PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Spinal Injuries”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1992

Spinal trauma. Pathophysiology and management of traumatic spinal injuries.

Spinal trauma can originate from internal or external sources. Injuries to the spinal cord can be classified as either concussive or compressive and concussive. The pathophysiologic events surrounding spinal cord injury include the primary injury (compression, concussion) and numerous secondary injury mechanisms (vascular, biochemical, electrolyte), which are mediated by excessive oxygen free radicles, neurotransmitter and electrolyte alterations in cell membrane permeability, excitotoxic amino acids, and various other biochemical factors that collectively result in reduced SCBF, ischemia, and eventual necrosis of the gray and white matter. Management of acute spinal cord injuries includes the use of a high-dose corticosteroid regimen within the initial 8 hours after trauma. Sodium prednisolone and methylprednisolone, at recommended doses, act as oxygen radical scavengers and are anti-inflammatory. Additional considerations are the stability of the vertebral column, other conditions associated with trauma (i.e., pneumothorax), and the presence or absence of spinal cord compression, which may warrant surgical therapy. Vertebral fractures or luxations can occur in any area of the spine but most commonly occur at the junction of mobile and immobile segments. Dorsal and dorsolateral surgical approaches are applicable to the lumbosacral and thoracolumbar spine and dorsal and ventral approaches to the cervical spine. Indications for surgical intervention include spinal cord compression and vertebral instability. Instability can be determined from the type of fracture, how many of the three compartments of the vertebrae are disrupted, and on occasion, by carefully positioned stress studies of fluoroscopy. Decompression (dorsal laminectomy, hemilaminectomy, or ventral cervical slot) is employed when compression of the spinal cord exists. The hemilaminectomy (unilateral or bilateral) causes less instability than dorsal laminectomy and therefore should be used when practical. The preferred approach for atlantoaxial subluxation is ventral, and the cross pinning, vertebral fusion technique is used for stabilization. Fracture luxations of C-2 are repaired with small plates on the ventral vertebral body. The thoracic and upper lumbar spine is stabilized with dorsal fixation techniques or combined dorsal spinal plate/vertebral body plate fixation. Several methods of fixation can be used with lower lumbar or lumbosacral fractures, including the modified segmental technique and the combined dorsal spinal plate/Kirschner-Ehmer technique.

Animals↗
PubMed1992

Pediatric spinal injury: review of 174 hospital admissions.

Injury to the spinal column and spinal cord occurs relatively infrequently in the pediatric population. A review of 174 pediatric patients is presented, representing 5.4% of all patients admitted with spinal injury. Spinal cord injury was present in 45% of patients. A distinct injury profile, explained by anatomical and biomechanical features, distinguishes the young patient with an immature spine from older adolescents with a more mature, adult-like spine. The younger patients, while less likely to have spinal injury, had a higher incidence of neurological injury, in addition to a higher frequency of both spinal cord injury without radiological abnormality and upper cervical cord injury. In addition, younger patients with spinal cord injury and no radiological abnormality were more likely to have complete or severe cord injury. Prognosis was determined by the severity of spinal cord injury. Patients with complete cord injuries showed little improvement, while patients with incomplete injuries generally fared much better, with 74% showing significant improvement and 59% experiencing a complete recovery of neurological functions. There were six deaths, but none was attributed solely to spinal injury. The authors conclude that outcome is quite good after pediatric spinal cord injury that does not produce a physiologically complete cord deficit.

Adolescent↗
PubMed1977

Paraplegia from traumatic spinal injury.

Acute spinal injury with paresis or paralysis is an increasing problem in modern communities. The corrdinated efforts of many are necessary for its management. The expertise developed by various disciplines through work with nonparaplegic patients should be coupled with the specific expertise of those responsible for total care. Generally, operative techniques have only a limited application, whereas basic medical and nursing techniques give good results.

Contracture↗
PubMed1975

Spinal injuries in children.

