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PubMed1974

Spinal injuries.

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Architecture↗
PubMed1994

Paraventriculospinal tract as a model for axon injury: spinal cord.

The response of immunocytochemically identified hypothalamic axons innervating the rat spinal cord was examined at varying times after cord hemisection in a model of axonal injury using the paraventriculospinal projection. The purpose was to determine whether these long descending peptidergic axons would show signs of regrowth after injury. From 1 to 180 days after hemisection, horizontal sections of the spinal cord were stained with peroxidase immunocytochemistry. Antiserum against neurophysin was used to identify axons projecting from the hypothalamic paraventricular nucleus to the spinal cord. The paraventricular nucleus innervates all rostrocaudal segments of the cord, yet the projection is not massive, allowing the trauma response of individual axons to be studied. Immediately caudal to a T4 hemisection, axons began decreasing in number by 2 days after surgery. Ten days postoperatively, only a few axons could be found caudal to the cut; these remaining axons arose from the contralateral cord. A substantial increase in the number of stained axons was found rostral to the hemisection 3-12 weeks after surgery. In that an increase in axon number could be due to both increasing staining efficacy and sprouting, the orientation of axons in control and hemisected rats was studied. Three millimeters rostral to the hemisection, axons had a greater variance in orientation and were more likely to project medially out of the dorsolateral white matter compared with the contralateral control side. Rostral to the hemisection, a statistically significant two- to fourfold increase in the number of branches per axons was found in comparison to the contralateral control side. Axons were found in the dorsal white matter 4 months after surgery; in controls, immunostained axons were not found here. At all intervals after surgery, structures suggestive of growth were found, including terminal growth cones and lateral filopodia and lamellipodia extending from axons whose distal ends had been severed by hemisection. Similar structures were not found in control spinal cord. Together, these data suggest that after cord hemisection, axons from the paraventricular nucleus sprout rostral to the injury.

Animals↗
PubMed1992

[Indications, choice of procedure and results of conservative therapy of spinal injuries].

For conservative treatment of injuries of the cervical spine, two different methods are available: The HALO fixator and the collar. The choice depends on the kind and extension of the injury. Stable thoracic and lumbar vertebral fractures are treated in a conservative functional way in order to strengthen the muscular apparatus. Three-point-fixation with a brace is not necessary. Functional therapeutic methods can also be applied in the case of instable fractures if they are not operable. During a rigid confinement to bed, the postural reduction by increasing lordosis has turned out to be the treatment of choice. As an essential measure the patient has to take part in a "backschool" with postural exercises for the daily life.

Braces↗
PubMed1990

[Prevention of spinal injuries at the work place].

Work-related back problems can be induced by a fixed and forced posture, heavy manual labour, climatic factors, and exposure to partial and whole-body vibration. In most cases, a combination of factors are involved. Fixed and forced postures can be avoided by a better arrangement of the workplace and by individual measures. Technical progress has diminished the number of workplaces requiring heavy manual labour. In the remaining jobs, however, appropriate techniques for lifting and back-relief must be taught. Today the prevention of sitting-induced back lesions is very important; the use of adequate chairs and individualized techniques of sitting can be taught. Exposure to vibration can only be reduced by technical measures which neutralize vibration. It is especially important to avoid exposure to vibration in the resonance frequencies of the human spine (3.5-8 Hz).

Back Pain↗
PubMed2000

Functional electrical stimulation-assisted walking for persons with incomplete spinal injuries: changes in the kinematics and physiological cost of overground walking.

This study was conducted to investigate the change in the kinematics and physiological cost of walking that occurs during training with functional electrical stimulation (FES)-assisted walking in persons with incomplete injuries. The main effect of FES-assisted walking was to change hip excursion and ankle dorsiflexion during swing and at foot contact, whereas training with FES-assisted walking changed the spatio-temporal parameters of walking (walking speed, cycle length and frequency as well as time in stance). The use of FES-assisted walking does not change the walking speed achieved during a 5-minute trial nor the physiological cost of walking but when combined with walking training, eight of the nine participants improved either their physiological cost index or their walking speed. It is concluded that FES-assisted walking changes the joint angular kinematic pattern of walking, but training is necessary to integrate these changes into functional gains.

