Spine Damage Research Articles

Airway management of maxillofacial and neck trauma patients

Background Airway injury has been commonly seen after maxillofacial trauma and neck trauma, and this complication increases mortality in patients. Therefore, airway management is crucial to prevent death in patients with maxillofacial and neck trauma. Objective To review the characteristics of maxillofacial trauma and neck trauma, and the management of injured airway in these conditions. Content Different from maxillofacial trauma, neck trauma often causes damage in cervical nerve and spine, which complicates airway management. In patient with maxillofacial trauma, tracheal ventilation can be achieved through a tubing from nose, mouth, submentum, and an incision in trachea. In patients with neck trauma, tracheal ventilation should be under the guidance of laryngoscope or optical fiber to avoid further damages in airway, and appropriate strategies may be required to stabilize the tubing. Trend Mechanical ventilation is an important procedure in airway management in patients suffered from maxillofacial and neck trauma. Strategies and devices to maintain adequate ventilation in patients should be the focuses of the future studies. Key words: Maxillofacial and neck trauma; Airway management

A wearable embedded device for chronic low back patients to track lumbar spine position

In present scenario, people always work in an enclosed environment where they sit in the bend posture that causes severe damage in lumbar spine. According to the survey of World Health Organization, around the world 500,000 to 800,000 people are suffering from spinal cord injury (SCI). In that about 53% of the people who are aged between 16 and 30 suffer from chronic low back pain. A new wearable device which consists of miniature gyroscope and accelerometer are used in detecting the voluntary action of lumbar spine in the proposed system. The proposed system consists of a vibrator, Bluetooth element, a microcontroller and an android application. The vibrator motor is used to intimate the improper sitting position of the person. A Bluetooth element is used in transmitting the data from the module and the android application that runs on smart phone. It records the analyzed data of the sensor. A microcontroller is used to control the overall working of the designed system. The capability of this cost effective, simple device is capable to measure the lumbar spine position with the efficiency of 95% and provide a feedback to the user.

Spinal fracture in polytrauma situation

The timing of surgical stabilization of a thoracolumbar spine fracture in a polytrauma situation is controversial. While delayed surgery was considered safe and the norm, over the last few years there is an increasing amount of literature available that supports early stabilization of the spine fracture with good neurological and non-neurological outcomes. Adequate “resuscitation” of the patient prior to surgical intervention is of paramount importance to reduce surgery associated “second hit”. The “spine damage control” approach is a safe and appropriate management strategy in a polytrauma situation. Minimally invasive stabilization follows the principles of “damage control orthopedics” and appears to be a good surgical option.

Performance of the classification criteria in patients with late-onset axial spondyloarthritis

Aim: To evaluate the performance of four different classification criteria for spondyloarthritis (SpA) in patients with late-onset symptoms and to compare the clinical, laboratory and radiographic outcomes among the patients with symptoms before and after 45 years of age.Patients and methods: A total of 329 patients with SpA were enrolled in this prospective cohort. Patients with psoriatic arthritis, reactive arthritis, colitis associated arthritis and peripheral or undifferentiated SpA were excluded. The remaining individuals were divided into two groups based on their ages at the time of onset of symptoms: from 16 to 45 years of age (adult-onset, A-O) and after 45 years of age (late-onset, L-O). The clinical data were collected, including BASDAI, BASFI, BASMI, mSASSS, ASDAS, as were concomitant diseases and medications, efficacy and safety data. The performance of four SpA classification criteria, including modified New York, ESSG, Amor and ASAS, was evaluated in both groups. p value <.05 was considered as significant.Results: Thirty-two patients (9.72%) had L-O axial SpA. Mean age of diagnosis and symptoms were 57.6 (8.0) years and 7.6 (5.1) years, respectively. L-O patients had statistically worse functional impairment and higher disease activity. However, they had lower radiographic sacroiliac and spine damage (p < .001).Conclusion: Our data showed that almost 10% of the patients with SpA had late-onset of symptoms. Moreover, they had higher disease activity, worse physical function and lower spine radiographic damage than A-O SpA patients. Additionally, the ASAS classification criteria had the best performance and might be used in clinical practice.

