scholarly journals A Comparison of Cervical and Thoracolumbar Fractures Associated with Diffuse Idiopathic Skeletal Hyperostosis—A Nationwide Multicenter Study

2020 ◽  
Vol 9 (1) ◽  
pp. 208
Author(s):  
Hiroyuki Katoh ◽  
Eijiro Okada ◽  
Toshitaka Yoshii ◽  
Tsuyoshi Yamada ◽  
Kei Watanabe ◽  
...  

In diffuse idiopathic hyperostosis (DISH), the ankylosed spine becomes susceptible to spinal fractures and spinal cord injuries due to the long lever arms of the fractured segments that make the fracture extremely unstable. The aim of this retrospective multicenter study was to examine the differences in DISH-affected spine fractures according to fracture level. The data of 285 cases with fractures of DISH-ankylosed segments diagnosed through computed tomography (CT) imaging were studied and the characteristics of 84 cases with cervical fractures were compared to 201 cases with thoracolumbar fractures. Examination of the CT images revealed that cervical fracture cases were associated with ossification of the posterior longitudinal ligament and had fractures at the intervertebral disc level, while thoracolumbar fracture cases were associated with ankylosing of the posterior elements and had fractures at the vertebral body. Neurologically, cervical fracture cases had a higher ratio of spinal cord injury leading to higher mortality, while thoracolumbar fracture cases had lower rates of initial spinal cord injury. However, a subset of thoracolumbar fracture cases suffered from a delay in diagnosis that led to higher rates of delayed neurological deterioration. Some of these thoracolumbar fracture cases had no apparent injury episode but experienced severe neurological deterioration. The information provided by this study will hopefully aid in the education of patients with DISH and raise the awareness of clinicians to potential pitfalls in the assessment of DISH trauma patients.

2021 ◽  
pp. 1357034X2110256
Author(s):  
Denisa Butnaru

Motility impairments resulting from spinal cord injuries and cerebrovascular accidents are increasingly prevalent in society, leading to the growing development of rehabilitative robotic technologies, among them exoskeletons. This article outlines how bodies with neurological conditions such as spinal cord injury and stroke engage in processes of re-appropriation while using exoskeletons and some of the challenges they face. The main task of exoskeletons in rehabilitative environments is either to rehabilitate or ameliorate anatomic functions of impaired bodies. In these complex processes, they also play a crucial role in recasting specific corporeal phenomenologies. For the accomplishment of these forms of corporeal re-appropriation, the role of experts is crucial. This article explores how categories such as bodily resistance, techno-inter-corporeal co-production of bodies and machines, as well as body work mark the landscape of these contemporary forms of impaired corporeality. While defending corporeal extension rather than incorporation, I argue against the figure of the ‘cyborg’ and posit the idea of ‘residual subjectivity’.


1984 ◽  
Vol 61 (5) ◽  
pp. 925-930 ◽  
Author(s):  
Ronald W. J. Ford ◽  
David N. Malm

✓ Hypocarbia, normocarbia, or hypercarbia was maintained for an 8-hour period beginning 30 minutes after acute threshold spinal cord injuries in cats. No statistically significant differences in neurological recovery or histologically assessed tissue preservation were found among the three groups of animals 6 weeks after injury. No animal recovered the ability to walk. It is concluded that maintenance of hypercarbia or hypocarbia during the early postinjury period is no more therapeutic than maintenance of normocarbia. Mortality rates and tissue preservation data suggest, however, that postinjury hypocarbia may be less damaging than hypercarbia.


