Common Cause Of Spinal Cord Injury Research Articles

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 "SCI, Spine trauma, Emergency, management, Traumatic cervical SCI" 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.

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.

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.

Incidence and etiology of traumatic spinal cord injury in Khyber Pakhtunkhwa from 2010 to 2020: A cross-sectional study

Background: Spinal cord injury (SCI) is a traumatic occurrence that causes motor and sensory deficits for the rest of one's life. Despite many investigators' best attempts to establish genuine therapeutic interactions, traumatic SCI is a traumatic experience after which recovery of function is restricted. Quadriplegia occurs when an injury occurs above the first thoracic vertebra, so both the upper and lower limbs are paralyzed. However, if the lesion occurs below the first thoracic vertebra, paraplegia occurs, and the patient's condition can range from limited lower-limb mobility to total paralysis of both lower limbs. Objective: To determine the incidence rate and etiology of traumatic spinal cord injuries in Khyber Pakhtunkhwa from 2010 to 2020. Methods: This is a descriptive cross-sectional study, which was performed at different rehabilitation centers of KPK from September 2010 to November 2020. Patients with traumatic SCI between 2010 and 2020, who were residents of Khyber Pakhtunkhwa, were included while patients with other etiology of SCI or residents of other provinces were excluded from the study. Secondary data was collected through self-structured performa. Using SPSS version 23, the collected data was analyzed to obtain the collected data regarding our topic. Results: Total of 2022 patients were included in the study; their mean age was 33.3 years. Males were 1631 patients (80.6%), while females were 319 patients (19.3 %). Fall from the height (33.1 %) was the most common cause of SCI which was followed by RTA (26.8%) and firearm injury (FAI) (21.5 %) respectively. Thoracic (55.29 %) was the most common level injured. Complete injuries were 1588 (78.5 %) and incomplete ones were 429 (21.21 %). Most patients were from Peshawar District (20.7 %). Conclusion: This study concludes that fall from height was the main cause of Traumatic Spinal Cord Injury, followed by road traffic accidents and firearm injuries. Males were at higher risk of Traumatic Spinal Cord Injury.

Epidemiology of Spinal Cord Injuries and Their Outcomes: A Study at King Khalid Hospital (KKH), Najran, Saudi Arabia, June 2018–June 2019

Introduction: Spinal cord injury (SCI) is a life-changing neurological injury that puts a significant load on the healthcare system. SCI can be caused by several reasons such as road traffic accident (RTA), motor traffic accident (MTA), fall, gunshots, or bomb blast. There is not much national data concerning the etiology of SCI in Saudi Arabia. Therefore, we conducted this study to quantify the number of SCI incidence at King Khalid Hospital (KKH), Najran between June 2018 and June 2019. The study aimed at reviewing the rate and epidemiology of SCI at KKH for all patients admitted to the hospital during the study period and examining the causes of SCI for suggesting prevention strategies.
 Methodology: This retrospective study included all patients with SCI admitted to KKH during the mentioned period. Several factors for each patient were recorded including their age, gender, nationality, cause of SCI, and the outcomes of neurological injury.
 Result: In total, 182 SCI patients were admitted during the study period: 53% of them were male, and those aged 16–30 years were most vulnerable to SCI. RTA was the most common cause of SCI for males (59%), followed by bomb blasts (15%). While fall was ranked as the second cause of SCI in males (15.4%), it was the main reason for SCI in females 13%, followed by RTA. The majority of admitted cases in younger age was stable and improved, however, after RTA four patients had quadriplegia and six cases had paraplegia.
 Conclusion: RTA is the most common cause of SCI followed by fall and bomb blast. Younger patients are more likely to improve after SCI compared to elderly patients.

Etiology and epidemiology of spinal cord injury in Korea

Acute spinal cord injury (SCI) is a catastrophic traumatic event that affects the physical and psychological well-being of individuals and results in considerable socio-economic losses. SCI is an incurable condition; therefore, prevention is critical. Thorough understanding of the epidemiology of SCI is essential to implement optimal preventive measures and effectively plan clinical services. The incidence of SCI was 54 and 40.2 cases per million population in the United States and Japan, respectively; however, national statistical data regarding SCI are unavailable in Korea. Considering that the incidence in Korea is similar to that observed in the United States or Japan, it is estimated that 2,000 to 2,500 new cases of SCI are observed in Korea annually. The male:female ratio is 3:1 to 5:1 in most countries and 3:1 in Korea. More than 50% of patients with SCI are aged <30 years at the time of the injury. However, the incidence of SCI is rapidly increasing in elderly individuals and in women. The most common causes of SCI in descending order of frequency include traffic accidents, falls, sports injuries, and violence. Incomplete injury is increasingly being observed in recent times in contrast to a higher incidence of complete injury reported previously. It is important to establish an accurate comprehensive statistical database in Korea, similar to The National Spinal Cord Injury Statistical Center, USA.