Early anti-inflammatory intervention ameliorates axial disease in the proteoglycan-induced spondylitis mouse model of ankylosing spondylitis

BackgroundAnkylosing spondylitis (AS) is characterised by immune-mediated arthritis and osteoproliferation, ultimately leading to joint ankylosis. Whether inflammation is necessary for osteoproliferation is controversial, fuelled by the unclear efficacy of anti-inflammatory treatments on radiographic progression. In proteoglycan-induced spondylitis (PGISp), a mouse model of AS, inflammation is the prerequisite for osteoproliferation as osteoproliferation was only observed following inflammation-driven intervertebral disc (IVD) destruction. We hypothesised that early intervention with a potent anti-inflammatory therapy would protect IVD integrity and consequently alter disease progression.MethodsPGISp mice received vehicle or a combination of etanercept (ETN) plus prednisolone (PRD) therapy for 2 or 6 weeks initiated at an early disease stage. Peripheral arthritis was scored longitudinally. Spinal disease was assessed using a semi-quantitative histological scoring regimen including inflammation, joint destruction and excessive tissue formation.ResultsETN + PRD therapy significantly delayed the onset of peripheral arthritis. IVD integrity was significantly protected when treatment was commenced in early disease. Six-weeks of treatment resulted in trends towards reductions in intervertebral joint damage and excessive tissue formation. IVD score distribution was dichotomized, likely reflecting the extent of axial disease at initiation of therapy. In the sub-group of mice with high IVD destruction scores, ETN + PRD treatment significantly reduced IVD destruction severity, inflammation and bone erosion and reduced cartilage damage and excessive tissue formation.ConclusionsEarly intervention with anti-inflammatory treatment not only improved inflammatory symptoms but also ameliorated structural damage of spine in PGISp mice. This preclinical observation suggests that early anti-inflammatory intervention may slow radiographic progression in AS patients.

Results from Polish Spondyloarthritis Initiative registry (PolSPI) - methodology and data from - the first year of observation.

ObjectivesReport on one-year results from the Polish Spondyloarthritis Initiative registry (PolSPI), containing the cross-sectional analysis of clinical and imaging data as well as database methodology.Material and methodsThe PolSPI registry includes patients with axial (axSpA) and peripheral (perSpA) spondyloarthritis according to ASAS classification criteria, and/or patients with ankylosing spondylitis according to modified New York criteria, psoriatic arthritis according to CASPAR criteria, arthropathy in inflammatory bowel disease, reactive arthritis, juvenile spondyloarthritis or undifferentiated spondyloarthritis. Epidemiologic data and history of signs, symptoms and treatment of spondyloarthritis are collected and assessment of disease activity is performed. Radiographic images of sacroiliac joint, cervical and lumbar spine, and results of bone densitometry are collected. Every 6 months blood samples for inflammatory markers, and for long-term storage are taken.ResultsDuring a one-year period from September 2015 to August 2016, 63 patients were registered on an electronic database; 44 (69.8%) of patients were classified as axial spondyloarthritis (axSpA) and 19 (30.2%) as peripheral spondyloarthritis (perSpA) according to ASAS criteria. Statistically significant differences between axSpA and perSpA were discovered in the percentage of HLA-B27 antigen occurrence (92.6% and 50%, respectively), BASDAI (2.8% and 4.1%, respectively), DAS 28 (2.66% and 4.03%, respectively), percentage of peripheral arthritis (20% and 88.8%, respectively), enthesitis (26.7% and 70.6%, respectively), dactylitis (6.7% and 88.9%, respectively), as well as extra-articular symptoms: acute anterior uveitis (26.7% and 5.6%, respectively) and psoriasis (6.9% and 55.6%, respectively). Patients with axSpA had significantly higher mean grade of sacroiliac involvement according to New York criteria, higher mSASSS score, and lower T-score in femoral neck in bone densitometry.ConclusionsAt the early stage of the disease patients with axSpA compared to those with perSpA, have more advanced structural damage of sacroiliac joints and spine, and lower bone mineral density in the femoral neck. In the upcoming years the PolSPI registry will prospectively follow-up patients with SpA, recording response to treatment and carrying out research on interaction of inflammation and bone remodelling.

