Cause Of Spinal Cord Injury Research Articles

Traumatic spinal cord injuries due to falls from trees in a tertiary rehabilitation center: a retrospective analysis of causes and outcomes

Aims: Falls from heights are a major cause of spinal cord injury. In developing countries such as Turkey, where fruit picking from trees is an important part of the agricultural economy, falls from trees are common. This study aims to comprehensively analyze the causes and consequences of spinal cord injuries due to falls from trees. Methods: This retrospective study reviewed cases of spinal cord injury resulting from falls from trees, treated at a tertiary rehabilitation center between March 2020 and November 2023. Data encompassed demographics (age, gender, occupation, education), spinal injury specifics (level, severity), additional injuries, tree fall details (type of tree, height of fall, cause of fall, safety precautions), and treatment details (surgery need, hospital stay duration). The patients who fell from trees were divided into two groups: those who fell from walnut trees and those who fell from other trees, and statistical analyses were performed accordingly. Results: Among the 49 patients falling from trees, the mean age was 52.3 ± 13.4 years, with 73.5% being male, 32 patients (%65.3) had graduated from primary or secondary school. No safety precautions were taken by any participants. Paraplegia (%87.8) and complete spinal cord injuries (57.1%) were common. Additional injuries occurred in %61.2 of cases. In terms of fall causes, the most common was branch breakage (%57.1), while walnut trees accounted for %44.9 of falls. There was a significant difference in education levels between the group that fell from walnut trees and the group that fell from other trees (p:0.028). Falls from walnut trees resulted in higher fall heights, complete injury rates, and longer hospital stays (p:0.003, p:0.047, p: 0.010). Conclusion: This study found that spinal cord injuries from falls often lead to additional injuries, with none of the patients taking safety precautions. This study found that walnut trees were the most common cause of spinal cord injury from falling trees. This study highlights the need for improved safety precautions and educational interventions.

Secretion of GPNMB from Neural Stem Cells Induced by ET-1 Contributes to Angiogenesis after Spinal Cord Injury.

The feeble plasticity of spinal cord microvascular endothelial cells (SCMECs) after trauma is one of the major causes of spinal cord injury (SCI). Neural stem cells (NSCs) play an important role in nerve repair. Glycoprotein nonmetastatic B (GPNMB) has neuroprotective effects and can be stimulated by endothelin 1 (ET-1), and its expression is upregulated in SCI. Here, we aim to investigate whether elevated ET-1 levels stimulate NSCs to secrete GPNMB, thereby further promoting angiogenesis. Mouse SCMECs and NSCs were isolated, cultured, and identified by flow cytometry and immunofluorescence staining. NSCs were treated with ET-1, while SCMECs were cocultured with NSCs, followed by treatment with ET-1. NCS and SCMEC viability were evaluated using cell counting kit 8 (CCK-8) assay, while cell proliferation, migration, invasion, and angiogenesis were examined using 5'-Ethynyl-2'-Deoxyuridine (EdU) staining, wound healing assay, Transwell assay, and tube formation assay. GPNMB expression in NCSs and SCMECs was quantified by western blot assay, quantitative Real-Time polymerase chain reaction (qRT-PCR), or enzyme-linked immunosorbent assay (ELISA). Mouse SCMECs and NSCs were successfully isolated and cultured. ET-1 promoted NSC viability and proliferation and upregulated GPNMB expression. NSCs and ET-1-treated NSCs promoted the viability, migration, invasion, angiogenesis, and GPNMB expression in SCMECs compared with control group cells, while GPNMB antibody reversed the above effects of ET-1 on the SCMECs. ET-1 promotes SCMEC migration and invasion, along with angiogenesis, by enhancing NSC-mediated GPNMB secretion, so ET-1 may be a novel therapeutic target for SCI.

Spinal cord injury etiology, severity, and care in East Asia: a cross-sectional analysis of the International Spinal Cord Society Database Project.

