New Cases Of Spinal Cord Injury Research Articles

Effectiveness of Respiratory Proprioceptive Neuromuscular Facilitation Techniques on Pulmonary Functions in Patients with Spinal Cord Injury - A Pilot Study

Background: 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 which is a life threatening condition that carries a high risk of morbidity and mortality. The Incidence of SCI varies from 9.2 to 56.1 per million. In the Indian setup, Approx. 20,000 new cases of SCI are added every year. Spinal cord injury (SCI) patients are at increased risk of chronic respiratory symptoms as Respiratory muscle paralysis both restricts maximum inflation of the lungs and impair the ability to cough. Patients with tetraplegia have decreased chest wall and lung compliance, rib cage stiffness with paradoxical chest wall movements. Material and method: A Pilot study was carried out on 04 Traumatic Spinal cord injury patients. The purpose of the study was To find out effectiveness of respiratory PNF on pulmonary functions (FVC & FEV1) & Chest Expansion in patients with spinal cord injury. The pulmonary Functions (FVC & FEV1) and chest expansion was measured by using Spirometer (PFT machine) and inch tape. The data was analyzed using standard statistical software. Result: In this study After 4 weeks of Intervention there was Significant Improvement in Pulmonary Functions ( Pre Mean of FEV1 & FVC 0.99 L & 1.03L and Post Mean of FEV1 & FVC was 1.25 L & 1.35L respectively) and Chest Expansion (Pre Mean was 1.15 cm and Post Mean was 1.62 cm at Xiphoid Process Level). Conclusion: This Study concluded that Respiratory PNF increases Pulmonary Functions and chest expansion in Patients with Spinal Cord Injury after 4 weeks of Intervention. Keywords: Spinal Cord Injury, Forced Expiratory Volume (FEV1), Forced vital Capacity, Peak expiratory flow rate, Respiratory Proprioceptive Neuromuscular Facilitation Technique.

From disability to fatherhood: Journey of serving soldiers with spinal cord injury

BackgroundApart from neurological consequences, most distressing sequels of spinal cord injury (SCI) in men are erectile dysfunction, ejaculatory dysfunction and abnormal semen quality. Of these, ejaculatory dysfunction and poor semen parameters pose the biggest challenge to their biological fatherhood. Penile vibratory stimulation (PVS) and electroejaculation are first-line modalities for anejaculation, and surgical sperm retrieval (SSR) is adopted when other treatments fail. Sperms obtained using these techniques can be used for various fertility treatments for couples with spinal cord injured men. The aim of the study was to study the effectiveness of various modalities of sperm retrieval for assisted reproductive treatment in men with SCI. MethodsIt was a prospective observational study, wherein partners of 12 men with SCI presenting for subfertility underwent assisted reproduction after retrieving sperms via various modalities. The primary outcome was to assess efficacy of PVS in obtaining sperms and of SSR if PVS failed. The secondary outcome was to assess the pregnancy rate in their partners. ResultsPVS was successful in obtaining ejaculate in 7 of 12 men, and SSR was fruitful in 4 of 5 men. In vitro fertilization cycle for men who underwent PVS resulted in a pregnancy rate of 57.14% and 75% in couples for men who underwent SSR with an overall pregnancy rate of 58.33%. ConclusionWith new cases of SCI occurring primarily in young men at the peak of their reproductive health, it is imperative that medical professionals involved with reproductive health should be aware of the various modalities to help them achieve biological paternity.

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.

Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

SummaryBackgroundTraumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury.MethodsWe used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility.FindingsIn 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30–30·30 million) new cases of TBI and 0·93 million (0·78–1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331–412) per 100 000 population for TBI and 13 (11–16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40–57·62 million) and of SCI was 27·04 million (24·98–30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (−0·2% [–2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (−3·6% [–7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0–10·4 million) YLDs and SCI caused 9·5 million (6·7–12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82–141) per 100 000 for TBI and 130 (90–170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions.InterpretationTBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments.FundingBill & Melinda Gates Foundation.

Reproductive Health of Men with Spinal Cord Injury.