Spinal injuries with neurologic sequelae are a rare but catastrophic injury. Many of these injuries might be preventable through proper parent and child education, particularly in water sports and vehicles accidents. A significant number of neurologic injuries are incomplete at the time of injury and proper rescue and initial care may make the difference between life as a quadriplegic and life as a normal individual. Because of the complexity of the management of the child with spinal injuries and their relative rarity, the definitive care is best undertaken at hospitals which specialize in the care of spinal injuries. Progressive deformity of the spine, a problem unique to childhood and adolescent paralysis, is often preventable with prolonged immobilization and protection of the spine. Progressive deformities which interfere with function or result in neurologic deterioration require an aggressive surgical approach.

Accidents, Traffic↗
PubMed2026

Treatment of spinal injury muscle spasticity by spinal subpial AAV9-GAD65/VGAT delivery: An efficacy and safety study in rat, pig, and NHP.

The loss in segmental inhibitory GABAergic tone plays the key role in the development of spinal injury-induced muscle spasticity. We use a subpial segment-targeted delivery of adeno-associated virus vector(s) expressing GAD65 (glutamic acid decarboxylase-65) and VGAT (vesicular GABA transporter) transgenes in rats with spinal transection-induced spasticity. In treated animals, a significant suppression in spasticity was seen at 5-8 weeks after treatment. Naive rats, pigs, and non-human primates (NHPs) injected with human equivalent dose of treatment vectors and surviving for 3 weeks to 4.5 years showed normal motor function and pinch-evoked response. A significant increase in the number of VGLUT2 terminals co-expressing GAD65 and VGAT protein in vector-injected segment was seen. This corresponded with the presence of transgene-specific rat Gad2 or human GAD2 and rat Slc32a1 or human SLC32A1 mRNA signal. No spinal toxicity was noted in NHPs at 4.5 years post vector delivery. Analysis of peripheral organs (liver, spleen, and skeletal muscle) showed minimal or no detectable transgenes in pigs and NHPs. These data demonstrate that a single-time-point spinal-segment-targeted subpial delivery of GAD65/VGAT transgenes is effective in suppressing spinal injury-induced spasticity and has a favorable long-term safety profile as defined by normal neurological function and histopathology in naive pigs and NHPs.

Animals↗
PubMed1992

Pediatric spinal injury: review of 61 deaths.

Injury to the spinal column and spinal cord occurs relatively infrequently in the pediatric population. The authors present a unique review of 61 pediatric deaths associated with spinal injury. This group represented 28% of the total pediatric spine-injured population and 45% of the total pediatric spinal cord-injured group studied. The ratio of pediatric to adult spinal injury mortality was 2.5:1. Of the 61 children, 54 (89%) died at the accident scene. Thirty patients underwent a complete autopsy, 19 of whom had an Abbreviated Injury Scale Grade 6 injury (maximum score, untreatable). Spinal cord injury was found to be the cause of death in only eight children and was associated with injury to the high cervical cord and cardiorespiratory arrest. These children typically sustained severe multiple trauma. In this population, there appears to be little room for improved outcome through changes in treatment strategy.

Adolescent↗
PubMed1978

Spinal injuries in Rangoon, Burma.

Spinal injuries in Burma as a result of a fall from height, especially from trees, in young male adults in low socio-economic classes; road traffic accidents are the second commonest cause; deep vein thrombosis and pulmonary embolism is very rare during the period of immobilisation. There are still some social problems of getting back to work and living conditions. We are trying our best to help the patients with spinal injuries.

Accidents, Occupational↗
PubMed1992

The onset and progression of spinal injury: a demonstration of neutral zone sensitivity.