Cross-sectional study. To evaluate etiologic factors associated with spinal cord injury (SCI) severity and to identify predictive factors of reduction in SCI severity in six countries. SCI centers in Bangladesh, India, Malaysia, Nepal, Sri Lanka, and Thailand. Data from centers collected between October 2015 and February 2021 were analyzed using descriptive statistics and logistic regression. Among 2634 individuals, the leading cause of SCIs was falls (n = 1410, 54%); most occurred from ≥1 meter (n = 1078). Most single-level neurological injuries occurred in the thoracic region (n = 977, 39%). Greater than half of SCIs (n = 1423, 54%) were graded American Spinal Injury Association Impairment Scale (AIS) A. Thoracic SCIs accounted for 53% (n = 757) of all one-level AIS A SCIs. The percentage of thoracic SCIs graded AIS A (78%) was significantly higher than high cervical (52%), low cervical (48%), lumbar (24%), and sacral (31%) SCIs (p < 0.001). Regression analyses isolated predictive factors both of SCI severity and inpatient improvement. Four factors predicted severity: age, neurological level, etiology, and country of residence. Four factors predicted improvement: age, neurological level, AIS grade on intake, and country of residence. Findings can be used by healthcare providers and public health agencies in these countries to inform the public of the risk of SCI due to falls. Future studies should examine the social and occupational milieux of falls. Country-to-country comparisons of prehospital and inpatient care are also justified. Fall prevention policies can encourage the use of safety equipment when performing tasks at heights ≥1 meter.

Characteristics of Spinal Cord Injury Presenting to Tertiary Care Center in Gandaki province of Nepal: A Descriptive Cross-sectional Study.

Spinal cord injury is one of the common injury which causes damage to the spinal cord due to trauma, diseases or degenerations leading to disability and decreasing life expectancy. The study aims to find the characteristics of spinal cord injury presenting at a tertiary care centre. A Descriptive hospital based cross-sectional study was conducted at Pokhara, Gandaki Province, from 28th March to 25th September, 2023. 139 participants were interviewed for the study. Structured interview schedule and validated questionnaires were used for data collection. Ethical approval was taken for the study (Reference number: 151/079). A total of 139 cases were observed; most common affected age group was between 25-55 years with a mean age of 48.68 years. Most (66.9%) of the spinal cord injury patients were not enrolled in health insurance program. Most 107 (77.0%) common cause for spinal cord injury was falls from height. Age, gender, occupation and duration of stay in the hospital were statistically significant with mode of treatment. Spinal cord injury mostly traumatic commonly due to fall from height affecting mainly male population residing in rural areas at their fourth decade of life who are mainly involve in manual work and agriculture. Spinal cord injury is a major health problem at global and local level causing major morbidity.

Causes of Traumatic Spinal Cord Injury with Gender Distribution and Most Commonly Affected Age Group

Background: Spinal cord injury (SCI) has significant consequences, especially for young adults, requiring comprehensive support. Additionally, non-traumatic SCI is under-researched in Pakistan, highlighting the need for further investigation. Managing readmissions post-discharge remains a global challenge for SCI patients. This study conducted at Paraplegic Centre Peshawar aims to find the traumatic causes of spinal cord injury with gender and age distribution. Methods: A retrospective study was conducted at Paraplegic Center in Hayatabad and Prime Teaching Hospital, Peshawar. Over two months, 1843 patients were recruited from hospital records with permission from the department head. Data collection forms were designed to include age, gender, and cause of SCI, ensuring confidentiality by excluding personal identifiers. SPSS-V19 was used for data analysis. Results: Our study included 1843 patient records, with males comprising 80.7% and females 19.3%. Among different age groups, individuals aged 30 and older represented the highest proportion at 52.7%. The primary causes of spinal cord injury were falls from height (46.3%) and firearm injuries (25.9%). Paraplegic injuries were more prevalent, accounting for 87.9% of cases compared to quadriplegic injuries at 12.1%. These findings shed light on the demographics and patterns of spinal cord injuries, providing valuable insights for healthcare management and prevention strategies. Conclusion: Falls are major cause of spinal cord injury (SCI). Mean age patients suffers are 26. frequency of SCI is more in males then females. Paraplegia is more common then quadriplegia. The socioeconomic impact of SCI is eminence because it is affecting the youth population. It is important to understand the epidemiological features of SCIs which could lead to plan appropriate cost-effective prevention strategy in order to reduce the SCI prevalence and incidence in our community.