Most men with spinal cord injury (SCI) are infertile due to a combination of erectile dysfunction, ejaculatory dysfunction, and abnormal semen quality. This article addresses issues that should be considered when managing the reproductive health of men with SCI. The authors present recommendations based on their decades of experience in managing the reproductive health of more than 1,000 men with SCI. Men with SCI face obstacles when pursuing sexual activity and/or biologic fatherhood. Hypogonadism and premature symptoms of aging may interfere with sexual function. Erectile dysfunction is prevalent in the SCI population, and treatments for erectile dysfunction in the general population are also effective in the SCI population. Most men with SCI cannot ejaculate with sexual intercourse. The procedures of penile vibratory stimulation (PVS) and/or electroejaculation (EEJ) are effective in obtaining an ejaculate from 97% of men with SCI. The ejaculate often contains sufficient total motile sperm to consider the assisted conception procedures of intrauterine insemination or even intravaginal insemination at home. If PVS and/or EEJ fail, sperm may be retrieved surgically from the testis or epididymis. Surgical sperm retrieval typically yields enough motile sperm only for in vitro fertilization with intracytoplasmic sperm injection. The majority of new cases of SCI occur in young men at the peak of their reproductive health. With proper medical management, these men can expect to experience active sexual lives and biologic fatherhood, if these are their goals. Numerous tools are available to physicians for helping these patients reach their goals.

Acu-TENS might alleviate the dysfunction following spinal cord injury

Spinal cord injury (SCI) influences approximately 1000 individuals per million in the general population, and almost 12,000 newcases of SCI occur every year in theUnited States, which is a heavy social and economic burden for the society and involved families. A series of therapies exist for functional recovery following SCI, including surgery, prescription drugs, physical therapy, and supportive treatment. Acupuncture, which is based on traditional Chinese medicine theory, has been widely used for pain relief or neurological dysfunction in China. A recent systematic review demonstrated that the acupuncture treatment was beneficial for the functional recovery based on the motor American Spinal Injury Association scores and total Functional Independence Measure scores. Both basic research and clinical study have demonstrated the effect of acupuncture on SCI. The combination of implanted electroacupuncture electric stimulation and bone marrow-derived mesenchymal stromal cells transplantation obviously promotes functional improvements for animals with SCI, indicating that this combination method has the potential to treat SCI in humans. Electroacupuncture treatment may increase the expression of neurotrophin-3, and promote the cell number and differentiation of endogenous oligodendrocyte precursor cells, along with the functional improvement of demyelinated

Who are the women and men in Veterans Health Administrations current spinal cord injury population?

Spinal cord injury (SCI) care is a high priority for the Veterans Health Administration (VHA). Aging Veterans, new cases of SCI from recent conflicts, and increasing numbers of women Veterans have likely changed the profile of the VHA SCI population. This study characterizes the current Veteran population with SCI with emphasis on healthcare utilization and women Veterans. We analyzed VHA administrative data from 2002-2003 and 2007-2008, analyzing composition, demographics, and healthcare use. The population is mostly male (>97%) and largely between 45 and 64 years old. Over 30% are over the age of 65. They are frequent users of healthcare, with an average of 21 visits per year. Women Veterans with SCI form a small but distinct subpopulation, being younger and less likely to be married and having a higher burden of disease. We must understand how the VHA population with SCI is changing to anticipate and provide the best care for these complex patients.

Current Literature Review

Apart from neurological consequences, most distressing sequels of spinal cord injury (SCI) in men are erectile dysfunction, ejaculatory dysfunction and abnormal semen quality. Of these, ejaculatory dysfunction and poor semen parameters pose the biggest challenge to their biological fatherhood. Penile vibratory stimulation (PVS) and electroejaculation are first-line modalities for anejaculation, and surgical sperm retrieval (SSR) is adopted when other treatments fail. Sperms obtained using these techniques can be used for various fertility treatments for couples with spinal cord injured men. The aim of the study was to study the effectiveness of various modalities of sperm retrieval for assisted reproductive treatment in men with SCI.It was a prospective observational study, wherein partners of 12 men with SCI presenting for subfertility underwent assisted reproduction after retrieving sperms via various modalities. The primary outcome was to assess efficacy of PVS in obtaining sperms and of SSR if PVS failed. The secondary outcome was to assess the pregnancy rate in their partners.PVS was successful in obtaining ejaculate in 7 of 12 men, and SSR was fruitful in 4 of 5 men. In vitro fertilization cycle for men who underwent PVS resulted in a pregnancy rate of 57.14% and 75% in couples for men who underwent SSR with an overall pregnancy rate of 58.33%.With new cases of SCI occurring primarily in young men at the peak of their reproductive health, it is imperative that medical professionals involved with reproductive health should be aware of the various modalities to help them achieve biological paternity.