Spinal injuries are a great cost to society and the afflicted individuals. It is well known that most spinal injuries are not bony fractures but rather soft tissue lesions falling in the 'subfailure' region. For the clinical diagnosis of spinal injuries, abnormal motion patterns under physiological loads are considered an important factor. The purpose of the present study was to determine the onset and progression of spinal injury, and compare the sensitivity of three motion parameters: neutral zone (NZ), elastic zone (EZ), and range of motion (ROM). Spinal injury was defined as a significant increase in any of the three motion parameters. A repeatable high-speed flexion-compression load vector was applied individually to six porcine cervical spine specimens. Several impacts of increasing severity were applied to each specimen. After each impact, flexion-extension motion was measured. Neutral zone was the residual deformation from the neutral position to the position under zero load at the start of the final load cycle. Elastic zone was the displacement from zero load to the maximum load on the final load cycle. Range of motion was the sum of the neutral and elastic zones. The first significant increase in motion was determined by the neutral zone parameter with few observable anatomic lesions on the specimens. This was the onset of spinal injury. The next significant motion increase was also determined by the neutral zone parameter. After this motion increase, termed the progression of injury, ligament ruptures were observed in some specimens. It was concluded that the neutral zone was the most sensitive motion parameter in defining the onset and progression of spinal injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Complications in surgical management of spinal injuries].

Operative treatment of spinal injuries requires an accurate surgical technique and biochemical know-how to avoid complications due to mistakes in device handling, operative technique, and indication. Device failures are caused by loosening of locking clamps or fracture of Schanz screws, followed by loss of angle stability and early loss of reduction. Maldisplacement of pedicle screws may involve irritation of neurovascular structures or loss of correction as well as insufficient transpedicular bone reduction and bone grafting. In burst fractures with destruction of the vertebral body and loose canal fragments, the posterior approach is less efficient than a combined procedure.

Biomechanical Phenomena↗
PubMed1979

Allergy to rubber condom urinals and medical adhesives in male spinal injury patients.

In the National Spinal Injuries Unit at Stoke Mandeville Hospital, rubber condom urinals, kept on the penis with a medical adhesive, are used for incontinent male patients where possible. However, contact allergy to rubber condoms and/or the adhesives is a common problem and can cause considerable morbidity in paralysed patients. This paper investigates the rubber chemicals and adhesives most commonly implicated in causing contact allergy. The survey was divided into two parts: 1. Patch testing symptomatic inpatients 2. A questionnaire sent to new patients from January 1974 to ascertain the overall incidence of contact allergy. It was found that allergy to mercaptobenzthiazole (MBT)- and thiuram-containing condoms was relatively common and that latex/petroleum tube medical adhesives most commonly caused adhesive allergy. It is suggested that a condom made of the least allergenic rubber and an adhesive causing the least number of allergic reactions should be used from the outset for paralysed patients requiring a condom urinal.

Adhesives↗
PubMedDate not supplied

[Effect of spinal cord and spinal injuries on the phagocytic activity of neutrophils].

Study of neutrophil phagocytic activity in injuries to the spinal cord and spine and in damage to the spine without involvement of the spinal cord showed that injuries to the spinal cord have no specific effect on this activity. True, the phagocytic reaction is inhibited in the first 2-3 weeks after the trauma both in patients with injury to the spinal cord and spine and in those with injury only to the spine. In later periods after the trauma, however, with the neurological status remaining the same, the values of the phagocytic reaction do not differ from those in healthy persons. The level at which the spinal cord is injured hardly affects the activity of phagocytosis. The examination was conducted in 117 patients with spinal fractures 94 of whom had also sustained injury to the spinal cord.

Acute Disease↗
PubMed1992

Indian spinal injuries centre.

A 110-bedded spinal injury centre is under construction in New Delhi. This centre will be equipped through Indo-Italian friendship with the latest medical and technical equipment. The centre will be ready in September 1992 for the treatment of acute injuries from Delhi and surrounding areas and will treat complicated cases referred by other centres/hospitals in India. Research and training of doctors, nurses and rehabilitation staff will be an integral part of the centre.

Health Facilities↗
PubMed1992

Hyperpyrexia in spinal injury patients.

