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PubMed2002

Spinal injuries caused by the acceleration of ejection.

The speed and altitude at which modern military aircraft operate are such that escape can only be achieved by some means of forcibly propelling the aircrew clear of the aircraft. The most common method of doing this is by use of an ejection seat. The use of such seats, whilst generally life saving, exposes aircrew to forces that may be at the limits of human tolerance. Each phase of the ejection sequence is associated with characteristic injury patterns and of particular concern is the occurrence of spinal compression fractures, which are caused by the upward acceleration of the ejection seat. Thorough investigation of aircrew who eject is necessary and magnetic resonance imaging of the spines of these aircrew is now becoming mandatory. Aircrew who sustain stable anterior wedge compression fractures usually require no invasive treatment, but are prevented from flying aircraft fitted with ejection seats for 3-4 months.

Acceleration↗
PubMed1998

The hydroxyl radical scavenger Nicaraven inhibits glutamate release after spinal injury in rats.

Neuronal degeneration after trauma is mediated in part by release of excitatory amino acids (EAAs) and oxygen free radicals (OFR). We evaluated the effect of i.v. treatment with a hydroxyl radical scavenger ((+/-)-N,N'-propylenedinicotinamide; AVS) and spinal hypothermia (33 degrees C) on spinal CSF glutamate release after spinal trauma. In a control group, spinal compression evoked at 10 min a significant increase (5-fold) in glutamate which declined over 4 h (2.1-fold). AVS treatment attenuated glutamate release but had no additive effect. These data suggest that this compound can be effective in modulating spinal excitotoxicity resulting from increased OFR synthesis and corresponding potentiation of EAA release.

Animals↗
PubMedDate not supplied

The Katz Adjustment Scale: modification for use with victims of traumatic brain and spinal injury.

Although the assessment of the social, emotional and personality sequelae of traumatic injury is of central clinical and medico-legal importance, no satisfactory standard assessment device for this purpose has yet been developed. A multicentered study of a mixed group of head and spinally injured patients is reported. Factor analysis of a modified version of the relatives' form of the Katz Social Adjustment Scale (KAS-R) yielded 30 first-order factors under three main domains of emotional/psychosocial, physical/intellectual and psychiatric changes, together with seven second-order factors which were readily identifiable in terms of syndromes accompanying traumatic injury. Discriminant function analyses indicated that prediction of patient group using KAS-R data was most accurate using the current study's first-order factors as compared with the original factor structure proposed by Katz and Lyerly or the second-order factors from the current analyses. The modified KAS-R shows considerable promise as an instrument for measuring the complex social, emotional and personality changes following traumatic injury, with special significance for assessing brain-injury victims. The representativeness of the current patient sample and implications for future development of the method are discussed.

Activities of Daily Living↗
PubMed2001

Pharmacological aids to locomotor training after spinal injury in the cat.

This Topical Review summarizes some of the work we have done mainly in the cat using agonists and antagonists of various neurotransmitter systems injected intravenously or intrathecally to initiate or modulate the expression of hindlimb locomotion after a spinal lesion at T13. The effects of the same drugs are compared in various preparations: complete spinal, partial spinal or intact cats. This has revealed that there can be major differences in these effects. In turn, this suggests that although the locomotor rhythm might normally be triggered and modulated by the activation of a variety of receptors (noradrenaline, serotonin, glutamate), after spinalization there appears to be a predominance of glutamatergic mechanisms. Recent work also suggests that, in the cat, the integrity of the midlumbar segments is crucial for the expression of spinal locomotion. Taken together, this work raises some hope that a targeted pharmacotherapy with better understood drugs and mode and locus of delivery could become a clinical reality.

2-Amino-5-phosphonovalerate↗