Advance in pediatric spinal cord injury

AbstractThe incidence rate of spinal cord injury in children is lower than that in adults, accounting for about 5% of all spinal cord injuries. Motor vehicle accidents are the main cause of spinal cord injuries in children. As the spine of children is still in the process of growth and development, the anatomical structure and biomechanics have unique characteristics, and its etiology, injury site, and clinical manifestations are different from those of adults. Misdiagnosis and delayed diagnosis can lead to severe spinal deformity and neurological complications. Children and adolescents with spinal cord injuries may suffer from lifelong disability, which will do great harm to children, families, and society. Early magnetic resonance imaging examination can effectively avoid underdiagnosis of spinal cord injury without radiographic abnormality and select appropriate treatment. In addition, it is also important to establish a family‐centered rehabilitation model to help the affected children reintegrate into society and achieve the goal of returning to normal life. This article reviews the etiology, epidemiology, clinical characteristics, complications, and treatment of spinal cord injury in children and adolescents.

Utilization of rehabilitation services in violent versus nonviolent traumatic spinal cord injury

AbstractBackgroundViolence is the third leading cause of spinal cord injury (SCI) in the United States, and people with violence‐related SCI have worse long‐term outcomes compared to other traumatic SCI etiologies. Little is known, however, about the underlying reasons for these differences. Access to and utilization of rehabilitation services may differ in this population, but their outpatient care has not been previously investigated.ObjectiveTo evaluate differences in utilization patterns of outpatient rehabilitation services between people with violence‐related SCI and other traumatic SCI etiologies.DesignRetrospective cohort study.SettingAcademic tertiary care hospital system.PatientsA total of 41 patients with violence‐related SCI residing in King County at the time of injury who completed inpatient rehabilitation (IPR) in our institution were identified from the hospital trauma registry and matched with 41 control patients with nonviolent traumatic SCI.InterventionsNot applicable.Main Outcome Measure(s)The number of appointments attended, canceled, and missed during the first year after discharge from IPR were obtained by chart review for physical medicine &amp; rehabilitation (PM&amp;R) physicians and therapy services.ResultsPeople with violence‐related SCI had decreased follow‐up with outpatient rehabilitation services after IPR discharge compared to non‐violent traumatic SCI, including PM&amp;R (2.50 ± 2.44 vs. 3.76 ± 2.21 visits, β = −1.28, p = .017), physical therapy (8.91 ± 11.02 vs. 17.57 ± 15.26, β = −9.79, p = .009), occupational therapy (4.28 ± 7.90 vs. 10.04 ± 14.42, β = −6.18, p = .033), and recreational therapy (0.293 ± 0.955 vs. 1.37 ± 2.86, β = −1.07, p = .035). The rate of missed appointments was also higher among people with violence‐related SCI compared to controls for PM&amp;R (25.2% ± 28.5% vs. 9.9% ± 16.5%, β = 14.6%, p = .014) and physical therapy (26.0% ± 32.0% vs 4.2% ± 13.2%, β = 22.1%, p = .009).ConclusionsIndividuals with violence‐related SCI had fewer follow‐up appointments with PM&amp;R physicians and other allied health professionals and were more likely to miss scheduled appointments compared to other traumatic SCI etiologies. Decreased outpatient follow‐up may affect long‐term outcomes for people with violence‐related SCI.

Peripheral blood RNA biomarkers can predict lesion severity in degenerative cervical myelopathy.

