Lack of justification for routine abdominal ultrasonography in patients with chronic spinal cord injury

Abstract

Little evidence-based research is available to indicate which procedures should routinely be performed for screening exams in patients with spinal cord injuries (SCIs). It had been the procedure to routinely perform abdominal ultrasonography on a yearly basis at our medical center. Therefore, we conducted a retrospective study to determine whether the repetition of these procedures resulted in detection of any pathology warranting treatment that otherwise would have gone undetected. The electronic records of 174 individuals were reviewed, along with a total of 359 abdominal ultrasounds and exams. High incidences of abnormal findings were found in the liver, pancreas, spleen, gallbladder, and kidney; however, no specific interventions were noted solely on the basis of the ultrasound findings. Moreover, no added benefits could be documented through the performance of repetitive exams. We recommend that further evidence-based studies be performed to ascertain the benefits of performance of routine procedures in patients with SCIs.

Ultrasound findings of the urinary tract in patients with spinal cord injury: a study of 1005 cases

“…4 Early diagnosis is important because hydronephrosis can lead to renal insufficiency or kidney damage especially if it is obvious and left untreated. 7,16 No case of hydronephrosis was reported by Sipski et al 2 In the present study, the incidence of hydronephrosis was 5.4%, which is consistent with the finding of Tins et al 3 (5%) and Edokpolo et al 7 (6%). The majority of cases were of mild hydronephrosis (74.5%).…”

“…Therefore, early detection and appropriate treatment of possible further complications is important to prevent upper urinary tract deterioration, which is associated with increased morbidity, and premature mortality. [1][2][3] It is well known that patients with SCI have an increased risk of urinary calculi compared with the general population with a higher chance of recurrence. 5,[10][11][12] Calculi formation is likely multifactorial with multiple lithogenic factors.…”

“…LUT dysfunction can cause a variety of long-term deleterious complications including urinary tract infections, calculus disease, morphological alterations of the bladder and urethra, vesicoureteral reflux, hydronephrosis, bladder carcinoma and renal failure. [1][2][3][4][5] The principle aim of managing LUT dysfunction is the prevention of complications and preservation of upper urinary tract function. 1,[6][7][8] Therefore, these patients need life-long urological assessment at regular intervals to minimize urinary tract-associated morbidity.…”

Spinal Cord Injury Causes Chronic Liver Pathology in Rats

“…In one study, > 70% of patients with SCI had abnormal liver changes, including fatty infiltration and/or parenchymal liver disease. 18 Other data show that hepatitis or cirrhosis is *7-fold higher in those with SCI compared with the general population. 39 Thus, SCI appears to place a person at increased risk for liver dysfunction and its associated metabolic problems.…”

Effects of Embryonic Neural Stem Cell Transplantation on DNA Damage in the Brain and Spinal Cord Following Spinal Cord Injury

“…This phenomenon may be due to moderation of vascular abnormalities, decreases in the levels of free radicals, intensification of lipid peroxidation and excitotoxicity, smoothing of electrolyte imbalances, and limitation of necrotic and apoptotic cell death, as well as due to inflammation-related immunologic responses. The absence of decreases in the liver, heart, and spleen samples, as compared with the chronic groups, may be due to systemic infections, especially urinary tract infections [35].…”