Influence of Previous Comorbidities and Common Complications on Motor Function after Early Surgical Treatment of Patients with Traumatic Spinal Cord Injury

Kreinest, Michael; Ludes, L; Biglari, Bahram; Küffer, Maike; Türk, Ansgar; Grützner, Paul Alfred; Matschke, Stefan

doi:10.1089/neu.2016.4416

Cited by 14 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is noteworthy that the researchers also indicated that VitD was a negative acute phase reactant, and post-SCI systematic inflammation might decrease the levels of plasma VDBP, which exacerbated VitD insufficiency ( 71 ). Thirdly, SCI patients usually develop multiple complications and comorbidities, such as skeletal diseases, chest illness, neurological sequela, venous thromboembolism, intestinal dysfunction, etc., which may directly result in the lack of VitD or change the lifestyle and affect the level of VitD secondarily ( 72 , 73 ). For example, persons with SCI are likely to develop pressure ulcers and dysregulation of intestinal microflora with significant diet change, which may affect VitD level synergically via impairing its food supply and absorption ( 42 , 74 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of vitamin D on the prognosis after spinal cord injury: A systematic review

Wang

Gan²,

Wu³

et al. 2023

Front. Nutr.

View full text Add to dashboard Cite

Vitamin D (VitD) insufficiency is a worldwide health problem and affects billions of people. Spinal cord injury (SCI) patients seem more susceptible to developing suboptimal levels of VitD. However, the literature regarding its impact on the prognosis of SCI is limited. Thus, in this review, we systematically investigated the published studies via a combination of keywords associated with SCI and VitD in four medical databases (Medline, Embase, Scopus, and Web of Science). All included studies were analyzed, and selected clinical data on the prevalence of VitD insufficiency (serum 25-hydroxyvitamin D < 30 ng/ml) and deficiency (serum 25-hydroxyvitamin D < 20 ng/ml) were collected for further meta-analysis via random effects. Through literature review, a total of 35 studies were eligible and included. The meta-analysis of VitD status (13 studies, 1,962 patients) indicated high prevalence of insufficiency (81.6% [75.7, 87.5]) and deficiency (52.5% [38.1, 66.9]) after SCI. Besides, low levels of VitD were reported to be associated with a higher risk of skeletal diseases, venous thromboembolism, psychoneurological syndromes, and chest illness after injury. Existing literature suggested that supplemental therapy might act as an adjuvant treatment to facilitate post-injury rehabilitation. Non-human experimental studies highlighted the neuroprotective effect of VitD, which was associated with enhancing axonal and neuronal survival, suppressing neuroinflammation, and modulating autophagy. Therefore, the current evidence suggests that the prevalence of VitD insufficiency is high in the SCI population, and low-level VitD may impair functional restoration after SCI. VitD supplemental treatment may have potential benefits to accelerate rehabilitation in mechanistically related processes after SCI. However, due to the limitation of the available evidence, more well-designed randomized controlled trials and mechanism experimental research are still needed to validate its therapeutic effect, elucidate its neuroprotective mechanism, and develop novel treatments.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of vitamin D on the prognosis after spinal cord injury: A systematic review

Wang

Gan²,

Wu³

et al. 2023

Front. Nutr.

View full text Add to dashboard Cite

show abstract

“…The treatment of SCI mainly relies on surgical operations and postoperative rehabilitation. However, the recovery of nerve function and the occurrence of complications are still unpredictable (Kreinest et al, 2016). During treatment, multiple system complications could occur, including respiratory failure, pneumonia, bedsores, urinary tract infection (UTI), thromboembolic diseases, and cardiovascular accidents (Maharaj et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Bioinformatic Analysis of the Proteome in Exosomes Derived From Plasma: Exosomes Involved in Cholesterol Metabolism Process of Patients With Spinal Cord Injury in the Acute Phase

et al. 2021

Front. Neuroinform.

