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Biomedical subjects

G Bedbrook

Publications and source records attributed to G Bedbrook.

17 recordsLinked to original sources
PubMed1992

Fifty years on fundamentals in spinal cord injury care are still important.

The fundamentals of care in spinal cord injury were laid down many years ago. Prevention----therapy----follow up is basic in medicine. In spinal cord injury, admission to a comprehensive unit then application of simple, repetitive disciplines for patient and staff, and education are the fundamentals to be emphasised. The great pioneers, Munro, Guttmann and Botterell achieved advances long before sophisticated technology moved to a stage when now it could swamp hensive units catering for acute care but, more importantly, lifetime care with acceptance of the fundamental medical axis of prevention, therapy and follow up. The details of fundamental care include secondary and tertiary prevention techniques in hospital and community, and an acceptance by staff as well as spinal men and women of their simplicity, their repetitiveness, the need for disciplined action and the requirement for education at all levels. In the future, primary prevention must be given more emphasis as cure is many decades away even with the volume of basic research now being undertaken.

Comprehensive Health Care↗
PubMed1987

Long-term results of conservative and operative management in complete paraplegics with spinal cord injuries between T10 and L2 with respect to function.

This study analyzed 87 athletes attending the Para Olympic Games at Stoke Mandeville in 1984. All athletes had had complete neurologic lesions between the levels of T10 adn L2. Clinical details were obtained from each athlete. Assessment then consisted of measurement of spinal movement in the sagittal plane using spondylometers and movement in the rotation plane using a rotameter. Body trunk strength was measured with the athletes in their own wheelchairs using a myometer. This gave a recording of kilograms of force. Trunk balance was assessed on both a static and a dynamic basis. The age, sex, follow-up period, and body weight for both spinal fusion and conservatively treated groups were similar. There was little difference in the incidence of pain between those treated by conservative and operative methods. There was statistically significant difference in the range of sagittal plane and rotation movement. There was no difference in flexor trunk power measured with the myometer between the two groups, but when extensor power was measured it was found to be 25% less in the spinal fusion group. There was no difference between the two groups when tested for static and dynamic trunk balance. Two other athletes who had had spinal fusions extending from the upper thoracic region to the sacrum showed unusually poor trunk stability. Overall, this study demonstrates that spinal fusion, particularly over multiple segments in complete paraplegics, has a deleterious effect not only on spinal movement but also on body trunk strength.

Adolescent↗
PubMed1985

Preventive measures in the tertiary care of spinal cord injured people.

There are complications of spinal cord paralysis peculiar to the extended care period. These may be motor skeletal, neurogenic, visceral and psychogenic. If practised regularly, prevention can be very effective in reducing the disability in all groups. Limb oedema, joint contractures, myasthenia and pain can be materially reduced by regular activity, maintaining joint mobility and the use of recreational motor skeletal activities. Urinary tract infection and decubiti can be largely eliminated by careful attention to anti-bacterial suppression and better hygiene, both personal and at home. Decubiti can be eliminated by regular skin care and eliminating friction and pressure. Most episodes of such complications can be effectively prevented and treated by the expert home visiting nurse. Social complications and drug abuse are areas of increasing concern. These can be kept to a minimum by regular assessment and, most importantly, when diagnosed early by the home visiting professional.

Alcoholism↗
PubMed1982

Survival following traumatic tetraplegia.

The records of 363 patients presenting to the Spinal Unit of Royal Perth Rehabilitation Hospital with traumatic tetraplegia are reviewed. Mortality rates in both short and long terms are tabulated and correlated with the level of the lesion, age of the patient at the time of injury and completeness of the lesion. The mortality rate for patients sustaining a complete lesion above C5 at the end of 1 year after injury was 20 per cent if under the age of 45 years and 75 per cent if over the age of 45 years. The mortality rate of patients sustaining a complete lesion below C5 at the end of 1 year after injury was 8 per cent if under the age of 45 years and 66 per cent if over the age of 45 years.

Adolescent↗
PubMed1980

Recovery of spinal cord function.

Sixty-five per cent of cervical dorsal injuries with neurological change will be incomplete on admission whilst 5 to 50% lumbo dorsal neurological injury will manifest root sparing. The presence of such neurological incompleteness improves the prognosis. Results of long-term neurological examination and observation and their application over a period of years are less well known. Over a period of 22 years subsequent to the establishment of the Spinal Paralysis Unit in Perth, Western Australia, a small series of 17 cases originally admitted to hospital with complete paraplegia or tetraplegia (and substantiated by clinical examination on admission and discharge initially) showed interesting clinical change over a 10 to 15 years observation period. These changes are only sensory: (a) Improvement in somatic function, (b) Improvement in autonomic function. Such improvement resulted in patients having sensation at a useful level, although no real attempt had been made to develop this sensation over a period of time. In no case was long-term motor recovery noted of use. Careful regular monitoring of neurological dysfunction is of value. Repeated stimuli of many types should be used in the treatment to improve sensory function. Rehabilitation of sensory function is of much more importance than has been hitherto discussed.

Adolescent↗
PubMedDate not supplied

Spontaneous resolution of spinal canal deformity after burst-dispersion fracture.

We reviewed the records of 28 patients with 30 burst-dispersion spinal fractures treated since the introduction of CT facilities in Western Australia. Twenty-five patients showed spinal canal deformity and stenosis with bone fragments protruding into the canal on the initial scan. Of these, 22 patients were treated nonsurgically. Fifteen of the conservatively treated patients were available for follow-up, and they form the basis of this report. Thirteen of the 15 patients who had repeat CT at follow-up showed correction of the previously measured spinal canal stenosis by spontaneous resorption of intraspinal bone fragments. In view of this previously unreported finding, it is suggested that the role of surgical correction of spinal canal stenosis resulting from displaced bone fragments after trauma be more clearly defined.

Adolescent↗