Clinical and Radiological Differences in Patients Following Traumatic SCI at Different Ages

2021 ◽  
Vol 23 (4) ◽  
pp. 305-314
Author(s):  
Thalia Saraiva Mendonça ◽  
Vitor Dias de Arruda Andrade ◽  
Pedro Nogarotto Cembraneli ◽  
Julia Brasileiro de Faria Cavalcante ◽  
André Salotto Rocha ◽  
...  

Background. Traumatic spinal cord injury (SCI) is a lesion that can affect several spinal structures, including the vertebrae, spinal cord, ligaments, and other adjacent parts of the spine. Traumatic spinal cord injury (SCI) can cause functional changes in patients of different ages. Material and methods. The study aims to determine whether there are social, clinical, and radiological differences between young, middle-aged, and elderly adults with SCI caused by a ground-level fall. This retrospective study analyzed the records of patients with a clinical diagnosis of SCI. It enrolled patients with traumatic spinal cord injury after a ground-level fall divided as follows: young aged adults 18–35 years of age (G1); middle-aged adults aged 36–60 years (G2); and elderly adults aged over 60 years (G3). Their clinical, social, and radiological variables were analyzed. Results. It is observed that low schooling level, being widowed, and being a homemaker were more frequently encountered among elderly adults, whereas being single was more common in middle-aged adults. The morphologic diagnosis of compression fracture and the associated injury of facial trauma occurred more frequently in elderly adults, with an increasing tendency with age. Conservative therapeutic management was most commonly encountered in elderly adults, compared to surgery from a posterior approach in middle-aged adults. Listhesis was better identified in middle-aged adults by computed tomography (CT). Spinal cord contusion and injury to the C1 vertebra were demonstrated in young adults by magnetic resonance imaging (MRI). Conclusions. 1. Elderly adults with low education level, widowed, and homemakers were more susceptible to SCI caused by a fall. 2. Single marital status was more frequently noted in young adults. 3. The most frequent clinical aspects were the morphological aspect of compression fracture and fa­cial trauma as an associated injury in elderly adults, with the occurrence of facial trauma increasing with age. 4. Conservative therapeutic management was more common in elderly adults than surgery from a po­sterior approach in middle-aged adults. 5. Re­garding the radiological aspects of CT, listhesis was better identified in middle-aged adults. Spi­nal cord contusions and C1 vertebra lesions were better identified in young adults by MRI.

2018 ◽  
Author(s):  
Ryan Martin ◽  
Lara Zimmermann ◽  
Kee D. Kim ◽  
Marike Zwienenberg ◽  
Kiarash Shahlaie

Traumatic spinal cord injury currently affects approximately 285,000 persons in the United States and carries with it significant morbidity and cost. Early management focuses on adequate ventilation and hemodynamic resuscitation of the patient and limiting motion of the spine to prevent a second injury. Medical management targets maintenance of adequate blood flow to the spinal cord, whereas surgical management focuses on decompression, realignment, and stabilization of the vertebral column. In this chapter, we discuss the approach to the patient with traumatic spinal cord injury, injury types, and medical and surgical management. This review contains 9 figures, 4 tables and 30 references Key Words: American Spinal Injury Association score, burst fracture, Chance fracture, compression fracture, hangman, mean arterial pressure therapy, odontoid fracture, spinal cord injury, traction


2018 ◽  
Author(s):  
Ryan Martin ◽  
Lara Zimmermann ◽  
Kee D. Kim ◽  
Marike Zwienenberg ◽  
Kiarash Shahlaie

Traumatic spinal cord injury currently affects approximately 285,000 persons in the United States and carries with it significant morbidity and cost. Early management focuses on adequate ventilation and hemodynamic resuscitation of the patient and limiting motion of the spine to prevent a second injury. Medical management targets maintenance of adequate blood flow to the spinal cord, whereas surgical management focuses on decompression, realignment, and stabilization of the vertebral column. In this chapter, we discuss the approach to the patient with traumatic spinal cord injury, injury types, and medical and surgical management. This review contains 9 figures, 4 tables and 30 references Key Words: American Spinal Injury Association score, burst fracture, Chance fracture, compression fracture, hangman, mean arterial pressure therapy, odontoid fracture, spinal cord injury, traction


2018 ◽  
Author(s):  
Ryan Martin ◽  
Lara Zimmermann ◽  
Kee D. Kim ◽  
Marike Zwienenberg ◽  
Kiarash Shahlaie

Traumatic spinal cord injury currently affects approximately 285,000 persons in the United States and carries with it significant morbidity and cost. Early management focuses on adequate ventilation and hemodynamic resuscitation of the patient and limiting motion of the spine to prevent a second injury. Medical management targets maintenance of adequate blood flow to the spinal cord, whereas surgical management focuses on decompression, realignment, and stabilization of the vertebral column. In this chapter, we discuss the approach to the patient with traumatic spinal cord injury, injury types, and medical and surgical management. This review contains 9 figures, 4 tables and 30 references Key Words: American Spinal Injury Association score, burst fracture, Chance fracture, compression fracture, hangman, mean arterial pressure therapy, odontoid fracture, spinal cord injury, traction


2018 ◽  
Author(s):  
Ryan Martin ◽  
Lara Zimmermann ◽  
Kee D. Kim ◽  
Marike Zwienenberg ◽  
Kiarash Shahlaie

Traumatic spinal cord injury currently affects approximately 285,000 persons in the United States and carries with it significant morbidity and cost. Early management focuses on adequate ventilation and hemodynamic resuscitation of the patient and limiting motion of the spine to prevent a second injury. Medical management targets maintenance of adequate blood flow to the spinal cord, whereas surgical management focuses on decompression, realignment, and stabilization of the vertebral column. In this chapter, we discuss the approach to the patient with traumatic spinal cord injury, injury types, and medical and surgical management. This review contains 9 figures, 4 tables and 30 references Key Words: American Spinal Injury Association score, burst fracture, Chance fracture, compression fracture, hangman, mean arterial pressure therapy, odontoid fracture, spinal cord injury, traction


2018 ◽  
Author(s):  
Ryan Martin ◽  
Lara Zimmermann ◽  
Kee D. Kim ◽  
Marike Zwienenberg ◽  
Kiarash Shahlaie

Traumatic spinal cord injury currently affects approximately 285,000 persons in the United States and carries with it significant morbidity and cost. Early management focuses on adequate ventilation and hemodynamic resuscitation of the patient and limiting motion of the spine to prevent a second injury. Medical management targets maintenance of adequate blood flow to the spinal cord, whereas surgical management focuses on decompression, realignment, and stabilization of the vertebral column. In this chapter, we discuss the approach to the patient with traumatic spinal cord injury, injury types, and medical and surgical management. This review contains 9 figures, 4 tables and 30 references Key Words: American Spinal Injury Association score, burst fracture, Chance fracture, compression fracture, hangman, mean arterial pressure therapy, odontoid fracture, spinal cord injury, traction


2018 ◽  
Vol 1 (2) ◽  
pp. 34
Author(s):  
Mochamad Targib Alatas

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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