Epidemiology of Spinal Cord Injuries and their Outcomes: A Retrospective Study at the King Khalid Hospital.

Background: Spinal cord injury (SCI) is a life-changing neurological injury. Besides having significant implications for the patient, SCI places a considerable burden upon healthcare resources. Common causes of SCI include falls, road traffic accident (RTA), gunshots, and bomb blast. There is limited national data recording the aetiology of SCI in Saudi Arabia. The aim of this study is to collate SCI data obtained from patients admitted to King Khalid hospital (KKH), Najran, over the year covering June 2018 to June 2019.Aim: To measure the frequency and epidemiology of SCI at KKH for all patients admitted to the hospital during the study period; also to evaluate the aetiologies and use the information to propose strategies to minimise SCI.Methods: Data for all patients admitted to KKH with SCI were assessed. Reviewed data included patients’ age, gender, nationality, the cause of SCI, and the outcome.Results: Throughout the study duration, a total of 182 patients were admitted with SCI. Of those, 53% were male, many of whom were between the ages of 16 and 30 years. Amongst males, the most common cause of SCI was RTA (59%); the second most common cause was falls (15%), which is almost tied with bomb blast (15%). Falls are the most common cause of SCI in females (13%); RTAs are the second most common cause of SCI in females. The majority of young patients were stable and had improved. However, six patients were paraplegic following RTA-initiated SCI; four patients were quadriplegic.Conclusion: The most common cause of SCI is RTA, which is followed by fall and bomb blast. The recovery prospects of young SCI patients tend to be better than the prospects of elderly patients.

Characteristics of neuropathic pain in individuals with chronic spinal cord injury.

Objectives:To present the characteristics of neuropathic pain in individuals with chronic spinal cord injury (SCI).Methods:We recruited all individuals with chronic SCI referred to the Brain and Spine Injury Research center with a diagnosis of neuropathic pain from April 2013 to September 2015 into this historical cohort study.Results:Forty individuals with chronic SCI-induced neuropathic pain entered this study with a mean age of 43.67±13.12 years and a majority of who were male (n=30, 75%). Motor vehicle collision (n=25, 62.5%) and fall (n=7, 17.5%) were the most common causes of SCI in our participants. There were 13 (32.5%) cervical, twenty (50%) thoracic, and 7 (17.5%) lumbosacral SCI. The mean ‘maximal pain intensity’, ‘overall pain intensity during the past week’, and ‘the pain intensity at the initial consultation in pain clinic’ measured by numerical rating scale (NRS) in this cohort were 8.71±1.73, 6.32±1.60, and 6.11±2.48, respectively. Burning pain was the most frequently used description of pain reported by our participants. Pain intensity significantly decreased after six months of treatment for all three above categories.Conclusion:This study provides characteristics of neuropathic pain in a group of individuals with chronic SCI. Further large prospective studies are needed to determine the association between lesion level, completeness of injury, and region of pain.

Diagnostic Challenges inInfections related to Spinal Cord Injury

Spinal cord injury (SCI) is an ancient disease, described by Hippocrates and traction techniques were recommended to straighten the spine. Motor vehicle accidents, falls, attempted suicide, gunshot wounds, military conflicts and support injuries are most common cause of SCIs. Most hospitalized SCI patients have nosocomial infection. SCI Patients may suffer from stress, malnutrition, renal failure; receive medications that impair immune responses. Frequent insertion of urologic, vascular, orthopedic, respiratory, gastrointestinal, and neurosurgical devices predispose to various prosthesis-related infections. Diagnostic challenges include inability to recognize the signs and symptoms of cord damage, and delay in diagnosing spinal epidural abscess. Treatment of infection e.g., two opposing factors resulting from changes in body composition in following SCI can alter the disposition of systematically administered antibiotics, such as vancomycin and aminoglycosides. Frequently diagnosed infections in SCI patients are urinary tract infection (UTI), pneumonia, pressure sores, osteomyelitis, infection due to multi-resistant organisms, and intra-abdominal infection. SCI patients are at high risk for Fournier gangrene that affects the perineal and genital regions and usually results from polymicrobial infection.Common pathogens are Staphylococcus aureus, including methicillin resistant Staphylococcus aureus(MRSA),Streptococci, vancomycin resistant Enterococcus(VRE)gram-negative bacilli including ESBL producing Klebsiella pneumoniae and Escherichia coli. Earlydiagnosis, gram negative coverage when initiating empirical antibiotic therapy has lower mortality and better outcomes.