2019 ◽  
Vol 6 (3) ◽  
pp. 83-91
Author(s):  
Mohaddeseh Hedayatzadeh ◽  
Hamid Reza Kobravi ◽  
Maryam Tehranipour

Background: Spinal cord injury is one of the diseases that, no specific treatment has yet found despite the variety of works that have done in this field. Different approaches to treat such injuries have investigated today. One of them is invasive intra-spinal interventions such as electrical stimulation. Therefore, in this study, the effect of the protocol for intra-spinal variable and fixed electrical stimulation has been investigated in order to recover from spinal cord injury. Methods: In the study, 18 Wistar male rats randomly divided into Three groups, including intraspinal electrical stimulation (IES), IES with variable pattern of stimulation (VP IES) and a sham group. Animals initially subjected to induced spinal cord injury. After one week, the animal movement was recorded on the treadmill during practice using a camera and angles of the ankle joint were measured using the Tracker software. Then, the obtained data were analyzed by nonlinear evaluations in the phase space. Results: The motion analyses and kinematic analyses were carried out on all groups. According to the achieved results, the gait dynamics of the VP IES group has the most conformity to the gait dynamics of the healthy group. Also, the best quality of the balance preservation observed in the VP IES group. Conclusion: It can be concluded that the IES with variable pattern of stimulation along with exercise therapy has significant gait restorative effects and increases the range of motion in rats with induced spinal cord injury.


2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Huan-xia Li ◽  
Jing Cui ◽  
Jing-shi Fan ◽  
Jian-zhou Tong

Objective: To examine the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen therapy in treating thoracolumbar vertebral fracture-induced acute spinal cord injury (ASCI). Methods: From June 2015 to May 2018, 80 patients with thoracolumbar fractures and ASCI who were treated at Baoding First Central Hospital were selected. All patients underwent posterior laminectomy and screw fixation, and they were randomly divided into two groups using a random number table method. The control group received conventional postoperative treatment, while the experimental group was treated with riluzole combined with mannitol and hyperbaric oxygen on the basis of conventional treatment. The recovery of nerve function which included motor function and sensory function, and the changes of serum IL-6, CRP, BDNF, BFGF and other factors before treatment and four weeks after treatment of the two groups of patients were observed and evaluated. Results: After treatment, the motor function scores and sensory function scores of the two groups of patients were improved compared with those before treatment (p<0.05). Compared with the control group, the experimental group improved significantly, and the difference was statistically significant (p<0.05). The levels of IL-6, BDNF and NFGF in the experimental group were significantly lower than those in the control group (p<0.05). Conclusions: For patients with thoracolumbar fractures and ASCI undergoing laminar decompression and fixation, the comprehensive treatment plan of riluzole combined with mannitol and hyperbaric oxygen has certain advantages. Compared with the conventional therapy, it may significantly improve the movement and sensory functions of patients, relieve the inflammatory response of spinal cord, and promote recovery from the injury. doi: https://doi.org/10.12669/pjms.37.2.3418 How to cite this:Li H, Cui J, Fan J, Tong J. An observation of the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen in treating acute spinal cord injury. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3418 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2005 ◽  
pp. 015-019
Author(s):  
Igor Ivanovich Larkin ◽  
Valery Ivanovich Larkin

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.


2021 ◽  
Author(s):  
Zheng Cao ◽  
Weitao Man ◽  
Yuhui Xiong ◽  
Yi Guo ◽  
Shuhui Yang ◽  
...  

Abstract A hierarchically aligned fibrin hydrogel (AFG) that possesses soft stiffness and aligned nanofiber structure has been successfully proven to facilitate neuroregeneration in vitro and in vivo. However, its potential in promoting nerve regeneration in large animal models that is critical for clinical translation has not been sufficiently specified. Here, the effects of AFG on directing neuroregeneration in canine hemisected T12 spinal cord injuries were explored. Histologically obvious white matter regeneration consisting of a large area of consecutive, compact, and aligned nerve fibers is induced by AFG, leading to a significant motor functional restoration. The canines with AFG implantation start to stand well with their defective legs from 3 to 4 weeks postoperatively and even effortlessly climb the steps from 7 to 8 weeks. Moreover, high-resolution multi-shot diffusion tensor imaging illustrates the spatiotemporal dynamics of nerve regeneration rapidly crossing the lesion within 4 weeks in the AFG group. Our findings indicate that AFG could be a potential therapeutic vehicle for spinal cord injury by inducing rapid white matter regeneration and restoring locomotion, pointing out its promising prospect in clinic practice.


