Prevalence Of Spinal Cord Injury Research Articles

Protective effects of 1,2-benzisoxazole-3-methanesulfonamide (zonisamide)- loaded polymeric micelles against neurotoxicity in spinal cord: In vitro

The incidence and prevalence of spinal cord injury (SCI) as a high disabling injury have enc ouraged the researchers to find some therapeutic strategies. The spinal cord is highly sensitive to oxidative stress and maintaining homeostasis is essential for redox status in neurons. Therefore, in this study. On the other hand, the application of drugs can induce some unwanted effects on the viability of neurons. Therefore, in this study, 1,2-benzisoxazole-3-methanesulfonamide (zonisamide) as a second-generation antiepileptic drug was formulated by micelles and characterized by TEM and DLS techniques. Afterward the protective effects of 1,2-benzisoxazole-3-methanesulfonamide-loaded micelles against stimulated oxidative stress and cytotoxicity were assessed by MTT, ROS, staining and enzyme activity assays. It was shown that the fabricated 1,2-benzisoxazole-3-methanesulfonamide-loaded micelles with a size of about 60–90 nm have a good colloidal stability and show a sustained drug release at physiological pH. Furthermore, it was determined that the neuroprotective effects of 1,2-benzisoxazole-3-methanesulfonamide-loaded micelles against cytotoxicity, ROS production, morphological changes, caspase-3 activation triggered by H2O2 was more pronounced than non-formulated drug. In conclusion, this study may provide useful information regarding the advancement of therapeutic approach for treatment of SCI.

Burden of Neurological Disorders Across the US From 1990-2017

Accurate and up-to-date estimates on incidence, prevalence, mortality, and disability-adjusted life-years (burden) of neurological disorders are the backbone of evidence-based health care planning and resource allocation for these disorders. It appears that no such estimates have been reported at the state level for the US. To present burden estimates of major neurological disorders in the US states by age and sex from 1990 to 2017. This is a systematic analysis of the Global Burden of Disease (GBD) 2017 study. Data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of major neurological disorders were derived from the GBD 2017 study of the 48 contiguous US states, Alaska, and Hawaii. Fourteen major neurological disorders were analyzed: stroke, Alzheimer disease and other dementias, Parkinson disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, traumatic brain injury, spinal cord injuries, brain and other nervous system cancers, meningitis, encephalitis, and tetanus. Any of the 14 listed neurological diseases. Absolute numbers in detail by age and sex and age-standardized rates (with 95% uncertainty intervals) were calculated. The 3 most burdensome neurological disorders in the US in terms of absolute number of DALYs were stroke (3.58 [95% uncertainty interval [UI], 3.25-3.92] million DALYs), Alzheimer disease and other dementias (2.55 [95% UI, 2.43-2.68] million DALYs), and migraine (2.40 [95% UI, 1.53-3.44] million DALYs). The burden of almost all neurological disorders (in terms of absolute number of incident, prevalent, and fatal cases, as well as DALYs) increased from 1990 to 2017, largely because of the aging of the population. Exceptions for this trend included traumatic brain injury incidence (-29.1% [95% UI, -32.4% to -25.8%]); spinal cord injury prevalence (-38.5% [95% UI, -43.1% to -34.0%]); meningitis prevalence (-44.8% [95% UI, -47.3% to -42.3%]), deaths (-64.4% [95% UI, -67.7% to -50.3%]), and DALYs (-66.9% [95% UI, -70.1% to -55.9%]); and encephalitis DALYs (-25.8% [95% UI, -30.7% to -5.8%]). The different metrics of age-standardized rates varied between the US states from a 1.2-fold difference for tension-type headache to 7.5-fold for tetanus; southeastern states and Arkansas had a relatively higher burden for stroke, while northern states had a relatively higher burden of multiple sclerosis and eastern states had higher rates of Parkinson disease, idiopathic epilepsy, migraine and tension-type headache, and meningitis, encephalitis, and tetanus. There is a large and increasing burden of noncommunicable neurological disorders in the US, with up to a 5-fold variation in the burden of and trends in particular neurological disorders across the US states. The information reported in this article can be used by health care professionals and policy makers at the national and state levels to advance their health care planning and resource allocation to prevent and reduce the burden of neurological disorders.