A Clinical Perspective and Definition of Spinal Cord Injury.

Spinal cord injury (SCI) can be complete or incomplete. The level of injury in SCI is defined as the most caudal segment with motor function rated at greater than or equal to 3/5, with pain and temperature preserved. The standard neurological classification of SCI provided by the American Spinal Injury Association (ASIA) assigns grades from ASIA A (complete SCI) through ASIA E (normal sensory/motor), with B, C, and D representing varying degrees of injury between these extremes. The most common causes of SCI include trauma (motor vehicle accidents, sports, violence, falls), degenerative spinal disease, vascular injury (anterior spinal artery syndrome, epidural hematoma), tumor, infection (epidural abscess), and demyelinating processes (). (SDC Figure 1, http://links.lww.com/BRS/B91)(Figure is included in full-text article.).

Incidence of Spinal Cord Injury in Traumatic Patients Admitted to a Trauma Referral Center in Guilan

Background & Aim: Patients with spinal cord injury (SCI) impose a heavy burden on health care system. Awareness on prevalence and incidence of SCI is important because this would show the necessity of prevention. This study aimed to investigate the epidemiology and types of traumatic spinal cord injuries in a trauma referral center in Guilan. METHODS & Materials/Patients: This is a descriptive study which was conducted on patients with spinal cord trauma using a questionnaire during one year. The questionnaire included demographic information, injured spinal cord area, mechanism of injury, and type of neural damage based on ASIA scale. The data were analyzed using SPSS18 and descriptive statistics. RESULTS: Out of 76 study patients, 68 (88.2%) were men with mean age of 35.2 ± 1.45 years. The most common cause of SCI was motor vehicle accidents (MVA) (48.7%). 34 patients (44.7%) had cervical spine injury and in 23 patients (30.3%), thoraco-lumbar injuries caused SCI. 29.7% of patients suffered from paraplegia and 10.8% quadriplegia. 25 patients (38.5%) had complete SCI. 7 patients with SCI (9.2%) died during hospitalization. In this study, increased age was identified as a risk factor for death. In 4 of these patients (57.1%) cervical SCI was the underlying cause of death. CONCLUSION: Young men were the group at highest risk and the most mechanism leading to SCI was motor vehicle accidents. Many of these accidents are preventable; thus, more attention should be devoted to safety policies based on needs of the vulnerable groups. Besides, comprehensive education program with clear and practical goals should be developed. Language: en

Rehabilitation of spinal cord injuries.

Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients' family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary.

Global prevalence and incidence of traumatic spinal cord injury

BackgroundSpinal cord injury (SCI) is a traumatic event that impacts a patient’s physical, psychological, and social well-being and places substantial financial burden on health care systems. To determine the true impact of SCI, this systematic review aims to summarize literature reporting on either the incidence or prevalence of SCI.MethodsA systematic search was conducted using PubMed, MEDLINE, MEDLINE in process, EMBASE, Cochrane Controlled Trial Register, and Cochrane Database of Systematic Reviews to identify relevant literature published through June 2013. We sought studies that provided regional, provincial/state, or national data on the incidence of SCI or reported estimates of disease prevalence. The level of evidence of each study was rated using a scale that evaluated study design, methodology, sampling bias, and precision of estimates.ResultsThe initial search yielded 5,874 articles, 48 of which met the inclusion criteria. Forty-four studies estimated the incidence of SCI and nine reported the prevalence, with five discussing both. Of the incidence studies, 14 provided figures at a regional, ten at a state or provincial level and 21 at a national level. The prevalence of SCI was highest in the United States of America (906 per million) and lowest in the Rhone-Alpes region, France (250 per million) and Helsinki, Finland (280 per million). With respect to states and provinces in North America, the crude annual incidence of SCI was highest in Alaska (83 per million) and Mississippi (77 per million) and lowest in Alabama (29.4 per million), despite a large percentage of violence injuries (21.2%). Annual incidences were above 50 per million in the Hualien County in Taiwan (56.1 per million), the central Portugal region (58 per million), and Olmsted County in Minnesota (54.8 per million) and were lower than 20 per million in Taipei, Taiwan (14.6 per million), the Rhone-Alpes region in France (12.7 per million), Aragon, Spain (12.1 per million), Southeast Turkey (16.9 per million), and Stockholm, Sweden (19.5 per million). The highest national incidence was 49.1 per million in New Zealand, and the lowest incidences were in Fiji (10.0 per million) and Spain (8.0 per million). The majority of studies showed a high male-to-female ratio and an age of peak incidence of younger than 30 years old. Traffic accidents were typically the most common cause of SCI, followed by falls in the elderly population.ConclusionThis review demonstrates that the incidence, prevalence, and causation of SCI differs between developing and developed countries and suggests that management and preventative strategies need to be tailored to regional trends. The rising aging population in westernized countries also indicates that traumatic SCI secondary to falls may become an increasing public health challenge and that incidence among the elderly may rise with increasing life expectancy.