JOURNAL/nrgr/04.03/01300535-202506000-00027/figure1/v/2024-08-05T133530Z/r/image-tiff Degenerative cervical myelopathy is a common cause of spinal cord injury, with longer symptom duration and higher myelopathy severity indicating a worse prognosis. While numerous studies have investigated serological biomarkers for acute spinal cord injury, few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy. This study involved 30 patients with degenerative cervical myelopathy (51.3 ± 7.3 years old, 12 women and 18 men), seven healthy controls (25.7 ± 1.7 years old, one woman and six men), and nine patients with cervical spondylotic radiculopathy (51.9 ± 8.6 years old, three women and six men). Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics. Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities. Using least absolute shrinkage and selection operator analysis, we constructed a five-gene model (TBCD, TPM2, PNKD, EIF4G2, and AP5Z1) to diagnose degenerative cervical myelopathy with an accuracy of 93.5%. One-gene models (TCAP and SDHA) identified mild and severe degenerative cervical myelopathy with accuracies of 83.3% and 76.7%, respectively. Signatures of two immune cell types (memory B cells and memory-activated CD4+ T cells) predicted levels of lesions in degenerative cervical myelopathy with 80% accuracy. Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.

Radiology diagnostics of spinal corel injury in early children: a prospective study

INTRODUCTION: Spinal cord injury (SCI) in young children includes a relatively higher prevalence of cervical spine injury, multiple thoracic vertebral compression fractures, and spinal cord injury. Spinal cord injuries without radiological changes/signs of fractures or dislocations (SCIWORA) also occur in young children. X-ray assessment of damage to immature vertebrae and cartilage in young children is difficult, since incompletely formed vertebral bodies can be confused with fractures. Accordingly, an MRI is required, which provides a detailed anatomical image of all structures of the spinal column and also diagnoses damage to the spinal cord, ligaments and muscles.OBJECTIVE: To investigate the possibilities of methods of radiation diagnosis of spinal cord injury in young children (up to 3 years).MATERIAL AND METHODS: 20 children aged from 11 months up to 3 years old were studied with spinal cord injury. X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) were performed. The standard MRI protocol for SCI in children under 3 years of age included: MR myelography in the coronary and sagittal projections, sagittal projection STIR, DTI and T2WI FS SE, axial projection T2WI FS SE or T2*WI FS GE; coronary projection T2WI SE; 3D T1WI FS GE before and after contrast enhancement.RESULTS: An analysis of the data of patients included in the category of polytrauma was carried out. The causes of SCI in these patients were road accidents and falls from various heights. X-ray and CT scans were uninformative, and had large discrepancies with MRI results. All anatomical and morphological changes revealed by MRI correlated well with clinical manifestations and corresponded to the classification of the level and severity of spinal cord injury (ASIA). An increase in the volume and change in the signal of the spinal cord due to edema and / or hemorrhage in the spinal cord is the main sign of damage to the spinal cord, and is best indicated on T2WI and STIR, as a hyperintense signal.DISCUSSION: MRI is critical in the emergency assessment of spinal cord injury or compression to predict the outcome of SCI. There is currently no spinal cord imaging technique that can compete with MRI. Increased volume and signal changes in the spinal cord due to edema and/or hemorrhage are a sign of spinal cord injury and are best demonstrated on T2WI and STIR as a hyperintense signal. Incomplete spinal cord injury is also manifested by a hyperintense signal on T2WI and/or FLAIR, which in intensity and extent correlates with the degree of injury. Hemorrhagic injuries are better detected using T2*GRE or SWI, and spinal cord edema is better detected using T2WI SE and STIR. In addition, STIR can identify bone marrow edema in injured vertebrae, even when the injury is not detected on CT.CONCLUSION: When performing MRI in patients with SCI, three quantitative parameters should be assessed: the maximum damage to the spinal cord, the maximum compression of the spinal cord, and the length of the affected area. In addition to the results of quantitative parameters, potential predictive qualitative MRI findings should be evaluated such as intramedullary hemorrhage, focal and diffuse spinal cord edema, soft tissue injury, probable stenosis before injury, and disc herniation.