Психоемоційний стан у молодих дорослих з ювенільним ідіопатичним артритом

Aim.&nbsp;To determine emotional state in adults with juvenile idiopathic arthritis (JIA) using questionnaires/ Material and Methods.&nbsp;Patients diagnosed with JIA (N=106) aged over 18 years were examined on the basis of the Alexander Municipal Clinical Hospital, Kyiv, Ukraine. The diagnosis was verified according to the classification criteria of the International League of the Association of Rheumatologists. The study did not include patients with organic pathology of the brain, encephalopathy associated with hypertension, diabetes mellitus, and chronic renal failure. Clinical examination included count of swollen and painful joints; count of joints requiring prosthetics in consequence of destructive changes; assessment of disease activity with regard to administered anti-rheumatic drugs; assessment of quality of life and health with the questionnaires SF-36, HAQ, PHQ-9; evaluation of anxiety by Beck and Hamilton (HAM-A) questionnaires; evaluation of depression by Beck questionnaire surveys and Chaban questionnaire on self-evaluation of anxiety and depression; and determining the social factors that appear to affect health. Results and Discussion.&nbsp;All patients were divided into two groups, depending on the need for prosthetic joints regardless of JIA clinical variants. Group I included 20 patients aged 24,20±8,7 years, with the need of one or more prosthetics joints as a result of JIA. The second group included 86 patients who did not require prosthetic joints, with mean age 23,18±6,18 years. In group I, a longer disease duration (p=0.025), more deformed joints (p&lt;0.001), more frequent cervical spine damage (p=0.015), arthritis of hands joints (p=0.008), lesions of tendons (p=0.037), more systemic manifestations of JIA (p=0.003), higher ESR (p=0.001) and DAS 28 (p&lt;0,0001) were found; &nbsp;they also received more aggressive therapy, including longer course of glucocorticoids (GC) (81.74 months) than the patients in group II (15.34 months) (p&lt;0.0001) and a higher cumulative dose of GC (p = 0.001). The patients' physical condition according to the SF-36 was 33,92±14,0 in &nbsp;group I vs 43,74±13,62 in group II, indicating a lower level of physical health (p&lt;0.001) and poorer functional status by HAQ (p=0.034). However, the patients' psychological health by the SF-36 did not differ in two groups (p=0.832), although the PHQ-9 questionnaire showed that the patients in group I revealed moderate severity depression (11,17±6,19) vs light ("subclinical") depression (6,4±6,02) in group II (p=0.019), which is also confirmed by the self-evaluation scale for depression, where a tendency towards depression was found in group I (9,0±6,39) compared to no signs of depression (4,5±3,98) in group II (p=0.018). According to the questionnaire on psychosomatic disorders, higher need for medical psychologist's consultation (8,5±6,35) was found in &nbsp;group I (p=0.013) than in group II (4,08±3,56). However, in anxiety assessment, the difference was not detected by any questionnaires in both groups of patients, although the anxiety level was higher in group I. Conclusions.&nbsp;Patients with JIA with destructive changes in the joints have higher tendency towards psycho-emotional disorders that require medical consultations of a psychologist or a &nbsp;psychosomatic medicine professional. Active and early treatment of JIA using modern methods, including biological therapy, allow to prevent destructive changes in the joints, that in its turn reduces psycho-emotional disorders in adult patients with JIA. Patients with aggressive destructive course of JIA need higher social adjustment, which causes a need to include medical psychologists in the team of doctors (along with rheumatologists, podiatrists, rehabilitation professionals, and ophthalmologists) who treat adults with JIA.&nbsp

The Prevalence of Brain and Neck Injuries in Patients with Maxillofacial Fractures in Teaching Hospitals of Rasht in 2016

This study aimed to determine the prevalence of brain and neck injuries in patients with maxillofacial fractures in teaching hospitals of the city of Rasht in 2016. This is an analytical retrospective study. Some 361 patients of the training centers of Rasht who had been diagnosed with maxillofacial fractures entered the study, 286 of which were male and 75 were female. Information was collected through questionnaires and patients’ records who admitted to Emergency Department of Poursina and Velayat Hospitals with maxillofacial fractures. The patients were examined to see whether they have brain and cervical spine injuries. The diagnosis of the fracture and brain and neck injuries had been separately written by the related doctors on the records of the patients based on clinical examination and Plain radiography and CT scans. After data collection, the results were analyzed. The results showed that 61 percent of the fractures were due to accidents. Among the most common spine damages, 77 percent were related to bone fractures. The highest frequency of brain damages was related to Extradural Hematoma by 23.65 percent. Results of the treatments also showed that 76% of the patients were partially recovered.