Early and mid-term outcome of frozen elephant trunk using spinal cord protective perfusion strategy for acute type A aortic dissection

ObjectiveThis study aimed to evaluate the prevalence of spinal cord injury in total arch replacement with frozen elephant trunk for acute type A aortic dissection using our spinal cord protection technique.MethodsBetween January 2013 and December 2017, 33 patients underwent total arch replacement with frozen elephant trunk for acute type A aortic dissection (mean age 67.9 ± 13.3 years). Our spinal cord protection technique involved maintaining extracorporeal circulation through the left subclavian artery in all procedures, using aortic occlusion balloon during distal anastomosis, and inserting frozen elephant trunk above Th 8 with transesophageal echocardiographic guidance. Computed tomography was performed within 1–2 weeks, 12 months, and 36 months postoperatively. We compared the degree of thrombosis of the descending aorta between preoperation and early postoperative period by Fisher’s exact test. Moreover, we evaluated postoperative mortality and mobility (including spinal cord injury) at follow-up.ResultsThe operative mortality within 30 days was 6.1%. Neither paraplegia nor paraparesis was noted. We observed significant thrombosis of the false lumen at the distal arch and aortic valve level of the descending aorta in postoperative early term period (p < 0.01). At mid-term follow-up (mean 33.9 months), survival probability and 3-year freedom from reoperation rates were 93.9 ± 4.1% and 95.0 ± 4.9%, respectively.ConclusionsThe frozen elephant trunk technique with our spinal protection strategy provides good postoperative outcomes. Our strategy can maintain spinal cord perfusion without complete ischemia time even during lower body ischemia time. Implementation of our spinal protection strategy will help prevent spinal cord injury and dilated downstream aorta.

The prevalence of spinal cord injury in young adults in Brazil

Introduction: Spinal cord injury (MRT) is a traumatic external injury that compromises or not the function of the spinal cord or nerve roots. In Brazil it is estimated that about 40 new cases per year per million inhabitants occur. OBJECTIVES: To compare scientific publications through an integrative review, related to the prevalence of MRT in young adults in Brazil. Methodology: This is an integrative review based on articles from LILACS (Latin American and Caribbean Literature in Health Sciences) and SCIELO (Scientific Electronic Library Online), published from 2007 to 2017. It was built in the following phases: 1) problem formulation 2) data collection 3) data evaluation 4) analysis and interpretation 5) presentation of results. Results and Discussion: It was observed that the articles found that deal with spinal cord trauma, point to the prevalence of MRT in an age group that picks up from childhood the old age being more recurrent in young male adults. The results reveal that accidents involving cervical trauma are more frequent in the age group of 20- to 30-year-old males. It has also been observed in state hospitals that TRM injuries generate a longer time of hospitalization and, consequently, an increase in hospitalization costs. The main etiologies of TRM were falls and traffic accidents with cars and motorcycles. Conclusion: It is extremely important to educate the population about the risks of TRM through health education, as well as the creation of preventive campaigns both to reduce the occurrence of traffic accidents and to reduce the incidence of falls.

Ligaments disruption: a new perspective in the prognosis of spinal cord injury.

Ligaments disruption: a new perspective in the prognosis of spinal cord injury.

Tensile Failure Properties of the Perinatal, Neonatal, and Pediatric Cadaveric Cervical Spine