Emergency management of traumatic spinal cord injury: a systematic review

Globally, trauma is a prominent factor contributing to mortality and impairment. Hemorrhage accounts for up to 40% of fatalities resulting from traumatic injuries. Current approaches to improve mortality rates have prioritized the implementation of effective techniques for the early management of bleeding and the treatment of coagulation disorders. This is an updated systematic review of studies that examined the emergency care of traumatic spinal cord injury (SCI) from 2017 to 2023. A literature search was conducted using Google Scholar, Web of Science, Cochrane, and PubMed databases to find relevant research on our issue. The search terms used were &amp;quot;SCI, Spine trauma, Emergency, management, Traumatic cervical SCI&amp;quot; and were employed in different combinations. Furthermore, an assessment was conducted on original research that examines the emergency care of severe SCI. The inclusion criteria were based on full-text publications. Out of the 85 research that were collected, only nine satisfied the inclusion requirements. Out of the total number of studies, seven were conducted retrospectively, one was a case report, and another was a cross-sectional research. The research population consisted of around 159,982 individuals diagnosed with SCI. Respiratory ssues, septicemia, and cardiovascular complications were the leading causes of in-hospital mortality in those with complete acute SCI. Elderly people, physical injuries, paralysis of all four limbs, and reliance on mechanical breathing were all associated with greater death rates. The American Spinal Injury Association grade upon admission was the greatest predictor of morbidity and death. Road traffic accidents were the major cause of CI among Saudi men. Bomb blasts quickly followed falls, gaining second place. Road traffic accidents are the second most common cause of SCI among females, behind falls. Younger people who suffer spinal cord injuries frequently were found to have a better prognosis for recovery than older people.

Laminectomy Decompression and Posterior Stabilization in Spinal Cord Injury American Spinal Injury Association Impairment Scale B due to Spondylolisthesis Grade II

Spinal cord injury (SCI) is considered a serious neurological condition since it frequently causes significant morbidity and long-term disability. Physical trauma of the spine is the leading cause of SCI. It is also associated with other spinal anomalies, such as spondylolisthesis; a condition where the upper vertebra segment slips over the underlying vertebra and causing neurological symptoms. We report a case of a 40-year-old male patient who was admitted with cervical pain and weakness of all extremities as the chief complaint. One week before admission, he fell from the tree with his neck hitting the ground first. Physical examinations showed a prominent neurological deficit. Cervical spondylolisthesis was confirmed by an imaging test. Because of this condition, he underwent surgical decompressive laminectomy and posterior stabilization. Surgical intervention is the standard therapy for traumatic SCI. The goal of surgical intervention is realigning the spinal column, restoring spinal stability, and relieving the spinal cord’s compression due to bony or ligamentous structures. Although cervical SCI due to spondylolisthesis is a rare issue, it is one of the life-threatening cases. Therefore, early diagnosis and intervention are needed to prevent further injury and improve neurological functions. This study aimed to share one example of an SCI case with appropriate treatment, which mostly had a good neurological outcome.

Recent Advances in the Treatment of Spinal Cord Injury.

Spinal cord injury (SCI) is a complex, multifaceted, progressive, and yet incurable complication that can cause irreversible damage to the individual, family, and society. In recent years strategies for the management and rehabilitation of SCI besides axonal regeneration, remyelination, and neuronal plasticity of the injured spinal cord have significantly improved. Although most of the current research and therapeutic advances have been made in animal models, so far, no specific and complete treatment has been reported for SCI in humans. The failure to treat this complication has been due to the inherent neurological complexity and the structural, cellular, molecular, and biochemical characteristics of spinal cord injury. In this review, in addition to elucidating the causes of spinal cord injury from a molecular and pathophysiological perspective, the complexity and drawbacks of neural regeneration that lead to the failure in SCI treatment are described. Also, recent advances and cutting-edge strategies in most areas of SCI treatment are presented.

Neurotrauma from fall accidents in Ethiopia

BackgroundEthiopia is a fast-growing economy with rapid urbanization and poor occupational safety measures. Fall injuries are common and frequently result in traumatic brain injury (TBI) or spinal cord injury (SCI). MethodsWe prospectively included fall victims who were hospital-treated for neurotrauma or forensically examined in 2017 in Addis Ababa, Ethiopia. We registered sociodemographic factors, fall types, injuries, treatment, and outcome. ResultsWe included 117 treated and 51 deceased patients (median age 27 vs. 40 years). Most patients were injured at construction sites (39.9%) and only one in three used protective equipment. TBI (64.7%) and SCI (27.5%) were the most common causes of death among the deceased patients, of which most died at the accident site (90.2%). Many patients suffered significant prehospital time delays (median 24 h). Among treated patients, SCI was more frequent than TBI (50.4% vs. 39.3%), and 10.3% of the patients had both SCI and TBI. Most SCIs were complete (49.3%), whereas most TBIs were mild (55.2%). Less than half of TBI patients and less than one in five SCI patients were operated. There were twice as many deaths among TBI patients as SCI patients. Among those discharged alive, at a median of 33 weeks, 50% of TBI patients had a good recovery whereas 35.5% of SCI patients had complete injuries. ConclusionFalls at construction sites with inadequate safety measures were common causes of SCI and TBI resulting in severe disability and death. These results support further development of prevention strategies and neurotrauma care in Ethiopia.