Digital tomosynthesis as a new diagnostic tool for evaluation of spine damage in patients with ankylosing spondylitis.

We aimed to compare digital tomosynthesis (DTS) with radiographs for the assessment of spinal bone damage in patients with ankylosing spondylitis (AS). The study comprised 68 patients with AS who underwent both DTS and radiographs of the cervical and lumbar spine on the same day. Spinal bone damage was assessed using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and the presence of facet joint damage. The Wilcoxon signed-rank test and McNemar's test were used to compare spinal bone damage between the two modalities. In 68 AS patients with mean 4.5years of disease duration, the mean mSASSS was 11.7±11.3 with radiographs and 13.1±11.5 with DTS (p=0.001). A grade 1 (erosion, sclerosis, or squaring) score in the mSASSS system was higher with DTS than with radiographs (p=0.001), but grade 2 (syndesmophyte) and grade 3 (bridge) scores (p>0.005 each) were not. In particular, the grade 1 score was higher with DTS than with radiographs at the cervicothoracic (p<0.001) and thoracolumbar (p=0.003) junctions. With regard to facet joint damage, erosion/sclerosis of facet joints was better depicted by DTS than by radiographs in the cervical (54.4 vs. 22.1%, p<0.001) and lumbar spine (72.1 vs. 11.8%, p<0.001). DTS depicted more subtle damage of spinal vertebrae in patients with AS than radiographs did. Moreover, erosion/sclerosis of facet joints was better detected with DTS than with radiographs.

Radiographic damage and progression of the cervical spine in ankylosing spondylitis patients treated with TNF-α inhibitors: Facet joints vs. vertebral bodies.

To investigate radiographic damage and 4-year progression of the cervical facet joints in a prospective observational cohort of AS patients treated with TNF-α inhibitors, to compare this with damage and progression of the cervical vertebral bodies, and to study the relation with patient characteristics and clinical outcome. Patients from the Groningen Leeuwarden AS (GLAS) cohort starting TNF-α inhibitors with baseline and 4-year radiographs were included. Cervical facet joints and vertebral bodies were scored by two independent readers according to the method of de Vlam and mSASSS, respectively. At baseline, 25 of 99 (25%) AS patients had partial or complete ankylosis of the cervical facet joints, whereas 51 (52%) patients had non-bridging or bridging syndesmophytes of cervical vertebral bodies. During 4 years, 13 (13%) patients developed new (partial) ankylosis of the facet joints, whereas 26 (26%) developed new (bridging) syndesmophytes. Facet joint damage and progression without involvement of the vertebral bodies were seen in 5 (5%) and 8 (8%) patients, respectively. Damage of facet joints was associated with longer disease duration, history of IBD/uveitis/psoriasis, higher disease activity, larger occiput-to-wall distance, higher mSASSS, and presence of syndesmophytes. Progression of the facet joints was associated with larger occiput-to-wall distance and more facet joint damage at baseline. Cervical facet joints were frequently involved in AS. During 4 years of TNF-α blocking therapy, 13% of the patients showed radiographic progression of cervical facet joints of which the majority did not show progression of vertebral bodies.

Effects of spine damage and microhabitat on resource allocation of the purple sea urchin Strongylocentrotus purpuratus (Stimpson 1857)

