Systemic Complications of Spinal Cord Injury

Sweis, Rochelle; Biller, José

doi:10.1007/s11910-017-0715-4

Cited by 89 publications

(37 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TSCI is a multisystem disease that impairs ventilation and causes pulmonary infections (from diaphragmatic or intercostal muscle paralysis), bradycardia and hypotension (from damage to sympathetic cord pathways), as well as decubitus ulcers and deep venous thrombosis (from immobility) [11]. Patients with cervical or upper thoracic TSCI are generally admitted in intensive care units (ICUs) where there is wide variability in their management.…”

Section: Anesthetic and Medicalmentioning

confidence: 99%

Targeted Perfusion Therapy in Spinal Cord Trauma

Saadoun

Papadopoulos

2020

Neurotherapeutics

View full text Add to dashboard Cite

We review state-of-the-art monitoring techniques for acute, severe traumatic spinal cord injury (TSCI) to facilitate targeted perfusion of the injured cord rather than applying universal mean arterial pressure targets. Key concepts are discussed such as intraspinal pressure and spinal cord perfusion pressure (SCPP) at the injury site, respectively, analogous to intracranial pressure and cerebral perfusion pressure for traumatic brain injury. The concept of spinal cord autoregulation is introduced and quantified using spinal pressure reactivity index (sPRx), which is analogous to pressure reactivity index for traumatic brain injury. The Ushaped relationship between sPRx and SCPP defines the optimum SCPP as the SCPP that minimizes sPRx (i.e., maximizes autoregulation), and suggests that not only ischemia but also hyperemia at the injury site may be detrimental. The observation that optimum SCPP varies between patients and temporally in each patient supports individualized management. We discuss multimodality monitoring, which revealed strong correlations between SCPP and injury site metabolism (tissue glucose, lactate, pyruvate, glutamate, glycerol), monitored by surface microdialysis. Evidence is presented that the dura is a major, but unappreciated, cause of spinal cord compression after TSCI; we thus propose expansion duroplasty as a novel treatment. Monitoring spinal cord blood flow at the injury site has revealed novel phenomena, e.g., 3 distinct blood flow patterns, local steal, and diastolic ischemia. We conclude that monitoring from the injured spinal cord in the intensive care unit is a safe technique that appears to enable optimized and individualized spinal cord perfusion.

show abstract

Section: Anesthetic and Medicalmentioning

confidence: 99%

Targeted Perfusion Therapy in Spinal Cord Trauma

Saadoun

Papadopoulos

2020

Neurotherapeutics

View full text Add to dashboard Cite

show abstract

“…Although no clear definition for autonomic dysreflexia (AD) exists, it is described as a conglomeration of symptoms including headache, skin flushing, stuffy nose, diaphoresis, generalized feelings of unwellness and uncontrolled hypertension. [24][25][26][27] It is generally accepted that a sudden dangerous rise in blood pressure is the major symptom of autonomic dysreflexia to be avoided. To this end, all subjects at risk for AD received 20 mg of nifedipine sublingually 10-15 min before beginning their procedure.…”

Section: Methods Of Penile Vibratory Stimulation In Scimentioning

confidence: 99%

Comparison of three methods of penile vibratory stimulation for semen retrieval in men with spinal cord injury

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Life expectancy ranges from approximately 9 to 35 years for patients suffering an injury at the age of 40, up to 20 to 53 years for patients suffering an injury at the age of 20, depending on the level of injury and the extent of neurological damage. That leads to many years of disability at a decreased overall health status [47,48], increased burden on their families and social environment [49], and greatly increased private and public health care costs and living expenses [46,50].…”

Section: Spinal Cord Injurymentioning

confidence: 99%

Converging Robotic Technologies in Targeted Neural Rehabilitation: A Review of Emerging Solutions and Challenges

Nizamis

Athanasiou

Almpani

et al. 2021

Sensors

View full text Add to dashboard Cite

Recent advances in the field of neural rehabilitation, facilitated through technological innovation and improved neurophysiological knowledge of impaired motor control, have opened up new research directions. Such advances increase the relevance of existing interventions, as well as allow novel methodologies and technological synergies. New approaches attempt to partially overcome long-term disability caused by spinal cord injury, using either invasive bridging technologies or noninvasive human–machine interfaces. Muscular dystrophies benefit from electromyography and novel sensors that shed light on underlying neuromotor mechanisms in people with Duchenne. Novel wearable robotics devices are being tailored to specific patient populations, such as traumatic brain injury, stroke, and amputated individuals. In addition, developments in robot-assisted rehabilitation may enhance motor learning and generate movement repetitions by decoding the brain activity of patients during therapy. This is further facilitated by artificial intelligence algorithms coupled with faster electronics. The practical impact of integrating such technologies with neural rehabilitation treatment can be substantial. They can potentially empower nontechnically trained individuals—namely, family members and professional carers—to alter the programming of neural rehabilitation robotic setups, to actively get involved and intervene promptly at the point of care. This narrative review considers existing and emerging neural rehabilitation technologies through the perspective of replacing or restoring functions, enhancing, or improving natural neural output, as well as promoting or recruiting dormant neuroplasticity. Upon conclusion, we discuss the future directions for neural rehabilitation research, diagnosis, and treatment based on the discussed technologies and their major roadblocks. This future may eventually become possible through technological evolution and convergence of mutually beneficial technologies to create hybrid solutions.

show abstract

Systemic Complications of Spinal Cord Injury

Cited by 89 publications

References 19 publications

Targeted Perfusion Therapy in Spinal Cord Trauma

Targeted Perfusion Therapy in Spinal Cord Trauma

Comparison of three methods of penile vibratory stimulation for semen retrieval in men with spinal cord injury

Converging Robotic Technologies in Targeted Neural Rehabilitation: A Review of Emerging Solutions and Challenges

Contact Info

Product

Resources

About