Global, regional, and national burden of spinal cord injury, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Spinal cord injury (SCI) is a major cause of health loss due to premature mortality and long-term disability. We aimed to report on the global, regional, and national incidence, prevalence, and years of life lived with disability (YLDs) for SCI from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Using GBD 2019 data pooled in DisMod-MR 2.1, a Bayesian meta-regression tool, we systematically derived numbers and age-standardised rate changes with 95% uncertainty intervals (95% UIs) for the incidence, prevalence, and YLDs for SCI from 1990 to 2019 for the whole world, 21 GBD regions, and 204 countries and territories. We report trends based on age, sex, year, cause of injury, and level of injury. Globally, 20·6 million (95% UI 18·9 to 23·6) individuals were living with SCI in 2019. The incidence of SCI was 0·9 million (0·7 to 1·2) cases with an estimated 6·2 million (4·5 to 8·2) YLDs. SCI rates increased substantially from 1990 to 2019 for global prevalence (81·5%, 74·2 to 87·1), incidence (52·7%, 30·3 to 69·8), and YLDs (65·4%, 56·3 to 76·0). However, global age-standardised rates per 100 000 population showed small changes in prevalence (5·8%, 2·6 to 9·5), incidence (-6·1%, -17·2 to 1·5), and YLDs (-1·5%, -5·5 to 3·2). Data for 2019 shows that the incidence of SCI increases sharply until age 15-19 years, where it remains reasonably constant until 85 years of age and older. By contrast, prevalence and YLDs showed similar patterns to each other, with one peak at around age 45-54 years. The incidence, prevalence, and YLDs of SCI have consistently been higher in men than in women globally, with a slight and steady increase for both men and women from 1990 to 2019. Between 1990 and 2019, SCI at neck level was more common than SCI below neck level in terms of incidence (492 thousand [354 to 675] vs 417 thousand [290 to 585]), prevalence (10·8 million [9·5 to 13·9] vs 9·7 million [9·2 to 10·4]), and YLDs (4·2 million [3·0 to 5·8] vs 1·9 million [1·3 to 2·5]). Falls (477 thousand [327 to 683] cases) and road injuries (230 thousand [122 to 389] cases) were the two leading causes of SCI globally in 2019. Although age-standardised rates of incidence, prevalence, and YLDs for SCI changed only slightly, absolute counts increased substantially from 1990 to 2019. Geographical heterogeneity in demographic, spatial, and temporal patterns of SCI, at both the national and regional levels, should be considered by policy makers aiming to reduce the burden of SCI. Bill & Melinda Gates Foundation.

Demographic and Clinical Characteristics of Persons With Spinal Cord Injury in Bangladesh: Database for the International Spinal Cord Injury Community Survey 2023.

The study aims to explore the demographic and clinical characteristics of persons with spinal cord injury (SCI) in Bangladesh. A total of 3035 persons with SCI spanning from 2018 to 2022 were included in this cross-sectional study. Information about demographic and clinical variables was obtained from the medical records and verified through telephone calls to ensure accuracy and consistency. Approximately half (48.30%) of the study participants were located in Dhaka Division. The average age of persons with SCI was 38.3 years, with a standard deviation of 15.9 years, and the largest proportion (33.4%) fell within the age range of 18-30 years. Males outnumbered females by nearly 2.5 times. In the study, 59.6% had suffered traumatic injuries, whereas 40.4% had SCI attributable to disease-related causes; 58.1% were diagnosed with tetraplegia and 40.1% with paraplegia. Fall from height (42.1%) and road traffic trauma (27%) were the most common causes of traumatic injuries. Degenerative myelopathy (41.1%) was the most frequent cause of non-traumatic SCI, followed by tumors (27.7%) and tuberculosis (TB; 14.8%). Both traumatic (58.3%) and degenerative (56.7%) causes of SCI commonly affected the cervical spine, whereas TB (24.4%) and tumors (47.5%) had a higher incidence of affecting the dorsal spine. In the absence of a registry or national database for patients with SCI in Bangladesh, this study would serve as representative data for future studies.

