Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Spinal Injuries”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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

At least 127 records · Page 7Linked to original sources
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↗
PubMed2003

Functional outcome in trauma patients with spinal injury.

STUDY DESIGN: A retrospective data analysis of all trauma patients admitted the Helicopter Emergency Medical Service was performed. OBJECTIVE: To assess the long-term outcome of trauma patients with spinal injuries using Functional Independence Measure scores. SUMMARY OF BACKGROUND DATA: Mortality after severe multiple trauma is well documented. However, evaluating morbidity in survivors of multiple trauma is complex, and less information is available regarding functional outcome. There are very few systems that can effectively predict the outcome for patients sustaining multiple trauma with spinal injuries. The Functional Independence Measure scoring system, which is easy to use, can be used to assess disability after hospital discharge, and may also be used to predict the long-term outcome for patients after spinal injuries. METHODS: The records of 1500 trauma patients admitted over a 6-year period by the Helicopter Emergency Medical Service were examined. All patients with documented injuries to the spinal column were selected for study. The distribution and pattern of spinal injury, the injury severity score, and the radiologic findings were determined for each patient, along with clinical outcome measures at 1 year using Functional Independence Measure scores. RESULTS: Among the 1500 trauma patients, 263 patients (17.5%) (195 men and 68 women; mean age, 37 years; range, 3-92 years) had sustained an injury to the spinal column. Mortality (70/263; 27%) was significantly higher (P < 0.02) in these patients than in those without spinal injury (247/1237; 20%). Injury severity scores higher than 16 were found in 96 patients (55%). The median Functional Independence Measure score was 40 on admission, 86 at discharge from the hospital, 113 at 3 months, 119 at 6 months, and 124 at 12 months. There was significant correlation between discharge Functional Independence Measure (FIM) scores (FIM = 86) and 12-month FIM scores (FIM = 124) (P < 0.01). CONCLUSIONS: Most of the patients had poor initial Functional Independence Measure scores, but there was significant improvement by 12 months. Discharge FIM scores were a good indicator for functional outcome at one year.

Adolescent↗
PubMed1991

Sub-cervical spinal injuries with neural involvement. The Ga-Rankuwa Hospital experience.

A retrospective analysis of 48 patients with injuries of the thoracic and lumbar spine and with neural involvement showed that motor vehicle accidents (62.5%) and a fall from a height (20.8%) were the most common causes of injury. T11-L2 was the segment of the spine most commonly affected, accounting for 70% of all vertebral injuries. Associated, non-spinal injuries, frequently severe, were present in 50% of patients. There were 27 complete and 14 incomplete spinal cord injuries; of the cauda equina lesions, 3 were complete and 4 incomplete. Surgical reduction and stabilisation with dual Harrington distraction rodding, supplemented by sublaminar wiring, was performed in 85% of patients. Surgery reduced the period of obligatory bed-rest by half, but shortened the mean time in hospital by only 2.4 weeks (16%). Surgery did not appear to promote neurological recovery and no patient deteriorated neurologically in the course of treatment. Four out of 7 patients treated non-surgically improved neurologically, as did 14 out of 41 who underwent surgery. Ultimately, 17 patients became ambulatory, with or without walking aids. The Harrington rodding system as used was found to be reliable without additional external bracing. Dislodgement of hooks occurred in 7 patients. These all occurred as a result of judgmental or technical error and should be entirely preventable.

Accidents, Traffic↗
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↗
PubMed2003

Risk factors for surgical site infection in the patient with spinal injury.

STUDY DESIGN: A retrospective chart review of 1561 patients with spinal injury was conducted over a 4-year period. OBJECTIVES: To determine the rate of surgical site infection in the spinal trauma population, to compare infection rates after spinal operations for elective and traumatic indications, and to identify risk factors for postoperative wound infections in the traumatic subpopulation. SUMMARY OF BACKGROUND DATA: Surgical site infection after spinal operations is a dreaded complication. Risk factors have been investigated previously, but the subset of patients with acute traumatic spinal injury may be distinct. METHODS: The hospital's infection control program was used to identify surgical site infections after spinal operations, and infection rates were calculated. Data including patient characteristics, severity of injury indicators, surgical factors, and perioperative management factors were collected for the patients presenting with acute spinal injury over a 4-year period. RESULTS: Postoperative wound infections developed in 24 of 256 patients. This infection rate of 9.4% was significantly (P < 0.001) higher than for elective spinal operations during the same period (3.7%). Risk factors found to be independently significant included delay until operation, increased postoperative intensive care unit stay, single (neurosurgical or orthopedic) versus combined operative team. CONCLUSIONS: Risk factors for surgical site infection in the acute trauma setting are identified. Two surgical teams may be involved without causing a higher rate of infection.

Acute Disease↗
PubMed1999

Locomotor plasticity after spinal injury in the chick.

