
Cord Injury ◽  
Study Population

Object The aim of this multicenter, prospective study was to determine the spectrum, incidence, and severity of complications during the initial hospitalization of patients with spinal cord injury. Methods The study was conducted at 9 university-affiliated hospitals that comprise the clinical centers of the North American Clinical Trials Network (NACTN) for Treatment of Spinal Cord Injury. The study population comprised 315 patients admitted to NACTN clinical centers between June 25, 2005, and November 2, 2010, who had American Spinal Injury Association (ASIA) Impairment Scale grades of A–D and were 18 years of age or older. Patients were managed according to a standardized protocol. Results The study population was 79% male with a median age of 44 years. The leading causes of injury were falls (37%) and motor vehicle accidents (28%). The distribution of initial ASIA grades were A (40%), B (16%), C (15%), and D (29%). Fifty-eight percent of patients sustained 1 or more severe, moderate, or mild complications. Complications were associated with more severe ASIA grade: 84% of patients with Grade A and 25% of patients with Grade D had at least 1 complication. Seventy-eight percent of complications occurred within 14 days of injury. The most frequent types of severe and moderate complications were respiratory failure, pneumonia, pleural effusion, anemia, cardiac dysrhythmia, and severe bradycardia. The mortality rate was 3.5% and was associated with increased age and preexisting morbidity. Conclusions Knowledge of the type, frequency, time of occurrence, and severity of specific complications that occur after spinal cord injury can aid in their early detection, treatment, and prevention. The data are of importance in evaluating and selecting therapy for clinical trials.

scholarly journals URINARY TRACT INFECTIONS AND PRESSURE SORES AT GREEN PASTURES SPINAL INJURY UNIT

2003 ◽  
Vol 42 (146) ◽  
pp. 92-95
Author(s):  
Friedbert B Herm ◽  
R B Tripathi ◽  
Altrichter
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Spinal Injury ◽  
Pressure Sores ◽  
Hospitalization Period ◽  
Cord Injury ◽  
Tract Infections

ABSTRACTBetween 46-59% of Spinal Cord Injury (SCI) cases develop Urinary Tract Infection (UTI) and 16-18%develop pressure sores during the first year after the trauma. In a retrospective approach, the occurrence ofUTI and pressure sores at Green Pastures Hospital’s Spinal Injury Unit was studied. Between 1997-2000out of 39 included patients 27 had suffered a thoracic-lumbar, 12 a cervical trauma. Twenty of these( 51.2% ) developed UTI and 7 ( 17.9% ) developed pressure sores during their hospitalization period. Themost commonly organism found in both complications, UTI and pressure sores, was E. coli, followed byProteus in UTI and Staph. aureus in pressure sores. Detected UTI and pressure sores among referredpatients at admission was higher than expected (71.7% and 48.7% respectively). In conclusion, adherenceto a protocol by a multidisciplinary health care team resulted in favourable outcome of patients with SCIadmitted to the rehabilitation unit. This is believed to be an indicator for the need of specialized SCI units.However, also in the studied sample at Green Pastures there was room for further improvement within the expected range.Key Words: Spinal Cord Injury, Urinary Tract Infection, Pressure Sore.

scholarly journals Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes

2017 ◽  
Vol 11 (3) ◽  
pp. 412-418 ◽  
Author(s):  
Rouzbeh Motiei-Langroudi ◽  
Homa Sadeghian
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Treatment Protocol ◽  
Spinal Column ◽  
Surgical Approaches ◽  
Trauma Mechanism ◽  
Cord Injury

<sec><title>Study Design</title><p>Retrospective study.</p></sec><sec><title>Purpose</title><p>To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term.</p></sec><sec><title>Overview of Literature</title><p>SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column fractures. Most studies have not evaluated or have failed to show the influence of different surgical approaches and other parameters on neurological recovery.</p></sec><sec><title>Methods</title><p>A thorough history regarding sensory, motor, and urinary complaints was taken from 103 patients with SCI due to vertebral fracture; patients were followed by a thorough neurological examination. Subsequently, all medical records of patients, including neurological state after trauma, trauma mechanism, treatment protocol, surgical protocol, and imaging findings, were evaluated.</p></sec><sec><title>Results</title><p>Of the 103 patients, 73.8% were survivors of a major earthquake and 26.2% were victims of vehicle accidents; 92.2% patients were surgically treated, while 7.8% underwent conservative management. The mean follow-up duration was 10.3 years. In follow-up visits, 67.0%, 12.6%, 13.6%, and 6.8% patients showed no, partial, substantial, and complete motor improvement, respectively; 68.0%, 26.2%, and 5.8% showed no, mild, and substantial sensory improvement, respectively; and 73.8%, 17.5%, and 8.7% showed no, substantial, and complete urinary improvement, respectively. Logistic regression analysis showed that sex, age at injury time, follow-up duration, trauma mechanism, and stem cell therapy had no effect on motor, sensory, and urinary improvement. Higher initial scores on the American Spinal Injury Association (ASIA) classification, lumbar fracture level, and performance of laminectomy improved motor outcome; higher initial ASIA scores improved urinary and sensory outcomes.</p></sec><sec><title>Conclusions</title><p>The initial ASIA score is the most important factor for prognosticating motor, sensory, and urinary improvement in SCI patients. Lumbar (L3–L5) and thoracic (T1–T10) fractures have the best and worst prognosis, respectively, in terms of motor recovery. Laminectomy during surgery improves motor function.</p></sec>

scholarly journals Successful surgical repair and recovery in a 2-week-old infant after birth-related cervical fracture dislocation