Stem Cell Scaffolds for the Treatment of Spinal Cord Injury-A Review.

Spinal cord injury (SCI) is a profoundly debilitating yet common central nervous system condition resulting in significant morbidity and mortality rates. Major causes of SCI encompass traumatic incidences such as motor vehicle accidents, falls, and sports injuries. Present treatment strategies for SCI aim to improve and enhance neurologic functionality. The ability for neural stem cells (NSCs) to differentiate into diverse neural and glial cell precursors has stimulated the investigation of stem cell scaffolds as potential therapeutics for SCI. Various scaffolding modalities including composite materials, natural polymers, synthetic polymers, and hydrogels have been explored. However, most trials remain largely in the preclinical stage, emphasizing the need to further develop and refine these treatment strategies before clinical implementation. In this review, we delve into the physiological processes that underpin NSC differentiation, including substrates and signaling pathways required for axonal regrowth post-injury, and provide an overview of current and emerging stem cell scaffolding platforms for SCI.

Long-term changes of Th17 and regulatory T cells in peripheral blood of dogs with spinal cord injury after intervertebral disc herniation

BackgroundIntervertebral disc herniation (IVDH) is one of the most common causes of spinal cord injury (SCI) in dogs. As a result of acute SCI, a complex inflammatory response occurs in the spinal cord. Th17 cells (Th17) produce pro-inflammatory cytokines, while regulatory T cells (Treg) have opposite effects producing anti-inflammatory cytokines. Therefore, the aim of this study was to determine whether Th17- and Treg cells are involved in the pathogenesis of SCI or whether cellular changes occur due to coexisting inflammatory diseases. We hypothesized that chronic alterations in the Th17/Treg ratio are associated with a worse outcome after SCI.MethodsTwenty-six paretic or plegic dogs with IVDH with and without coexisting inflammatory disease were investigated in the acute stage of the disease and after recovery of SCI. In addition, a healthy control group was included (n = 14). Quantification of Th17 and Treg cells, from peripheral blood samples, was performed by multicolor flow cytometry and IL17 was measured using an enzyme-linked immunosorbent assay (ELISA).ResultsAfter recovery significantly higher levels of Th17 (p = 0.0265) and Treg cells (p = 0.00025) were detected compared to acute IVDH but Th17/Treg ratio did not differ significantly. Recovered dogs and the control group did not differ significantly from each other. No association between an imbalance in the ratio and neurologic severity or underlying inflammatory diseases was found.ConclusionThis study demonstrated that altered Th17 and Treg levels in peripheral blood are altered in the acute stage of IVDH, preexisting inflammatory diseases seem not to influence these cell populations. Th17 and Treg cells could be considered when evaluating new treatment strategies for SCI.

Incidence of Acute Complications Associated with Spinal Cord Injury (SCI): A Study of the Ayub Teaching Hospital, Abbottabad