Causes of Spinal Cord Injury

Knowledge of the causes of spinal cord injury (SCI) and associated factors is critical in the development of successful prevention programs. This study analyzed data from the National SCI Database (NSCID) and National Shriners SCI Database (NSSCID) in the United States to examine specific etiologies of SCI by age, sex, race, ethnicity, day and month of injury, and neurologic outcomes. NSCID and NSSCID participants who had a traumatic SCI from 2005 to 2011 with known etiology were included in the analyses (N=7,834). Thirty-seven causes of injury documented in the databases were stratified by personal characteristics using descriptive analysis. The most common causes of SCI were automobile crashes (31.5%) and falls (25.3%), followed by gunshot wounds (10.4%), motorcycle crashes (6.8%), diving incidents (4.7%), and medical/surgical complications (4.3%), which collectively accounted for 83.1% of total SCIs since 2005. Automobile crashes were the leading cause of SCI until age 45 years, whereas falls were the leading cause after age 45 years. Gunshot wounds, motorcycle crashes, and diving caused more SCIs in males than females. The major difference among race/ethnicity was in the proportion of gunshot wounds. More SCIs occurred during the weekends and warmer months, which seemed to parallel the increase of motorcycle- and diving-related SCIs. Level and completeness of injury are also associated with etiology of injury. The present findings suggest that prevention strategies should be tailored to the targeted population and major causes to have a meaningful impact on reducing the incidence of SCI.

Effects of chronic pain on quality of life and depression in patients with spinal cord injury

A cross-sectional study. To assess the effects of pain on quality of life (QoL), functional independence and depression in patients with spinal cord injury (SCI). An inpatient rehabilitation center. A total of 140 patients (104 M, 36 F) with SCI who underwent inpatient rehabilitation treatment were examined. A questionnaire including clinical variables was applied. Motor score of Functional Independence Measure was used to assess daily-life activities, the 36-Item Medical Outcomes Short-Form Health (SF-36) for QoL and Beck Depression Inventory (BDI) for depression. Patients were then divided into those having chronic pain (Group I) and those without any pain (Group II), and groups were compared according to demographic and clinical variables. The most common causes of SCI were falls (35.0%) and motor vehicle accidents (34.2%). Chronic pain was present in 78% of patients. Patients employed before injury and patients who had complete injury had lower Numerical Rating Scale scores (P<0.05). SCI patients with chronic pain had higher depression ratings and their BDI scores were correlated with some of the SF-36 domains (general health, vitality, social functioning and mental health). Only bodily pain and social functioning (P<0.05) scores were found to be lower in Group I (P<0.05) when compared with Group II. As mood and QoL are negatively affected with pain in SCI patients, we suggest that chronic pain should always be treated in a multidisciplinary setting where pharmacological, physical and psychological therapies are combined.

Preventing motor vehicle crashes related spine injuries in children

Spinal cord injury (SCI) is a devastating event that results in permanent disability for injured children. Among all etiologies of SCI, motor vehicle crashes (MVCs) are the leading cause and account for 29% of all traumatic SCIs in children. We tried to evaluate types and mechanisms of MVC-related spinal column and spinal cord injuries, risk factors, safety issues and legislation. A literature review was performed using PubMed from 1966 to 12th April 2010 with the following key words: children OR pediatric, spine, injury OR trauma, restraint, seat belt, motor vehicle, road OR traffic, collision OR crash, safety. Cross referencing of discovered articles was also performed. Risk factors for MVC-related SCI include single vehicle crashes, vehicle rollover, and ejection of the passenger from the vehicle. Any anatomic region of the spinal cord may be injured as a result of MVC and may vary according to the type of accident and restraint system usage. Increasing use of three-point seat belts, which are more protective than isolated lap seat belts, has decreased the incidence of MVC-related SCI. There is evidence that airbag use without seatbelt use is associated with an increased risk of cervical spine fractures with or without SCI. Vehicle designers need to give more attention to the prevention of vehicle rollover and to improve occupant protection when rollover occurs. MVC is a common cause of SCI in children; therefore, paying attention to risk factors and modes of prevention is important. As MVC-related SCI can lead to permanent disability, prevention and education play an important role in decreasing childrens' morbidity and mortality. Making behavior, roads and vehicles safer can significantly reduce MVC-related SCI in children.