Biomechanical tensile testing of perinatal, neonatal, and pediatric cadaveric cervical spines to failure. To assess the tensile failure properties of the cervical spine from birth to adulthood. Pediatric cervical spine biomechanical studies have been few due to the limited availability of pediatric cadavers. Therefore, scaled data based on human adult and juvenile animal studies have been used to augment the limited pediatric cadaver data. Despite these efforts, substantial uncertainty remains in our understanding of pediatric cervical spine biomechanics. A total of 24 cadaveric osteoligamentous head-neck complexes, 20 weeks gestation to 18 years, were sectioned into segments (occiput-C2 [O-C2], C4-C5, and C6-C7) and tested in tension to determine axial stiffness, displacement at failure, and load-to-failure. Tensile stiffness-to-failure (N/mm) increased by age (O-C2: 23-fold, neonate: 22 ± 7, 18 yr: 504; C4-C5: 7-fold, neonate: 71 ± 14, 18 yr: 509; C6-C7: 7-fold, neonate: 64 ± 17, 18 yr: 456). Load-to-failure (N) increased by age (O-C2: 13-fold, neonate: 228 ± 40, 18 yr: 2888; C4-C5: 9-fold, neonate: 207 ± 63, 18 yr: 1831; C6-C7: 10-fold, neonate: 174 ± 41, 18 yr: 1720). Normalized displacement at failure (mm/mm) decreased by age (O-C2: 6-fold, neonate: 0.34 ± 0.076, 18 yr: 0.059; C4-C5: 3-fold, neonate: 0.092 ± 0.015, 18 yr: 0.035; C6-C7: 2-fold, neonate: 0.088 ± 0.019, 18 yr: 0.037). Cervical spine tensile stiffness-to-failure and load-to-failure increased nonlinearly, whereas normalized displacement at failure decreased nonlinearly, from birth to adulthood. Pronounced ligamentous laxity observed at younger ages in the O-C2 segment quantitatively supports the prevalence of spinal cord injury without radiographic abnormality in the pediatric population. This study provides important and previously unavailable data for validating pediatric cervical spine models, for evaluating current scaling techniques and animal surrogate models, and for the development of more biofidelic pediatric crash test dummies.

Incidence and Prevalence of Spinal Cord Injury in Canada: A National Perspective

Background: Despite decades of research, there are no national estimates of the incidence or prevalence of spinal cord injury (SCI) in Canada. Our objective was to utilize the best available data to estimate the incidence and prevalence of traumatic SCI (TSCI) and non-traumatic SCI (NTSCI) in Canada for 2010. Methods: Initial incidence (number of TSCIs at injury scene) and discharge incidence (number discharged into the community) were calculated using published TSCI rates from Alberta and NTSCI rates from Australia. Prevalence was estimated by applying TSCI and NTSCI discharge incidence rates to historical Canadian population demographics using a cohort survival model and age-specific mortality rates for tetraplegia and paraplegia. Results: The estimated 2010 initial incidence of TSCI is 1,785 cases per year, and the discharge incidence is 1,389 (41 per million). The estimated discharge incidence for NTSCI is 2,286 cases (68 per million). The prevalence of SCI in Canada is estimated to be 85,556 persons (51% TSCI and 49% NTSCI). Conclusions: This study provides the first estimates of the incidence and prevalence of SCI in Canada. More population-based studies are needed, particularly for NTSCI, as an increasing number of Canadians are expected to be affected by SCI.

Concomitant Traumatic Spinal Cord and Brachial Plexus Injuries: Do They Affect Outcome?

Commentary Rhee et al. should be congratulated on their effort to describe the prevalence of spinal cord injury in their cohort of patients who were referred to their tertiary care center with brachial plexus injuries. The 12.2% prevalence rate in their study is significantly greater than the 2% to 5% prevalence rate previously reported. Their description of associated findings, such as supraclavicular vascular injury, cervical spine fracture, Horner syndrome, or phrenic nerve dysfunction, will help to define which patients have the greatest risk for having a combination of both injuries. They describe in detail how this may affect the outcomes of treatment in patients with combined injuries. There remains a very important question on this topic, which this paper does not answer. This study cohort contains a very heterogeneous group of spinal cord injuries. The authors take great pains to rigorously classify the nature of the spinal cord injury as definitive, probable, or possible. Yet out of thirty-one patients with combined injuries, only eight had identifiable spinal cord injury patterns. As described, the remaining twenty-three subjects had spinal cord injuries of unclear clinical significance. The authors defined “major” clinical evidence of spinal cord injury as a neurologic deficit such as motor, sensory, or sphincter dysfunction on the basis of the history and/or the physical examination. No distinction was made between patients with transient neurological symptoms at the time of injury versus permanent or prolonged neurological deficit. Of twelve subjects with “major” clinical evidence, five had only neurological symptoms in the extremity affected by the brachial plexus injury, but with imaging findings consistent with spinal cord injury. The authors do not explain how they differentiated the neurological deficit that was related to the spinal cord injury from the neurological deficit that was related to the brachial plexus injury in this subgroup. Another eleven subjects had “minor” clinical findings only, such as upper motor neuron signs on clinical examination, and imaging consistent with spinal cord injury. Out of thirty-one patients with combined injuries, only twenty-two had advanced imaging available; that imaging showed increased T2 signal intensity in the spinal cord in nineteen patients, and epidural or subdural hematoma, or both, in three. The authors discuss the significance of Brown-Séquard syndrome on the reconstruction outcomes of patients with brachial plexus injuries. What is not clear is whether the much more subtle spinal cord injuries described in this paper have any long-term impact on the outcome of treatment for the brachial plexus injury. The authors suggest that the presence of a transient neurological deficit at the time of injury or the presence of isolated upper motor neuron findings with increased signal intensity on magnetic resonance imaging (both scenarios that the authors would have defined as definite or probable spinal cord injuries) may result in worse outcomes at the time of reconstruction some months after injury. Without outcomes data, this supposition is unconvincing. Hopefully, the authors will continue to publish their outcomes data from their impressive clinical experience, which may allow them to answer this critical question.