Adult↗
PubMed1993

Pregnancy using spermatozoa aspirated from the vas deferens in a patient with ejaculatory failure due to spinal injury.

Aspiration of the vas deferens under local anaesthesia was carried out in a man with ejaculatory failure due to tetraplegia after rectal electrostimulation had failed to provide an ejaculate satisfactory for use in in-vitro fertilization. After passage through a discontinuous Percoll gradient and exposure to 3 mmol pentoxifylline and 3 mmol 2-deoxyadenosine, the final preparation consisted of 50,000 spermatozoa with 4% progressive motility. This was sufficient for the insemination of seven of the 23 oocytes that were collected from the patient's wife by transvaginal ultrasound-guided follicular aspiration. Three high-grade embryos were produced which were transferred transcervically into the uterus 2 days later. A singleton pregnancy resulted which is currently ongoing at 30 weeks gestation. Aspiration of the vas deferens is a relatively simple technique which provides an acceptable alternative to rectal electrostimulation, artificial sperm reservoirs and donor insemination in patients with ejaculatory failure.

Adult↗
PubMed2005

[Clinical relevance of "bone bruise" detected by MRI following spinal injuries in children].

BACKGROUND: MRI is a sensitive diagnostic tool, which is especially suited for the diagnosis of vertebral injuries in children since no radiation has to be applied to gonads or blood-producing organs. An indirect sign of vertebral injury is the presence of "bone bruise," an edema of the vertebral body without other bony lesions. The purpose of this study was to elucidate the clinical significance of "bone bruise" following vertebral trauma in children. PATIENTS AND METHODS: Between 1998 and 2003 a total of 66 children with vertebral injuries were treated at our institution; 34 of these patients initially underwent MRI. In this retrospective study 20 of these children who were diagnosed with a vertebral injury based on the presence of a "bone bruise" in an MRI on admission were examined clinically as well as by follow-up MRI. RESULTS: All 20 patients stated they felt no limitations in daily activities. On examination there were no significant pathologic findings. We did not note persistence of a "bone bruise" or a collapse of the affected bone in the follow-up MRI. CONCLUSION: If a "bone bruise" is detected in the MRI after vertebral trauma in children, it usually has a good prognosis. With adequate therapy, which in our regimen consists of bedrest and early mobilization, we did not note any secondary collapse of the affected vertebrae.

Child↗
PubMed1989

Tiger mauling: fatal spinal injury.

A 33 year old zoo keeper was attacked by a Sumatran tiger in captivity. Apart from severe lacerations and penetrating wounds to the head and neck, the patient sustained comminuted fractures of C1 and C2 vertebrae with resultant high laceration of the spinal cord. Major vascular injury as well as trauma to pharynx also occurred. The patient survived these injuries for 15 h.

Accidents, Occupational↗
PubMed1991

[Clinical and radiologic legal assessment of spinal injuries using the segmental principle].

Cat scanning of the traumatized spine led to an approved classification of different types of lesions. Its application is important--not only for therapeutic reasons but also for the judgement of the end results. The classification enables the definition of a remaining instability (radiological and clinical) and is useful for the evaluation of the prognosis according to the structural changes within the motion segments. The conventional way of appreciating working capacity is no longer satisfying considering the improved diagnostic tools and the increasing frequency of various deformities, instability and even ankylosis and their combinations. As in the evaluation of peripheral joint function a concept is proposed, which is based on the structural changes in the motion segments and their motility. According to the kind and amount of deformity and instability the segment value is multiplicated with factors 1 to 6. The number of involved segments is added to obtain the definite range of working capacity. The concept is practicable in all parts of the vertebral column and allows a differentiated judgement within the usual percentages.

Disability Evaluation↗