Functional recovery after spinal cord injury likely depends, in part, on the reorganization of undamaged spinal circuitry. Segmental afferent input from the limbs remains largely intact after spinal injury and may provide an important source of activation and regulation of the spinal circuits that have lost descending input as a result of the injury. This purpose of this study was to investigate the contribution of cutaneous afferent inputs to the recovery of motor function after spinal injury in the chick. After lateral thoracic spinal hemisection, the motion of the ipsilateral limb was impaired during both walking and swimming. By 2 weeks postoperatively, limb motion recovered to preoperative values for walking but not for swimming. It was hypothesized that phasic afferent inputs experienced during walking, but not swimming, contributed to recovery of limb motion during walking. When a source of phasic cutaneous input was provided during swim training sessions, limb motion gradually improved to preoperative values. After 2 weeks of training, this improved motion was retained even after the source of cutaneous stimulation was removed. The proposed mechanism is an experience-dependent strengthening of the circuits activated during the improved limb motion, leading to a permanent change in limb action during swimming. Thus, the afferent inputs experienced during movement repetition are important during the acquisition of learned movements after spinal injury. These results are discussed in terms of behavioral, physiological, and anatomical evidence for spinal plasticity in other species. It is concluded that the spinal cord has significant plastic capabilities, and efforts should be directed toward maximizing the contribution of this plasticity to functional recovery after spinal cord injury.

Animals↗
PubMed1988

A preliminary review of the use of Cotrel-Dubousset instrumentation for spinal injuries.

Twenty-seven patients with unstable spinal injuries underwent posterior reduction and internal fixation with Cotrel-Dubousset instrumentation. Anterior decompression and fusion was performed as well when the injury was a burst fracture. Neurologic status was assessed at the time of injury and one year later, using both the Frankel classification as well as the Motor Index Score. The study suggests that good fracture reduction, secure internal fixation with CD instrumentation, and satisfactory decompression of neural elements provide a favorable environment to maintain three-dimensional stability and to facilitate neurologic recovery.

Adolescent↗
PubMed1984

Spinal injury in a U.S. Army light observation helicopter.

All accident reports involving U.S. Army OH-58 series helicopters were analyzed to determine vertical and horizontal velocity change at impact and the relationship of this kinematic data to the production of spinal injury. This analysis determined that spinal injury is related primarily to vertical velocity change at impact and is relatively independent of horizontal velocity change. The dramatic increase in the rate of spinal injury occurring just above the design sink speed of the aircraft landing gear (3.7 m/s) suggests that the fuselage and seat provide little additional impact attenuation capability above that of the gear alone. It is concluded that if this aircraft were modified to provide protection to the occupants for impacts up to 9.1 m/s (30 ft/s), approximately 80% of all spinal injury incurred in survivable accidents could be substantially mitigated. The incorporation of energy absorbing seats is recommended.

Acceleration↗
PubMed2005

Pharmacological approaches to functional recovery after spinal injury.

Locomotion results from the activity in neural networks in the spinal cord that together with sensory and descending inputs generate coordinated motor outputs. Descending inputs include glutamatergic, monoaminergic, and peptidergic pathways. Spinal injuries interrupt these descending pathways, resulting in the disruption or loss of function. Drugs that target these endogenous transmitter systems have been used to improve function after spinal injury. However, individual drugs can have beneficial or deleterious effects in different studies and thus there is little consensus on optimal pharmacological strategies. The variability may be influenced by changes introduced by the type of lesion (complete or partial), time after injury, or the lack of specific ligands that target specific transmitter systems. It is now recognised that these transmitter systems do not necessarily act in isolation, but can interact to evoke additive, inhibitory, or novel metamodulatory effects. Meta interactions mean that differing chemical environments in lesioned spinal cords could influence drug effects. The spinal cord also exhibits injury-induced changes, which could alter the chemical environment and functional properties over time. While they have not been considered in pharmacological approaches to spinal injury, interactive and adaptive changes could influence the effects of spinal lesions and therapeutic interventions. The properties of endogenous transmitter systems in spinal locomotor networks before and after spinal lesions need to be understood, and pharmacological tools that target specific functional aspects need to be developed.

Adrenergic Agents↗
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↗
PubMed2004

Reduced sodium output following acute spinal injury.