2018 ◽  
Vol 21 (1) ◽  
pp. 16-20
Author(s):  
Sara Saleh ◽  
Kyle I. Swanson ◽  
Taryn Bragg
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Fracture Dislocation ◽  
Interdisciplinary Management ◽  
Cervical Fracture ◽  
Spine Stabilization ◽  
Cord Injury ◽  
Spine Injuries

Cervical spine injuries are the most common spine injuries in the pediatric population. The authors present the youngest known patient who underwent cervical spine fusion to repair birth trauma–induced cervical fracture dislocation, resulting in spondyloptosis and spinal cord injury. A 2-week-old boy was found to have spondyloptosis and spinal cord injury after concerns arose from reduced movement of the extremities. The patient’s birth was complicated by undiagnosed abdominal dystocia, which led to cervical distraction injury. At 15 days of age, the boy underwent successful C-5 corpectomy, with anterior C4–6 and posterior C2–7 arthrodesis, using an autologous rib graft for a C-5 fracture dislocation. MRI performed 2 weeks postoperatively revealed significant improvement in the alignment of the spinal canal. The patient was discharged from the hospital in a custom Minerva brace and underwent close follow-up in addition to occupational therapy and physical therapy. At the latest follow-up 4.5 years later, the patient was able to walk and ride a tricycle by himself. The authors describe the patient’s surgery and the challenges faced in achieving successful repair and cervical spine stabilization in such a young patient. The authors suggest that significant neurological recovery after spinal cord injury in infants is possible with appropriate, timely, and interdisciplinary management.

scholarly journals The Risk of Acute Spinal Cord Injury After Minor Trauma in Patients With Preexisting Cervical Stenosis

Neurosurgery ◽  
2015 ◽  
Vol 77 (4) ◽  
pp. 561-565 ◽  
Author(s):  
Victor Chang ◽  
Benjamin M. Ellingson ◽  
Noriko Salamon ◽  
Langston T. Holly
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Vehicle ◽  
Traumatic Event ◽  
Minor Trauma ◽  
Cervical Stenosis ◽  
Canal Diameter ◽  
Cord Injury ◽  
The Mean

Abstract BACKGROUND: Cervical stenosis patients are commonly advised to undergo surgery due to the risk of spinal cord injury (SCI) after a traumatic event. However, the actual risk of SCI in this scenario is unknown. OBJECTIVE: To evaluate the risk of SCI after minor trauma in a cohort of prospectively followed cervical stenosis patients. METHODS: Clinical and radiographical analysis was performed in 55 nonoperatively treated patients evaluated between 2009 and 2014. Each patient was asked standardized questions including: 1) whether a previous physician recommended neck surgery, 2) whether a physician indicated that they would become paralyzed after a traumatic event, and 3) whether they experienced a traumatic event during the follow-up period. RESULTS: The mean age was 65, with a mean modified Japanese Orthopedic Association score of 16.6. The mean canal diameter was 6.1 mm. Nineteen patients (35%) had evidence of intramedullary T2 signal abnormality. Thirty-one patients (56%) were previously recommended for surgery. Twenty-six patients (47%) were told that they would be paralyzed after a motor vehicle accident or fall unless surgery was performed. Ten patients (18%) experienced a traumatic event during the follow-up, with none sustaining an SCI. CONCLUSION: Asymptomatic and mildly symptomatic cervical stenosis patients are commonly recommended to undergo surgery due to risk of paralysis after a traumatic event. SCI was not observed after minor trauma in our cohort of prospectively followed patients. It seems that occurrence of SCI in this patient population after minor trauma is likely smaller than many physicians surmise, yet will require future prospective study in a large cohort of patients.

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.

scholarly journals SPINAL CORD TRAUMA PATIENTS TREATED IN A TERTIARY HOSPITAL IN PALMAS, BRAZIL

2015 ◽  
Vol 14 (3) ◽  
pp. 214-217
Author(s):  
Danilo Lopes Castro ◽  
Gustavo Fernandes Leobas ◽  
Maíse Santana Tolentino Marciano Araujo ◽  
Itágores Hoffman Lopes Sousa Coutinho ◽  
Márcio Antônio de Sousa Figueiredo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Vehicle ◽  
Spinal Injury ◽  
Tertiary Hospital ◽  
Alcoholic Beverages ◽  
Neurological Deficits ◽  
Trauma Patients ◽  
Cord Injury ◽  
Epidemiological Profile

Objective:Traumatic spinal cord injury is one of the leading causes of disability worldwide, mainly related to automobile accidents. It was decided to establish a clinical-epidemiological profile of spinal cord injury (SCI) in Palmas, Brazil.Method:Prospective study at the Public General Hospital of Palmas (HGPP), including all patients admitted in this hospital from January 2011 to February 2012.Results:They refer to 59 patients, of whom 81.4% were men and 47.4% of the victims had up to 40 years. The main mechanism of injury was motor vehicle accidents involving motorcycles. Clinically, the vertebral segment C4-C7 was the most damaged, and most patients were admitted with spinal injury and no neurological deficit (Frankel E).Conclusions:Primary involvement of young men in working age, trauma mainly due to car accidents that are usually associated with the use of alcoholic beverages. Patients admitted with more severe neurological deficits have evolved to milder impairments after conservative or surgical treatment.

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