The Epidemiology of Geriatric Spinal Cord Injury

The incidence and prevalence of spinal cord injury (SCI) in the geriatric population are increasing. Current estimates suggest that the annual incidence of spinal cord injury (SCI) in the geriatric (≯65 years of age) population is 67.9/million with a prevalence as high as 116.3/million. This results in significant morbidity, mortality, and socioeconomic consequences. This review examines epidemiological factors associated with SCI in the elderly. The most common scenario is a fall, causing a cervical incomplete cord injury, in patients with preexisting degenerative changes. This typically causes a central cord syndrome. Risk factors are biological, behavioral, environmental, and socioeconomic. Although there is no significant difference in neurological recovery between older and younger SCI groups, older patients exhibit significantly less functional recovery.

The Epidemiology of Geriatric Spinal Cord Injury

The incidence and prevalence of spinal cord injury (SCI) in the geriatric population are increasing. Current estimates suggest that the annual incidence of spinal cord injury (SCI) in the geriatric (≯65 years of age) population is 67.9/million with a prevalence as high as 116.3/million. This results in significant morbidity, mortality, and socioeconomic consequences. This review examines epidemiological factors associated with SCI in the elderly. The most common scenario is a fall, causing a cervical incomplete cord injury, in patients with preexisting degenerative changes. This typically causes a central cord syndrome. Risk factors are biological, behavioral, environmental, and socioeconomic. Although there is no significant difference in neurological recovery between older and younger SCI groups, older patients exhibit significantly less functional recovery.

Neurologic Injury in the Surgical Treatment of Idiopathic Scoliosis: Guidelines for Assessment and Management

Iatrogenic spinal cord injury resulting from surgical treatment of spinal deformity is a relatively uncommon but devastating complication. Publications on the prevalence of spinal cord injury following surgery are numerous, but no definitive review with clinically pertinent treatment guidelines exists. Methods to reduce the risk of neurologic complications with scoliosis surgery include adequate patient evaluation and preoperative planning, intraoperative preparation, intraoperative neuromonitoring, and postoperative management. Treatment algorithms may be useful in the clinical setting to manage intraoperative or postoperative neurologic injury.

Prevalence of Spinal Cord Injury in Tehran, Iran

Background/Objective: To determine the prevalence of traumatic spinal cord injury (SCI) in Tehran, Iran.Methods: A population-based study was performed. In a random cluster sampling, 100 addresses were selected as the starting point of the survey for each cluster consisting of 25 households. To expand the geographic dimension of each cluster, the interviewers skipped 3 of 4 houses in gathering data for each study unit. Each person with traumatic SCI was evaluated initially by a nurse and then by a neurosurgeon by physical examination and spinal imaging at the hospital or at home.Results: Ninety-seven percent of all surveyed agreed to participate in the study (2,425 households, or 9,006 persons). Four cases of SCI were identified. The point prevalence of SCI was 4.4 [95% CI = 1.2-11.4] per 10,000 people. Over the 5-year period from January 2003 through January 2008, the reported incidence rate of SCI was 2.2 (95% Cl = 0.27-8.00) per 10,000 people.Conclusions: In this, the first published population-based study from Iran, the prevalence of traumatic SCI in Tehran ranged from 1.2 to 11.4 per 10,000 people. More research is required to determine the patterns and causes of SCI. Development of a nationwide SCI registry or surveillance system is fundamental to an understanding of the epidemiology, and hence the prevention, of this costly health problem.