2020 ◽  
pp. 524-526
Author(s):  
Andreea DUMITRASCU ◽  
Ioana ANDONE ◽  
Aura SPÎNU ◽  
Carmen CHIPĂRUȘ ◽  
Cristina POPESCU ◽  
...  

Introduction: Spinal cord injuries (SCI) are major conditions that usually determine severe and permanent dysfunctions, or even important loss of basic functions, generating severe or rather permanent sequels. They can have important chronic consequences such as: tetraplegia or paraplegia.(1). Materials and Methods: This paper presents the case of a young 19-year-old patient who suffered in March 2019, a car accident (passenger) with spinal cord injury (SCI) at cervical and thoracic level in a politraumatic context, hospitalized at the Neurosurgery Clinic (NS) II of TEHBA in a severe condition, for complete AIS/Frankel A tetraplegia, with a C7 fracture, T3, T4, T5 cominutive fractures with fragments in the medullary channel, minor traumatic brain injury, multiple costal fractures, abdominal trauma and respiratory failure. When the patient became hemodynamic and respiratory stable it was decided a neuro-surgical intervention, initially at cervical level through an anterior approach, with mixed osteo-sinthesis and C7 discectomy. Because of the spine instability, thoracic surgical treatment was delayed with 11 days, when he suffers a neurosurgery for medullary decompression, drainage and stabilization of the spine. In our clinical division, the patient was admitted with an incomplete AIS/Frankel B tetraplegia and initially followed a rehabilitation nursing program and subsequently continued with a recovery therapy according to clinical stages. The patient was assessed functionally using the following scales: AIS/Frankel, modified Ashworth, Functional Independence Measure (FIM), Life Quality Assessment (QOL), FAC International Scale, Independence Assessment Scale in Daily Activities (ADL / IADL), Walking Scale for Spinal Cord Injury (WISCI). Results: The patient benefited from a complex neuro-muscular rehabilitation program, having a favorable evolution, with an increase in the evaluated scales scores – passing from AIS/Frankel B classification to a severe AIS/Frankel C stage, and thus, at the moment he is performing walking on short distances, through parallel bars, with long left leg orthosis and support from another person. It was tried a sphincter re-education, but, after urologic examination, because of the important spasticity in the lower limbs and of the urinary catheterization discomfort, it was decided that for a while the patient to remain with fixed urinary catheterization. Conclusions: Even if there is still no cure for SCI sequels, the accurate clinical-functional evaluation, the neurosurgical prompt therapeutic approach, adding complex nursing measures, personalized rehabilitative and kinetotherapy programs, in a young patient with SCI by car accident, determined neuro-locomotor improvements with an increase in patient’s quality of life.(1),(2). Keywords: spinal cord injuries, tetraplegia, traumatism, rehabilitation,


1983 ◽  
Vol 59 (2) ◽  
pp. 268-275 ◽  
Author(s):  
Ronald W. J. Ford

✓ Allen's weight-drop method for producing experimental spinal cord injuries was improved by placing a curved stainless steel plate anterior to the spinal cord to provide a smooth, hard surface for the receipt of posterior cord impact. In addition, an electronic circuit was used to ensure that cord injury was produced by a single impact, thereby enhancing the reproducibility of the injury mechanism. Using a spinal cord injury model with these modifications, the author found that the recovery of hindlimb function and the histopathological appearance of the injured cord 6 weeks after upper lumbar injury were closely related to injury magnitude. The curve of functional recovery versus injury magnitude has a sharp transition centered at 10 gm × 15 cm, and indicates that an injury of 10 gm × 20 cm produces a “threshold” lesion suitable for the future evaluation of spinal cord treatment methods.


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