Though phenotypically plastic responses in echinoids are well studied, the majority of the literature examines the effect of altered diet. Some species, however, such as the purple sea urchin, Strongylocentrotus purpuratus, occur over a large geographic range and thus experience a variety of substrate types and wave forces. To determine whether these factors impact resource allocation in adult intertidal S. purpuratus, a laboratory experiment was conducted using two types of microhabitat based on extremes inhabited by sea urchins in the field (flat substratum vs. concave pit), and two levels of spine damage to simulate wave exposure (monthly clipping vs. control). A suite of measurements were taken to determine the effects of these two treatments including feeding and movement behavior, test morphometrics, demipyramid (jaw) allometry, spine growth cycles, and mass and stereological counts of gonad sections. When given the opportunity, sea urchins remained in their pits for the duration of the experiment, which limited their ability to feed. This behavioral response caused a decrease in weight and volumetric growth, and an increase in jaw growth relative to test growth. Sea urchins in pits also grew more spheroid in shape (increased height:diameter ratio), while those on flat substrates decreased in height:diameter ratio. Further, both males and females in pits showed altered gametogenesis. While spine damage did not affect test growth, sea urchins with clipped spines showed decreased gonad index and altered production of mature oocytes. Altogether, these results are congruent with the life history strategy of long living species like S. purpuratus, in that it spreads reproductive efforts over multiple seasons, while diverting resources toward repairing damage, acquiring suitable refuge, and maximizing attachment area. Therefore, microhabitat and spine damage, by impacting movement, feeding, growth, and reproductive output, likely have important indirect impacts on the intertidal community by way of altered sea urchin grazing rates and susceptibility and value to predators.

Multiple spinal curvatures in a captive African dwarf crocodile &lt;i&gt;Osteolaemus tetraspis&lt;/i&gt; (Cope, 1861)

A 4 year old African dwarf crocodile that had been domiciled at the Zoological Gardens, University of Ibadan for 2 years was presented with a history of anorexia of two weeks’ duration and reluctance to move for about a week prior to presentation. Physical examination revealed body curvatures and radiography was requested. Dorsoventral, ventrodorsal and left lateral views were done and these revealed multiple curvatures of the cervical, thoracic and caudal vertebrae. There appeared to be a generalized reduction in bone density although there were no visible fractures. There was a lateral compression of the right lung and a downward displacement of the cardiac silhouette. There were also several mineral opacities within the stomach which are suspected to be stones. Metabolic Bone Disease is a non-infectious disease common to reptiles in captivity. It is a consequence of improper diet and husbandry. A diet of flesh without bone or calcium supplements can cause an imbalance leading to the signs and symptoms seen. This can also be worsened by lack of, or insufficient, Vitamin D. It has severe effects in young animals as they require a higher nutritional plane to meet growth requirements. It is essential that reptiles in captivity receive calcium supplementation to maintain calcium: phosphorus balance and adequate exposure to sunlight or artificial ultraviolet light to encourage the synthesis of Vitamin D in the skin. These will prevent the production of parathyroid hormone which causes bone resorption and leads to swollen misshapen bones, fractures, twisting of the spine and kidney damage. Keywords: African dwarf crocodile, Metabolic bone disease, Radiography, Spinal curvatures

Integrity of Damage Control Posterior Spinal Fusion Constructs for Patients With Polytrauma: A Biomechanical Investigation.

Biomechanical. Evaluate spinal stability achieved with different levels of posterior percutaneous fixation (postPerc) for thoracolumbar fractures in cadavers subjected to ICU activities. "Spine damage control" involves postPerc performed within 24 hours of injury and staged, elective, definitive stabilization. Amount of instrumentation needed to initially achieve adequate spinal stability, minimize morbidity, and accommodate ICU care needs between stages are not defined. In full-unembalmed cadavers motion-tracking sensors were placed at T11 and L1. A T12 corpectomy with PLC injury was stabilized with 1, 2, and 3 levels of PostPerc above/below the injury. Motions between T11 and L1 were measured during Log-Roll and Sit-Up on an ICU bed. After in situ testing, anatomic spinal motion ranges were determined under pure moment loads. 5 cadavers were evaluated. For Log-Roll, 2 and 3 levels above/below restored stability to intact, whereas 1 level above/below did not for axial rotation. For translation, all instrumentation restored stability to intact. During Sit-Up, a linear increase in flexion was observed. At 45° Sit-Up, 2 and 3 levels above/below were similar to intact for flexion; 1 level above/below had significantly more flexion. All instrumentations restored translation to intact for Sit-Up; significantly more axial collapse occurred for instrumentation compared with intact. During ex situ testing, 2 and 3 levels above/below were similar; 1 level above/below had significantly greater laxity in flexion, extension, and axial rotation. Posterior instrumentation 2 or 3 levels above/below a severe thoracolumbar fracture model can restore spinal stability back to its intact condition. 2 levels of fixation above/below this "worst-case scenario" is minimum fixation sufficient to provide absolute spinal stability in the ICU setting as a "Damage Control" technique in patients with polytrauma. In less severe injury models, 1 level of fixation above/below may provide adequate spinal stability; although this should be confirmed in future investigations. N/A.