View full text Add to dashboard Cite

Spinal cord injury (SCI) is a common but severe disease caused by traffic accidents. Coronary atherosclerotic heart disease (CHD) caused by dyslipidemia is known as the leading cause of death in patients with SCI. However, the quantitative analysis showed that the cholesterol and lipoprotein concentrations in peripheral blood (PB) did not change significantly within 48 h after SCI. Due to the presence of the Blood spinal cord barrier (BSCB), there are only few studies concerning the plasma cholesterol metabolism in the acute phase of SCI. Exosomes have a smaller particle size, which enables them relatively less limitation of BSCB. This study uses exosomes derived from the plasma of 43 patients in the acute phase of SCI and 71 patients in the control group as samples. MS proteomics and bioinformatics analysis found 590 quantifiable proteins, in which 75 proteins were upregulated and 153 proteins were downregulated, and the top 10 differentially expressed proteins are those including downregulating proteins: HIST1H4A, HIST2H3A, HIST2H2BE, HCLS1, S100A9, HIST1H2BM, S100A8, CALM3, YWHAH, and SFN, and upregulating proteins: SERPIND1, C1QB, SPTLC3, IGHV4-28, C4A, IGHV4-38-2, IGHV4-30-2, SLC15A1, C4B, and ACTG2. Enrichment analysis showed that the largest part of proteins was related to cholesterol metabolism among the downregulated proteins. The main components of cholesterol [ApoB-48 and ApoB-100 increased, ApoA-I, ApoA-II, ApoA-IV, ApoC, ApoE, and Apo(a) decreased] were changed in exosomes derived from plasma of patients. ELISA analysis showed that some components were disordered in the acute phase of SCI. These results suggested that the exosomes might be involved in cholesterol metabolism regulation in the acute phase of SCI.

show abstract

“…[ 21 ] In a study of early posterior laminectomy decompression for tSCI (perhaps not extensive decompression), Kreinest reported that pulmonary infection (30.8%) was the most common complication after urinary tract infection (57.9%). [ 22 ] In this study, one potential reason for the reduced rate of respiratory complications may be early extensive decompression leading to early respiratory muscle function recovery, simultaneously avoiding tissue edema and expectoration obstruction caused by tracheal traction in surgery with an anterior approach.…”

Section: Discussionmentioning

confidence: 99%

Influence of early extensive posterior decompression on hyponatremia and cardiopulmonary dysfunction after severe traumatic cervical spinal cord injury

Yang

Wang²,

Xu³

et al. 2020

Medicine

View full text Add to dashboard Cite

Retrospective single institution observational study. The aim of the present study was to analyze the influence of early extensive posterior decompression on complications in patients with severe traumatic cervical spinal cord injury (tcSCI). Cervical SCI is associated with a high prevalence of hyponatremia and cardiopulmonary dysfunction. However, very few studies have focused on this exploration to reduce the incidence of SCI early complications. We reviewed the medical records of consecutive patients undergoing extensive posterior decompression within 24 h for severe tcSCI (American Spinal Injury Association Impairment Scale [AIS] A to C) admitted between January 2009 and January 2018. The data collected retrospectively included age, gender, mechanism, and level of SCI, AIS grade, fracture or dislocation, electrolyte, and cardiopulmonary complications. Of the 97 enrolled patients, the baseline AIS grade was AIS A in 14, AIS B in 31, and AIS C in 52. Improvement of at least two AIS grades was found in 26 (26.8%), and improvement of at least one grade was found in 80.4% of patients at discharge. Twenty-nine (29.9%) patients had mild hyponatremia, 8 (8.2%) had moderate hyponatremia, and 3 (3.1%) had severe hyponatremia during hospitalization. The incidences of hyponatremia, hypotension, and tracheotomy were 41.2%, 13.4%, and 6.2%, respectively. The mean forced vital capacity (FVC) on admission and at discharge was 1.34 ± 0.46 L and 2.21 ± 0.41 L ( P < .0001), respectively. Five patients developed pneumonia. Our results suggest that early expansive posterior decompression significantly reduces the incidence of hyponatremia, hypotension, and tracheotomy by promoting recovery of spinal cord function after severe tcSCI.

show abstract

Influence of Previous Comorbidities and Common Complications on Motor Function after Early Surgical Treatment of Patients with Traumatic Spinal Cord Injury

Cited by 14 publications

References 18 publications

Impact of vitamin D on the prognosis after spinal cord injury: A systematic review

Impact of vitamin D on the prognosis after spinal cord injury: A systematic review

Bioinformatic Analysis of the Proteome in Exosomes Derived From Plasma: Exosomes Involved in Cholesterol Metabolism Process of Patients With Spinal Cord Injury in the Acute Phase

Influence of early extensive posterior decompression on hyponatremia and cardiopulmonary dysfunction after severe traumatic cervical spinal cord injury

Contact Info

Product

Resources

About