STUDY DESIGN: Assessment of sodium output in spinal injury patients. OBJECTIVES: The purpose was to examine the effects of sodium loading acutely by an infusion, long term by sodium supplements, to acutely injured spinal patients on a fixed sodium intake. This was compared with another group of acutely injured patients who were on a hospital diet of between 50 and 150 mmol of sodium daily. SETTING: The National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, Bucks HP21 8AL, UK. METHODS: A total of 53 studies were carried out on 52 patients between 1962 and 1964. In all, 49 patients were studied during the first 10 days after injury as follows: a control group of 39 patients received no supplementary sodium, two received NaCl infusion, two NaCl tablets orally, and six received NaCl infusion followed by NaCl tablets orally. Four patients were studied for more than 15 days after injury (one of these had been studied in the acute stage); they received NaCl infusion and one (42d) received in addition NaCl tablets for four subsequent days. RESULTS: In all patients urinary sodium excretion was minimal on day 2 and increased thereafter. On days 2-6, it was significantly lower in patients with a complete transection of the cervical cord than in patients with lower lesions. In the early studies, nine patients excreted less than 40% of the administered load within 24 h. In four of these patients excretion was 10% or less. In the later studies, three of the four patients excreted at least 80% of the infused Na+ on the same day. CONCLUSION: Sodium retention in the patient with cord injury is a response to trauma. The different responses seen in patients with different levels of cord transection are not due to direct changes in the innervation of the kidney but to compensation for sympathetic insufficiency, blood pressure being maintained by the secretion of aldosterone, vasopressin and other hormones. The decreased urinary output seen acutely after cord transection is not due to renal failure and the patient's condition can be made dangerously worse by attempts to create a diuresis.

Administration, Oral↗
PubMed1997

New spinal injuries in hockey.

OBJECTIVES: In this study, we wished to examine the nature and incidence of major spinal injuries sustained by ice hockey players and to add reported cases to a permanent registry. DESIGN: The study was a retrospective review of questionnaires returned by physicians reporting spinal injuries due to ice hockey. SETTING: Canada primarily, with reported cases from other nations. PATIENTS: Two hundred forty-one cases of fracture or dislocation of the spine have been reported. MAIN OUTCOME MEASURES: The registry includes annual incidence and mortality incidence as well as documentation of sex, age, mechanism of injury, vertebral level of injury, neurologic deficit, type of event, and type of fracture for most cases. RESULTS: Between 1982 and 1993, an average of 16.8 ice hockey related major spinal injuries were reported each year. Many of these injuries occurred to the cervical spine of players aged 16-20 years who were playing in supervised games. CONCLUSIONS: Prevention programs are beginning to become effective in decreasing the number of severe injuries and the number of injuries caused by a check from behind, although there has not been a significant decrease in the total number of injuries reported annually.

Adolescent↗
PubMed2006

[Spinal injury caused by a nail fired from a stud gun].

The patient, a 52-year-old male foreign citizen working as a construction worker, was attacked by his coworker who had fired a drive stud, 70 mm long, with reverse hooks from a powered gun at him; the stud pierced the worker's spine at the scapular level. The patient was taken to the nearest surgical ward. On the basis of clinical presentation and X-ray of the thoracic spine, the diagnosis of penetrating injury to the spinal column at the 7th thoracic vertebra level was made. Subsequently, the patient was admitted to the intensive care unit of our department. On admission the patients showed slight paresis of the right lower extremity and hypesthesia of the right thigh, but no other neurological deficit. After preoperative examination, the patient was operated on within six hours of the injury. Intraoperatively, a 3-mm-thick stud, piercing the T7 vertebral arch, was found on the left side, lateral to the T7 spinous process. After partial resection of the arch around the stud, the spinal canal was inspected. The stud passed paramedially on the right side through the dura mater and the centre of the spinal cord into the body of the 7th thoracic vertebra. The stud was gently removed. Subsequently, some sanguineous liquor appeared. The dura mater was sutured and the wound was closed layer by layer. The postoperative period was uneventful, and the patient was allowed to stand up on day 2. The drain was removed on day 4. Healing by first intention took place. At 6 weeks after surgery slight neurological deficit still remained. Key words: spinal penetrating injury, spinal gunshot injury.

Foreign Bodies↗
PubMed1982

Dynamic urethral function in the assessment of spinal injury patients.

Forty-two spinal injury patients underwent single or sequential urodynamic studies to assess the value of dynamic urethral pressure using transducer tipped catheters. Three groups of patients were identified: those with poor detrusor function, those with unsustained dyssynergia and those with sustained dyssynergia. All patients demonstrated some dyssynergia. Urethral needle EMG mirrored urethral pressure changes accurately. The addition of dynamic profilometry to fluoroscopy, detrusor pressure and urethral EMG has clarified our understanding of lower urinary tract behaviour after cord lesions.

Adolescent↗
PubMedDate not supplied

[New possibilities in the surgical treatment of lower thoracic and lumbar spinal injuries].

The paper presents new current approaches to surgically treating the lower thoracic and lumbar spinal injuries. By using new procedures for spinal stabilization, the authors propose algorithms for surgical treatment of spinal injuries in relation to the neurological symptomatology and the severity of fracture and its pattern. The study was performed in the clinical setting. Seventy patients with lower thoracic and lumbar spinal injuries were operated on. The outcomes of their surgical treatment are analyzed. Indications for nerve structural decompression, for approaches to vertebral bodies are defined.

Adult↗
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↗