Limit of the available spine radiologic scoring methods in ankylosing spondylitis when the facet joint is the only structure involved

BackgroundAnkylosing spondylitis (AS) is a chronic inflammatory disease that affects the axial skeleton and can lead to complete ankylosis of the involved joint. Unfortunately, involvement of the facet joints (FJ) is not evaluated by the available scoring methods that are supposed to quantify the structural damage of the spine. Aim of the workThe aim of the present study we assessed is the involvement of FJ in Tunisian AS patients with low radiological score. Patients and methodsResults of 8 AS patients (7 men; 1 woman) with FJ involvement and low radiological scores were retrospectively studied. Their median age was 36years, age at onset 26 and disease duration of 10years. The Bath AS Radiology Index (BASRI) and the Stoke AS Spinal Score (SASSS) were calculated in all patients from the radiographs of lateral cervical spine, anteroposterior and lateral lumbar spine. ResultsAll patients had FJ ankylosis without involvement of the anterior part of the spine. Six patients (75%) had inflammatory back pain and 2 had bilateral hip pain with radiological involvement. Cervical spine limitation was noted in 4 patients. Limited lumbar spine mobility and bilateral sacroiliitis were present in all cases. The HLA-B27 typing was positive in 6/7 cases. Five patients had restrictive lung disease and 3 had osteoporosis. ConclusionInvolvement of FJ in AS may be the only sign of spine damage and may be responsible for functional impairment, however, it is not evaluated by the available radiographic scores which is an important limitation to their use.

A Novel Mechanism of Spine Damages in Stroke via DAPK1 and Tau.

Synaptic spine loss is one of the major preceding consequences of stroke damages, but its underlying molecular mechanisms remain unknown. Here, we report that a direct interaction of DAPK1 with Tau causes spine loss and subsequently neuronal death in a mouse model with stroke. We found that DAPK1 phosphorylates Tau protein at Ser262 (pS262) in cortical neurons of stroke mice. Either genetic deletion of DAPK1 kinase domain (KD) in mice (DAPK1-KD−/−) or blocking DAPK1-Tau interaction by systematic application of a membrane permeable peptide protects spine damages and improves neurological functions against stroke insults. Thus, disruption of DAPK1-Tau interaction is a promising strategy in clinical management of stroke.

Spinal cord Injury management: current procedures and the future

Background: The term ‘spinal cord injury’ refers to damage to the spinal cord from trauma, disease, or degeneration. Estimated annual global incidences are 40 to 80 cases per million population; and in Asia are between 6.7 and 246 per million population. In Iran, the prevalence is 4.4 per 10,000 and annual incidences are 98 per million men and 47 per million women. The average age at injury is 42.6 years. In many records, 80% of cases are men. Causes are motor vehicle accidents (36–48%), violence (5–29%), falls (17–21%), and recreational activities (7–16%). While 56.5% of injuries are complete and 43% are incomplete, usually in developing countries cervical spine damage and quadriplegia is common. In developed countries, 58.7% are paraplegic because of thoracolumbar events. After the initial trauma, the spinal cord undergoes chronological pathologic changes. Primary injury mechanical and secondary injury (cellular and molecular) develop vascular abnormalities, free radicals, lipid peroxidation, excitotoxicity, and electrolyte imbalances, necrotic and apoptotic cell death, and inflammatory/immunologic responses. Objectives: For managing a disease, at first it is necessary to know all available and possible methods, their pros and cons, and knowledge gaps. We sought to review treatment of spinal injuries. Materials and Methods: We downloaded and reviewed more than 170 full textbooks and articles in English from the literature PubMed, and Google scholar websites. Results: There is different in vivo and in vitro managements. The primary approach is to stop injury with surgery or molecular therapeutic interventions. Other procedures are removal of inhibition, compensation for demyelization, promotion of axonal regeneration, enhancing conduction, creation of bridges, rehabilitation and long-term follow-up, and replacement of cells, among others. Conclusions: Available data implies that restorative therapies should focus on multiple targets and different intervals after injury. Yet, if we understand the key and basic origin of the injury, we may develop effective, complete, safe, and continual procedures.