We studied 13 spinal injury patients who had hyperpyrexia during an 18 month period (September 1984-March 1986) to discover if differences existed in the core temperature of patients with tetraplegia and those with paraplegia, and the contribution of these differences to the final outcome. Children were excluded from this study as well as patients with any sign of infection on first admission, patients with multiple injuries, and those referred from peripheral hospitals more than one week after injury. Patients with tetraplegia (C3-C7) had persistently high and uncontrollable core temperatures (average 39.5 degrees C) while those with paraplegia (T4-L5) showed lower core temperatures which were still high (average 38.1 degrees C). The difference in the average high core temperature (1.4 degrees C) is statistically significant. The lowest average core temperatures were about the same in tetraplegics and paraplegics (just over 35 degrees C). Four patients died: 3 tetraplegics and one paraplegic. Antipyretic analgesics were ineffective in reducing the high core temperatures.

Adolescent↗
PubMed1975

Spinal injury after ejection in jet pilots: mechanism, diagnosis, followup, and prevention.

In order to contribute to the study of spinal injury after ejection., the author analyzed the results of 100 cases of ejections carried out by military and civil Italian jet pilots in a period of 20 years. Of this group, 47 successfully ejected from aircraft without injury; 11 ejections proved fatal. The remaining 42 pilots sutained vertebral fractures, while 27 sustained other traumatic injuries different from spinal fractures. There were 23 vertebral fractures in 15 pilots and the most frequently affected vertebrae were those of the thoraco-lumbar junction. Analysis was make of the pathology, the clinical and radiological profiles, the therapeutic treatment, and the relative aeromedico-legal aspects concerning the temporary unfitness for flying or permanent grounding of the personnel as well as the possible prevention of spinal injury after ejection

Accidents, Aviation↗
PubMed1978

Multiple level spinal injuries: importance of early recognition.

Patients with severe trauma may simultaneously sustain more than one level of spinal injury. Often, the second or third levels of injury are not recognized early enough to prevent clinically significant extension of the neurologic deficit, pain pattern, spinal instability, and/or deformity. A review of 710 spinal injury patients admitted to the Midwest Regional Spinal Cord Injury Care System yielded 4.5% multiple noncontiguous vertebral injuries. Thirty cases were studied in respect to location and type of primary and secondary injury. Of the secondary lesions, 40% occurred above and 60% below the primary lesion. In half of the patients, there was a mean of 52.6 days delay in diagnosis of the secondary lesion. Three major patterns of injury emerged from this analysis. Knowledge of these patterns and careful total spine radiography in patients with severe trauma may be a significant aid in early recognition of multiple level injuries and possible prevention of their complication.

Adolescent↗
PubMed1979

Pressor response during cystomanometry in spinal injury patients complicated with detrusor-sphincter dyssynergia.

Herein attention is focused on the documentation of high blood pressure response with detrusor-sphincter dyssynergia in spinal cord injury patients and with its amelioration after extended sphincterotomy. During cystomanometric evaluation of the bladder the monitored blood pressure response in 53 spinal injury patients, 27 non-dyssynergic spinal injury patients and 18 non-spinal injury patients was compared. A high correlation was observed among the magnitudes of blood pressure increase, level of injury and the severity of detrusor-sphincter dyssynergia in spinal injury patients. During cystomanometry blood pressure increases of greater than 20 mm. Hg systolic and 10 mm. Hg diastolic in normotensive paraplegics (below T5) and also in non-spinal injury patients were significant to suspect detrusor-sphincter dyssynergia. In normotensive tetraplegic patients blood pressure increases of greater than 40 mm. Hg systolic and 20 mm. Hg diastolic were significant to suspect detrusor-sphincter dyssynergia. The mechanism of blood pressure increase is elucidated. The management of this high blood pressure response in patients with detrusor-sphincter dyssynergia by drug therapy and extended sphincterotomy is discussed. Based on our experience the use of carbon dioxide for cystomanometry seems preferable in patients with spinal lesions above T5 since expedient deflation of the bladder can prevent an inordinate blood pressure increase.

Adrenergic alpha-Antagonists↗