Prevalence of spinal cord injury in Helsinki

Retrospective register-based epidemiological study. To estimate the prevalence rate of persons with spinal cord injury (SCI) with special reference to ASIA Impairment Grade A-D. Helsinki, Finland. Cases were identified using the registers of the Kapyla Rehabilitation Centre, Helsinki University Central Hospital and the local organization for the disabled. Local health centres were informed about the study, residential service houses were contacted, and announcements were published in patient magazines. A regional population was found to have a prevalence rate of 28/100,000 inhabitants with SCI (ASIA Impairment Scale A-D). The prevalence rate in this study is consistent with the data published in other Nordic countries. The Finnish Cultural Foundation.

Prevalence of spinal cord injury in Australia.

Cohort study, based on cases of spinal cord injury (SCI) that occurred between 1986 and 1997 (n=2959). To estimate prevalence historically, currently and into the future. Australia. Prevalence was estimated on the basis of (1) historical data concerning survival and the relationship between the incidence of fatalities and SCI, (2) information on SCI incidence and survival 1986-1997, and (3) forecasts of incidence and population growth from 1997 to 2021 and consideration of survival. It was estimated that the prevalence of SCI in Australia was in the range 8096-9614 cases by 1985. By 1997, this had increased to nearly 10,000 and the prevalence rate was more than 681 per million of population. By 2021, this could increase to nearly 12,000 if age-specific SCI incidence rates continued at average values evident over the period 1986-1997 and national population projections applied. In addition, there would be more elderly SCI cases due to the ageing of the national population. The prevalent population could be reduced to less than 7000 if the incidence rate was reduced by -3% p.a. The prevalence of SCI in Australia has increased and it will continue to increase unless measures are taken to control incidence. The case mix will change due to the ageing of the population, and treatment services will need to be prepared for a larger and more elderly prevalent population. It was suggested that consideration should be given to a national health and welfare goal to reduce the SCI incidence rate by -3% p.a., focusing in particular on the prevention of transport crashes and falls.

Epidemiology of Cervical Spinal Cord Injury

Spinal cord injury has a devastating effect on patients, families, and society that is out of proportion to the relatively small numbers of individuals affected. The study of the epidemiology of spinal cord injury is essential to understanding this impact. This article will focus on the incidence and prevalence of spinal cord injury. Societal factors such as ethnic group, age of injury, marital status, occupational status, and discharge placement will be addressed. In addition, etiology of spinal cord injury, neurological level of injury, associated injuries, life expectancy, and lifetime costs will be addressed.

Spinal Cord Injury in the Australian Agricultural Work Force

While it has long been recognized that working in the agricultural industries isassociated with an exacerbated risk of injury, the extent of the additional risk is not wellunderstood. This current research investigated the incidence and prevalence of spinalcord injury (SCI) in a defined population and calculated the additional risk of sufferinga SCI associated with working in the agricultural industries as well as the additionalrisk associated with suffering a SCI that is work-related. Through the analysis of allnew traumatic spinal cord injuries between 1990 and 1996 in southeastern Australia, itwas found that those working in the agricultural industry were at more than six timesgreater risk of suffering a SCI than were the remainder of the population. Whenagricultural workers risk of SCI was compared with the risk of those employed in otherindustries, it was found that they were at approximately five times greater risk. Further,agricultural workers odds of suffering work-related SCI was more than twice that ofthose who worked in industries other than agriculture. Based on these findings it wasconcluded that those employed in the agricultural industries are not only a group inneed of primary intervention services, but they are also in need of secondary andtertiary interventions to allow them to return to a productive life following injury.

Surveillance of traumatic spinal cord injury in Australia: the identification of information needs.

