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At least 1,009 records · Page 56Linked to original sources
PubMed1988

[Acute management of spinal injuries. The thoracic and lumbar spine, surgical therapy].

The aims of internal fixation of thoracic and lumbar spinal fractures are immediate stability, preservation of spine mobility, and restoration of the anatomical form of the vertebra and of the canal diameter at acceptable risks. All these aims together can be achieved only by short posterior pedicle fixation systems, such as the external spine fixator, the various internal spine fixators, special dorsal Roy-Camille plates, Wolter plates, and the combined anterior and posterior unisegmental fusion with the USIS system. Isolated anterior procedures necessitate additional bracing. The indications for operative treatment are discussed in the light of the above-mentioned methods.

Bone Plates↗
PubMed1989

[Spinal injuries caused by the flexion mechanism].

The clinical documentation of 1,302 patients treated for spine injury from the flexing mechanism in 1965-1987 was analyzed. The relation between the degree of nervous system damage, the obtained neurological results and the character of injury (fracture or dislocation) as well as the level of spine injury was taken into account. It has been found that incidence of flexing injury of various parts of the spine oscillates slightly (39-44 per cent of all injuries). On the other hand, there is a significant predisposition to more frequent occurring of dislocations at flexing injury of the cervical spine and flexing fractures at thoracic spine injuries. The authors previous observations that young persons have more often fracture of the vertebra and older person--dislocation have been confirmed. Deep damage of the spinal cord is present more often at dislocation than fracture. The most serious damage of the spinal cord occurs at thoracic spine injury, in which the authors have found a very high percentage of patients with palsy (83 per cent at fracture, 98 per cent at dislocation).

Adolescent↗
PubMed1992

Virulence factors in Escherichia coli from urinary tract infections in patients with spinal injuries.

A collection of 70 strains of Escherichia coli from urinary tract infections in spine-injured patients undergoing long-term bladder catheterization were tested for characteristics that have been associated with the ability to produce pyelonephritis. The incidence of the virulence factors were: mannose-resistant haemagglutinins (30%), P-fimbriae (17%), haemolysin (27%), K-antigens (28%) and aerobactin (by bioassay 33%, by gene probe 39%). Only 54% of the strains belonged to the O-serotypes usually associated with urinary tract infections. E. coli carrying the full complement of virulence factors were rare in the urinary tract of the spinal patients and were not associated with episodes of symptomatic pyelonephritis. It is clear that the neuropathic bladder and the presence of the catheter permits a wide variety of bacterial types to colonize the urinary tract and cause infection of the kidney. The identification of host markers rather than bacterial factors is suggested as a more fruitful approach to the early detection of cases likely to progress to pyelonephritis in this group of patients.

Cross Infection↗
PubMed1994

Prevention of secondary disabilities after brain injury and spinal cord injury: implications for future research.

Over the past decade there has been increased emphasis upon prevention of disability. Although it is obvious that preventing a disability is the most desirable approach, disabilities will nonetheless occur. When they do, we must treat them and prevent additional disabilities from following the original ones. Indeed, this separation of disabilities has led to a clearer understanding of their prevention, namely primary, secondary, and tertiary prevention.

Brain Injuries↗
PubMedDate not supplied

Dorsal myelotomy for relief of spasticity in spinal injury patients.

Seven male patients, five complete quadriplegic and two complete high thoracic paraplegic, were treated by dorsal longitudinal myelotomy to relieve intractable spasticity of the lower extremities. All had intact neurogenic bladders before surgery. All patients had initial relief of spasticity but had recurrence of spasticity in varying degrees at two to three months postoperation. One patient had repeat myelotomy with similar results. One patient had successful relief of spasticity but lost neurogenic bladder function. Three patients required surgical releases of spastic contractures after surgery. Only one patient was satisfied with the procedure but required additional procedures for relief of spasticity. None of the procedures was considered successful. Dorsal longitudinal myelotomy is not successful in the treatment of spasticity in the spinal-injured patient.

Adult↗
PubMed2003

Thoracic spinal injuries: operative treatments and neurologic outcomes.

Between January 1983 and December 1997, 29 patients with either a fracture (11 patients) or a fracture-dislocation (18 patients) of the thoracic spine were treated operatively. All patients underwent posterior decompression and stabilization within a mean time of 4 days after injury (range, 0-45 days). Patients with complete paraplegia had no postoperative improvement in neurologic status, whereas all patients with incomplete spinal cord lesions improved in neurologic status after surgery. There was no significant association between time from injury to operation and final neurologic outcome. For thoracic fractures, the procedure of surgical decompression and stabilization is safe, and neurologic recovery may be anticipated in patients with incomplete spinal cord lesions.

Adolescent↗
PubMed1975

[Bladder stimulation of patients with spinal injuries].

Electric stimulation of the bladder through eight electrodes was performed in 7 patients suffering from innervation disturbances of various origin. In one case the device had to be removed because of endocarditis and sepsis after 8 months. In 6 cases the result was satisfactory as the patients were capable of emptying their bladder without catheterization. By abolishing vesico-ureteral reflux, recurrent pyelonephritis is eliminated, consequently life expectancy greatly improves. The method is believed to be suitable mainly in cases of peripheral bladder paralysis. In cases of central paralysis, the fibrosis of the bladder neck calls for additional interventions such as transurethral resection.

Adolescent↗
PubMed2000

Altered cellular anatomy and physiology of acute brain injury and spinal cord injury.

The cellular elements and the chemical mediators in secondary injury following TBI or SCI do not act alone. The interconnections between the cellular elements and their secretions, the immune system, and the nervous system are highly regulated in normal physiology, which benefits the organism. When there is traumatic injury to cells in the CNS, the interconnections between the systems become more than tight; these systems act together to strangulate the tissue, depriving it of local control over microcirculation and necessary oxygen, rendering membrane potentials useless to modulate neuron function. Surgical intervention during the acute stages of TBI and SCI continues to advance as do biomechanical and bioelectric therapeutics during the chronic and rehabilitation stages. There is hope, too, for effective pharmacologic intervention at the initial stages, before secondary injury begins. The fact that the mediators of secondary injury are already resident in normal physiology, whether during development or adulthood, means that their activity can be modified by specific agonists and antagonists directed to restoring homeostasis or promoting pathways that can lead to regeneration. This is the direction of much current basic and clinical research.

Axons↗
PubMed1989

[Transportation in a helicopter ambulance and resuscitation of patients with cervical spinal injuries. Our regional experience].

Clinical results concerning forty-three patients suffering from cervical column trauma, among whom, eighteen with myelic pathology and twenty five amyelic treated with conservative and not surgical method in intensive neuro-traumatological therapy are examined. We note that the substantial difference in mortality and healing of the lesion depends on whether the patient has been transported by an helicopter-ambulance and so with a time "trauma-bony segments alignment" much shorter or not longer than 100 minute or if the patient has arrived ad the department after a transportation by ambulance or makeshift transportation and so with a time "trauma-segments alignment" longer than 240 minutes.

Adolescent↗