Epidemiology of Spinal Cord Injury In Chiloren And Adolescents

Objective: To describe the unique aspects of the epidemiology of pediatric-onset spinal cord injury (SCI).Methods: The characteristics of persans with SCI enrolled in either the Shriners Hospitals for Children SCI database or the National SCI Statistical Center database from 1 9 73 through 2002 were evaluated based on age at time of injury (0–5 years, 6–1 2 years, 13–15 years, 16–21 years, and 22 years and older).Results: Males comprised a consistently decreasing proportion of new cases of SCI, ranging from 83% among persans between 16 and 21 years of age to only 51% among those aged 0 to 5 years. Among children and adolescents (under the age of 22), the proportion of SCI due to motor vehicle crashes was higher than in adults (22+ years). Sports, violence, and medical or surgical complications also accounted for a significantly greater proportion ofSCI in teenagers (13–21 years) than in adults. Violence has become the leading cause ofSCI among African American and Hispanic teenage mal es (1 3–21 years), whereas vehicular crashes are more common among African American and Hispanic men of older ages (22 years of age and above). Approximately one third of new cases of SCI in the youngest two age groups (0–5 years, 6–12 years) had cervical injuries compared with almost one half in the older age groups (age 1 3 and above). SCI was much more likely tobe neurologically complete in younger persans (69% age 0–5 years vs 51% age ;:::: 16 years).Conclusion: The pediatric-onset SCI population is heterogeneaus and exhibits distinct epidemiologic characteristics both within the different pediatric age groups and with the adult-onset SCI population.

A nationwide epidemiological study of spinal cord injuries in Taiwan from July 1992 to June 1996

This prospective epidemiological survey of spinal cord injury (SCI) In Taiwan was carried out by recruiting patients attended by physicians from various medical centers and general hospitals all over Taiwan from july 1992 to june 1996. A total of 6,410 cases of traumatic spirtal fracture were registered among which were 1,586 new cases of SCI. The results represented 70% of the scope of SCI in Taiwan. The observed average annual incidence ofSCI in Taiwan was 18.8 per million population. The mean age was 46. 1 yearsold with a plateau distribution for over 20 years and older. Geriatric victims are a major group of SCI in Taiwan. The male to female ratio was 3 to 1. The leading causes of SCI were traffic accidents and accidental falls. Motorcycle collisions accounted for 62% of the traffic accidents, and as most of the motorcycle riders were not helmet users, head injüry became the major associated injury of SCI in Taiwan. The effectiveness of the comprehensive care system for SCI patients in Taiwan is relatively good, as reflected by the low rates of complications of SCI, the low mortality rate (6.6%), and the high percentage (67.4%) of SCI patients achieving self-care ultimately at home after rehabilitation. The analysis of person days healthy life loss and quality adjusted survival time revealed that SCI patients in Taiwan required 4 years to cope with the morbidity, and on average, could return to the main stream of life for another 30 years. [Neural Res 1997; 19: 617-622]

A nationwide epidemiological study of spinal cord injury in geriatric patients in Taiwan.

This prospective epidemiological survey of spinal cord injury (SCI) in Taiwan was carried out among patients attended by physicians from various medical centers and general hospitals all over Taiwan from July 1992 to June 1996. In all, 1,586 new cases of SCI were registered, representing about 70% of all possible SCI cases in Taiwan. The observed average annual incidence of SCI in Taiwan was 18.8 per million people, whereas it was 47.5 for the geriatric section. The mean age was 46.1 years with a plateau distribution after 20 years and older. Geriatric victims (297 cases, 18.7%, group II) formed a major section of SCI cases in Taiwan. Another group of younger SCI patients (15-64 years old, 1,232 cases, group I) was selected for comparison. The results showed that the male-to-female ratio, pattern of neurological deficits, and causes of injury and death of geriatric SCI patients differed significantly from those of the younger SCI group. Elderly women were exposed to a higher risk of SCI than younger women (M/F ratio 1.7:1). Falls were the leading cause of geriatric SCI, and two thirds of them occurred on level ground. Traffic accidents accounted for a third of SCI cases, half of which involved motorcycle accidents, a fifth of them pedestrians. Quadriplegia and quadriparesis occurred more frequently among elderly cases of SCI than in the younger group and a higher proportion of them died of SCI complications. Two thirds of elderly SCI patients recovered well enough after comprehensive treatment to be able to take care of themselves at home. The government should initiate programs of prevention to reduce the prevalence of geriatric SCI in Taiwan.