Monitoring the occurrence of disease through any surveillance program necessarily requires the expenditure of scarce resources. The type of information accessible through surveillance and how it may be obtained deserve careful consideration in order to justify these costs. Therefore before establishing a new system of surveillance it is advisable to ascertain the information needs of potential users and to determine the feasibility of developing a system to meet them. As part of the planning for a national traumatic spinal cord injury surveillance system in Australia these data were sought by conducting a survey of key informants in 1993. The planning and evaluation of health care services, a knowledge of spinal cord injury epidemiology and its sequelae, injury prevention, external demands for information, and facilitation of research, were identified as the most important needs for information. It has been shown that the prevalence of spinal cord injury in Australia is increasing. As this occurs the need for specialised health services will also rise. Therefore, to facilitate the rational planning of services, and to monitor the well-being of the Australian spinal cord injured population, accurate surveillance data are essential.

A model for estimating spinal cord injury prevalence in the United States

A model was developed to provide a tool to forecast demographic trends in populations of people with traumatic spinal cord injury at the national and state level. This information is critical to planning for the allocation and distribution of resources to care for people with spinal cord injury. The literature on incidence, mortality, and prevalence of spinal cord injury in the United States was reviewed and reported values were evaluated for incorporation into the model. A linear relationship between age specific survival rates of the spinal cord injury population, and expected survival rates in the absence of spinal cord injury was established and this provided the basis for projections using age cohort survival methodology. The model's projections indicate a need for future expansion of capacity to treat traumatic spinal cord injury in the private sector, and a need to prepare for an aging disabled population. The annual number of traumatic spinal cord injury cases admitted to hospitals is projected to increase from approximately 11,500 in 1994 to almost 13,400 in 2010. Age adjusted post-hospitalization incidence rate in 1994 is estimated at approximately 38 per million (23 per million for females and 55 per million for males). A 20% increase in the US spinal cord injury prevalence can be expected over the next 10 years, going from approximately 207,000 estimated in 1994, to 247,000. During this time, the veteran segment, which currently comprises 22% of the spinal cord injury population, is projected to decline.(ABSTRACT TRUNCATED AT 250 WORDS)

Respiratory Complications and Management of Spinal Cord Injuries

Acute spinal cord injury is a devastating event occurring in the United States at a rate of 28 to 50 injuries per million persons per year. 1 Kraus JF Epidemiological aspects of acute spinal cord injury: a review of incidence, prevalence, causes, and outcome. in: Becker DP Povlishock JT Central nervous system trauma status report—1985. National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, M1985: 313-322 Google Scholar Presently, there are more than 200,000 cases of spinal cord injury in the United States. 2 DeVivo MJ Fine PR Maetz HM Stover SL Prevalence of spinal cord injury: a reestimation employing life table techniques. Arch Neurol. 1980; 37: 707-708 Crossref PubMed Scopus (97) Google Scholar Most injuries are related to motor vehicle, athletic, or industrial accidents. Pulmonary complications are the leading cause of death, with most respiratory deaths attributed to pneumonia. 3 Carter RE Respiratory aspects of spinal cord injury management. Paraplegia. 1987; 25: 262-266 Crossref PubMed Scopus (72) Google Scholar Because new advances in the respiratory system consequences of spinal cord injury have recently been reported, a review of this topic seems in order.

Spinal cord injury in the United States: a statistical update.

Major sources of data on incidence and prevalence of spinal cord injury (SCI) in the United States were reviewed, including many federal government agencies, state level rehabilitation and health departments, regional SCI systems, private voluntary organizations, available literature, and several unpublished studies. With the exception of the Veterans Administration, many of the federal databases did not prove helpful. For example, the estimates of the annual surveys conducted by the National Center for Health Statistics (NCHS) of traumatic SCI are likely to be inflated due to multiple hospital admissions of the same patient and deflated due to misclassification of SCI. The tendency for inflation and deflation, however, may balance each other, resulting in a rough estimate of annual traumatic SCI incidence of about 11,000 for 1984. Data from the Florida and Virginia Central Registries of SCI suggest a decrease in traumatic SCI incidence in recent years. Based on data abstracted from a regional study, the California Disability Survey, we estimate the prevalence of traumatic SCI to be about 238,000 in the United States for 1984.