Objective: To document the occurrence of acute problems as well as post-surgical improvements in individuals suffering from spinal cord injury. Materials and Methods: This study was conducted retrospectively in the Department of Neurosurgery. All patients of any age and both genders were included who were admitted with spinal injuries. The patients with cervical fractures received the anterior cervical plating plus graft placement in the cervical spine, whereas the patient with thoracolumbar fractures received the transpedicular fixation in thoracolumbar spine fractures. ASIA Impairment Scale for neurological status, GCS at admission, and acute complications developed within two weeks were noted. Results: 200 patients were included (mean age of 34.6 years). The common cause of SCI was a fall from an elevated position of 62.5%. On admission, 50% of patients’ neurological state was Asia grade A. The most common location involved in patients (70%) was a thoracolumbar junction. 20% of patients presented with neurogenic shock. Postoperatively, the GCS scores in all patients were been improved. The commonest acute complications associated with SCI were pulmonary in 60% of patients. 17% of patients developed an infection, 5% suffered from gastrointestinal issues, and 3% suffered from renal issues. Deep vein thrombosis (DVT) was observed in 9%. Conclusion: During the early phase of hospitalization, respiratory difficulties were among the most prevalent complications encountered in those suffering from traumatic SCI. These outcomes exacerbate the eventual suffering caused by the spinal cord injury; hence, recognizing the likelihood of occurrence, early detection, exact surgical treatment, and prevention are essential.

B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review.

Intramedullary tumors represent the major cause of spinal cord injuries, and its symptoms include pain and weakness. Progressive weakness may concomitantly occur in the upper and lower limbs, along with lack of balance, spine tenderness, sensory loss, trophic changes of extremity, hyperreflexia, and clonus. The study protocol was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search of the MEDLINE electronic database was performed to identify the studies reporting the clinical features of children and adults who presented with an intramedullary lymphoma. Twenty-one studies were included, reporting 25 cases. Manuscripts were excluded if the full-text article was not available, original data were not reported (e.g., review articles), or if the main disease was not intramedullary lymphoma. A structured data extraction form was employed to standardize the identification and retrieval of data from manuscripts. To enlighten the discussion, a case is also presented. An 82-year-old woman with Fitzpatrick skin type II, diagnosed and treated for non-Hodgkin's lymphoma 7 years ago, was admitted with mental confusion and memory loss for the past 2 months-evolving with recurring falls from her own height. One day before admission, she displayed Brown-Séquard syndrome. An expansive lesion from C2 to C4 in the cervical spinal cord was found and a hypersignal spinal cord adjacent was described at the bulb medullary transition to the C6-C7 level. A primary spinal cord tumor was considered, as well as a melanoma metastasis, due to the lesion's flame pattern. The patient presented a partial recovery of symptoms and a reduction of the spinal cord edema after being empirically treated with corticosteroids, but the lesion maintained its extent. Subsequently, a large diffuse B-cell lymphoma with nongerminal center was found in open body biopsy, infiltrating neural tissue. The main objective of the present study is to report a surgical case treated for a large diffuse B-cell lymphoma, in addition to presenting the results of a systematic review of primary intramedullary spinal cord lymphoma.

Obstetric and Neonatal Outcomes in People Who Acquired a Spinal Cord Injury During Pregnancy

ObjectiveThe objectives of this study were to determine the obstetric and neonatal outcomes of people who acquired spinal cord injuries (SCI) during pregnancy. MethodsThis is part of an international observational questionnaire examining pregnancy outcomes of people with SCI. The outcome measures included demographics, level of injury and American Spinal Injury Association scores, prenatal and postnatal complications, and neonatal outcomes. ResultsOf 780 responses, 14 (1.79%) participants reported acquiring an SCI while pregnant. 64.2% (9/14) of injuries were due to trauma. Of 14 pregnancies, 1 person miscarried, and 3 pregnancies were terminated. There were 11 live births. One participant had twins and 9 live births were singletons. Six participants delivered vaginally, 3 had a cesarean delivery and 1 was unreported. The preterm birth rate was 54.5% (6/11). Approximately 36% (4/11) of newborns were admitted to the neonatal intensive care unit. The average birth weight reported was 2409.7 g (456.3 g–3458.6 g). Forty percent (4/10) of participants reported experiencing postpartum blues or depression. Sixty percent (6/10) of participants breastfed for over 2 weeks. ConclusionsThis is the largest known cohort to date of persons acquiring SCI during pregnancy. The most common cause of SCI was a motor vehicle accident. Complications included preterm birth and neonatal intensive care unit admission. People who have an SCI during pregnancy are at risk for complications; however, positive pregnancy and neonatal outcomes are possible. Absolute small numbers of this event limit the ability to assess incidence of outcomes.