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PubMed2004

Medieval management of spinal injuries: parallels between Theodoric of Bologna and contemporary spine surgeons.

In recent decades there have been revolutionary technological advances in the management of traumatic spinal column injuries. Despite these advances, the basic principles of reduction and stabilization of vertebral fractures and dislocations remain similar to those proposed by ancient and medieval physicians. Theodoric of Bologna, in his text Chiurgica de Theodoric (ca. AD 1267), described an extracorporeal approach to the management of traumatic spinal column misalignments. Surprisingly, his techniques are still used in many instances by contemporary spine surgeons, despite the availability of a more advanced technological armamentarium than that existent in medieval times.

History, 20th Century↗
PubMed1993

Stabilization of subaxial cervical spinal injuries.

With subaxial cervical spine fractures, it has not been established which injuries can be adequately stabilized by external orthoses and which will require surgical stabilization. After review of 64 consecutive patients with C3-C7 spinal injuries, fracture characteristics on admission roentgenograms were identified that accurately predict the success or failure of nonoperative management. These include evidence of severe ligamentous injury (SLI) and severe vertebral body injury (SVBI). The presence of SLI, SVBI, or both SLI and SVBI correlated strongly with nonoperative stabilization failure (p < 0.001, p = 0.002, and p = 0.004, respectively). Injuries without SLI or SVBI were all successfully stabilized by cervical orthoses. Additionally, characterizing injuries by evidence of SLI and SVBI directs the approach for surgical stabilization.

Adolescent↗
PubMed2003

Some problems of the lower extremity in patients with spinal cord injuries.

Spinal cord injury (SCI) is devastating, leaving patients wholly or partly paralyzed. Health care providers who care for SCI patients during the acute or chronic phases are faced with different phenomena in the lower extremities of these subjects. In this article, the authors review the relevant changes associated with SCI. Preventive measures of these medical complications are directed according to the specific cause. Early comprehensive rehabilitation carried out by a specialized team prevents complications while enhancing functional gains.

Journal Article↗
PubMed1999

Vocational aspects of life care planning for people with spinal cord injury.

Spinal cord injury (SCI) is a catastrophic event with profound, long-term consequences in all aspects of an individual's life, including employment. The life care plan (LCP) is a methodology that is used to document the continuum of care needs that an individual with SCI will have across his or her life span. The LCP also highlights the critical stages of development necessary to maximize the person's functional potential and productivity. This article provides a brief overview, with a case study example, of how the LCP can be used in addressing an individual's post-injury employability needs.

Journal Article↗
PubMed1988

[First aid and diagnosis of spinal injuries].

One of the most neglected lesions are spinal fractures for which early diagnosis is essential. Deviation of the spinal axis must be avoided during emergency treatment and transport. X-ray diagnosis must focus on the injured segment, and indirect radiological signs are also important. A CT-scan is the optimal means of early diagnosis. Emergency reduction is indicated in cases of neurological deficit and severe kyphosis. In such cases reduction means decompression.

First Aid↗
PubMed1980

Pressure sore prevention for the wheelchair-bound spinal injury patient.

The concept of a wheelchair cushion fitting clinic for the prevention of pressure sores is reviewed in the light of recent estimates of the cost of pressure sores in the U.K. A method for measuring the pressure beneath the ischial tuberosities is discussed and techniques for measuring a patient's habitual exercise frequency and seated posture are described. Results from the records of 600 spinal injury patients including Rancho Los Amigos Hospital are reported and used to demonstrate the importance of low pressure beneath the ischial tuberosities as an indicator of wheelchair cushion suitability.

Humans↗
PubMed1991

[Treatment of suppurative-necrotic decubitus ulcers in patients with spinal injuries by using alginate coating teralgim and algimaf].

Alginate coating teralgim and algimaf were applied to 24 decubitus ulcers of various sites in 19 spinal patients. Stage--specific choice of applications produced a good cleansing effect and ulcer healing in 62.5% of the lesions within 48.5 days on the average. Indications for surgery were defined in 37.5% of the cases (repair of the ulcer defect) which were also treated with alginate coating with a good preoperative effect.

Adult↗
PubMed2004

Determinants of locomotor recovery after spinal injury in the cat.

After a spinalization at the most caudal thoracic spinal segment, the cat can recover locomotion of the hindlimbs when they are placed on a moving treadmill. This chapter summarizes some of the determinants of such a dramatic recovery of motor function. Fundamental to this recovery is undoubtedly the genetically based spinal locomotor generator, which provides an essential rhythmicity to spinal motoneurons and hence the musculature. Other factors are also important, however. Sensory feedback is essential for the correct expression of spinal locomotion because spinal cats, devoid of cutaneous feedback from the hindfeet, are incapable of plantar foot placement. The neurochemical environment also adapts to spinalization, i.e., the loss of all modulation by descending monoaminergic pathways. Post-transection spinal rhythmicity then becomes more dependent on glutamatergic mechanisms. Finally, we argue that the mid-lumbar spinal segments evolve to play a crucial role in the elaboration of spinal locomotion as their inactivation abolishes spinal locomotion. In summary, the above findings suggest that the recovery of spinal locomotion is determined by a number of factors, each of which must now be more fully understood in the ever-continuing effort to improve the rehabilitation of spinal-cord-injured subjects.

Animals↗
PubMed1983

[Spinal injuries with neurological signs while practicing a sport].

The authors report seventy-three cases of spinal cord injuries resulting from the practice of sports. The frequency of these accidents has not increased over the past ten years, and these accidents, resulting in paraplegia, only account for 7.3% of a population of one thousand spinal cord injuries. The victims are mainly young men, and the principal cause is diving. Tetraplegia predominates, and recovery is highly improbable.

Adult↗
PubMed1987

Prostaglandin derivative PGBx improves neurologic recovery after ischemic spinal injury.

Neurological dysfunction resulting from an ischemic insult in the central nervous system (CNS) is believed to be an indirect outcome of impaired energy production. Recent studies suggest that prostaglandin Bx (PGBx), an oligomer of PGB1 and 15-keto-PGB1, may be beneficial in protecting mitochondrial function after ischemic insults by preventing uncoupling of oxidative phosphorylation. In the present study, PGBx had a significant influence on neurological outcome after ischemic injury in the rabbit spinal cord. These findings suggest that PGBx may be beneficial in the treatment of CNS ischemic injuries.

Animals↗
PubMed1995

Prevention of spinal injuries from diving in Slovenia.

Injury of the cervical spine involving the spinal cord such as results from diving into shallow water causes very severe disability. In spite of progress in medical science, results of the treatment and rehabilitation of such patients are not satisfactory. Every effort should be undertaken to give young swimmers, the most frequent victims of diving injuries, proper instructions to prevent spinal cord injury. A broadly conceived national prevention programme, developed under the catch-phrase 'Do Not Jump into the Unknown', has been under way in Slovenia during the past 3 years, and has been promoted in collaboration with the Health Protection Institute of Slovenia. In these years the number of new spinal cord injuries decreased (one-two per year), but it is too early to conclude that this is the result of the prevention activities. But it is obvious that knowledge of this type of injury is now much more widespread.

Adolescent↗