The correlation analysis of content of α-defensins of neutrophils 1-3 and cytokines in blood plasma of patients in acute and early periods of traumatic disease of spinal cord.

The technique of enzyme-linked immunosorbent assay was implemented to analyze in acute and early period of traumatic disease of spinal cord the content of human α-defensins of neutrophils 1-3 and pro- and anti-inflammatory cytokines in blood of 40 patients with complicated damages of cervical spine. The implemented comparative analysis established new correlations, characterizing systemic inflammatory response during post-traumatic period.

Role of Wnt/β-catenin signaling in the protective effect of epigallocatechin-3-gallate on lead-induced impairments of spine formation in the hippocampus of rats

Epigallocatechin-3-gallate (EGCG) may significantly reverse Pb-related spine damage in developing rats by increasing the expression of Wnt7a and the activity of the Wnt/β-catenin pathway.

Randomized Clinical Trial to Evaluate the Effect of Two Physical Therapy Programs in Musculoskeletal Dysfunction in Subjects with Sickle Cell Disease

Sickle cell disease is a genetic disease that results in sickling of red blood cells, triggering phenomena of vaso-occlusion, pain and organ damage. Bone involvement is the most common clinical manifestation, and may cause chronic and progressive disorders such as avascular necrosis of the femoral head and spine damage, which in turn leads to disturbances in gait and activity and function limitation due to pain. There are few studies in the literature on the role of physiotherapy as a resource capable of preventing and treating disorders of the locomotor system of sickle cell disease patients. The aim of this study was to evaluate and compare the effect of two physical therapy programs for patients with sickle cell disease to decrease musculoskeletal pain in the hip and lower back and increase the functionality of these patients. One of the programs was conventional physical therapy in the soil compared with a protocol of exercises performed in a swimming pool. The study began with an evaluation of the volunteers the from functional scales (Scale LEFS – Lower Extremity Functional Scale; Lequesne’s Algofunctional Questionnaire and Oswestry Disability Index), measuring the range of motion (ROM) in flexion and extension of the trunk, flexion, extension, adduction and abduction of the hip, the assessment of muscle strength (MS) of the trunk flexors and extensors, flexors, extensors, adductors and hip abductors through load cell and surface electromyography (SEMG) of iliocostalis, dorsal longissimus, gluteus maximus, gluteus medius and tensor fasciae latae. The final sample consisted of 10 volunteers, randomized to two different groups: aquatic physiotherapy (AP) and conventional physiotherapy (CP). The AP group was composed of five volunteers with a median age of 42 (25-67) years. The CP group consisted of five volunteers with a median age of 49 (43-59) years. After randomization, subjects from both groups underwent intervention for twelve week, with two sessions per week, totaling 24 sessions. At the end of the intervention, patients were reassessed for comparison of pre-and post-intervention results. For statistical analysis ANOVA was used for repeated measures with transformation stations. Significance was established at the 5% level (p<0.05). Both programs lead to statistically significant improvement after the intervention for the variables Lequesne index (p=0.0217), Oswestry Disability Index (p=0.0112), trunk extension ROM (p=0.0320), ROM trunk flexion (p=0,0459) and MS extension (p=0.0062) and abduction (p=0.0257) of the hip. The variables Scale LEFS, trunk flexion ROM, ROM of flexion, extension, adduction and hip abduction, extension of MS trunk, MS flexion and hip adduction and all SEMG variables showed no statistically significant difference. However no difference was detected between aquatic or conventional physiotherapy. These results suggest that physical therapy seems to be a resource capable of preventing and treating musculoskeletal dysfunctions of patients with sickle cell disease, regardless of the technique used.Keywords: Sickle cell disease, physical therapy, aquatic therapy. DisclosuresNo relevant conflicts of interest to declare.

Integrity of “Damage Control” Posterior Spinal Fixation Constructs for Polytrauma Patients in the ICU Setting: A Biomechanical Investigation

Spine damage control procedures involve an early limited posterior stabilization procedure performed during the first 24 hours, and later followed by definitive stabilization in a second stage when the patient is in a physiologically more stable status. Because these patients will experience minimal activity during this phase in the intensive care unit, less instrumentation may be adequate to stabilize the spine.