The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia

Frankel, H L; Hancock, Darrell; Hyslop, George H.; Melzak, J; Michaëlis, L.S.; Ungar, G H; Vernon, Jordyn; Walsh, John J.

doi:10.1038/sc.1969.30

Cited by 1,710 publications

(924 citation statements)

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“…For all patients we determined the level of the spinal cord lesion as the most caudally normally functioning spinal cord segment at injury, and the functional level (Frankel or functional class) 16 at the latest follow-up. To facilitate the analysis of the in¯uence of neuro- n : number who answered the particular question in the stated group (SCI or NOR).…”

Section: Methods and Populationsmentioning

confidence: 99%

“…In Table 3 The total spinal cord injured population of 601 divided by gender, age at injury in years, cause of injury, neurological level at injury and functional class (Frankel) at last follow-up, 16 for responders to 1st and 2nd mailing, non-responders, and those who were dead at the time of the investigation Sleep disturbances in SCI F Biering-Sùrensen and M Biering-Sùrensen general the SCI-population did smoke signi®cantly (P50.00005) more than the normal population, in whom 34% were smoking (unknown for two).…”

Section: Basic Questionsmentioning

confidence: 99%

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Sleep disturbances in the spinal cord injured: an epidemiological questionnaire investigation, including a normal population

2001

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Study design: Epidemiological review. Objective: To evaluate sleep disturbances in the spinal cord injured. Setting: The Clinic for Para-and Tetraplegia, Hornbñk/Copenhagen, Copenhagen University hospital, Denmark. Methods: All patients admitted with traumatic SCI during the 20-year period 1968 ± 1987 were reviewed. The normal population consisted of 339, 222 men and 117 women. These groups were asked to ®ll in the self-administered Nordic Sleep Questionnaire (NSQ) containing 21 questions. Questions were added regarding employment, smoking, alcohol, co ee or tea consumption, height and weight. The questionnaire for SCI individuals included questions about bladder emptying method, mobility, and spasms. For the SCI population age at injury, cause of injury, neurological level, and functional class were retrieved. Results: Four hundred and eight SCI individuals, 331 men and 77 women, answered the NSQ corresponding to a response rate of 83.8%. Forty-seven per cent had a cervical cord lesion and about half of the population had a complete motor lesion. In comparison with the normal population the SCI individuals had greater di culty in falling asleep, described more frequent awakenings, slept subjectively less well, were more often prescribed sleeping pills, slept more hours, took more and longer naps, and snored more and for more years. In particular, spasms, pain, paraesthesia, and troubles with voiding were claimed to be part of the sleep problems. Conclusion: In spite of the same average age and a higher body mass index in the normal than the SCI population, the SCI individuals showed signi®cantly more sleep problems than the normal population. Spinal Cord (2001) 39, 505 ± 513

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Section: Methods and Populationsmentioning

confidence: 99%

Section: Basic Questionsmentioning

confidence: 99%

Sleep disturbances in the spinal cord injured: an epidemiological questionnaire investigation, including a normal population

2001

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“…The extent of invasion was evaluated by Enneking classification, which is the staging system for GCT of the extremities16. The neurological status was evaluated by Frankel classification preoperatively and postoperatively17. The recurrence of SGCT was diagnosed by clinical and radiological presentation, and part of them were further confirmed by surgery or puncture biopsy.…”

Section: Methodsmentioning

confidence: 99%

Recurrence of Giant Cell Tumor of the Spine after Resection: A Report of 10 Cases

Lin

Teng

et al. 2018

Orthopaedic Surgery

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ObjectiveTo review the clinical details and further treatments for recurrent spinal giant cell tumors (SGCT), and to analyze the risk factors of recurrence and shed new light on the treatment options and prognosis of recurrent SGCT.MethodsA retrospective analysis of recurrent SGCT between April 2003 and January 2014 was performed. A total of 10 patients comprising 3 men and 7 women with a mean age of 28.9 years (range, 21–40 years) were included in the study. All complete clinical data, radiographs, CT, MRI, scans and pathological data were reviewed. The tumor locations and the regions involved were evaluated by CT and MRI. The blood supply of the tumors was evaluated by enhanced CT and MRI. The mean follow‐up was 81.3 months (range, 35.7–172.1 months).ResultsAll patients had Enneking stage 3 tumors; 9 (90%) of them had different extents of spinal canal involvement in the primary time period. All patients underwent intralesional resection during their first surgery. Only 1 patient received local adjuvant treatments; no patient underwent selective arterial embolization or used denosumab at that time. Only 1 patient underwent adjuvant radiotherapy postoperatively, and another patient used bisphosphonates. After recurrence, 1 patient was cured using denosumab, and 2 patients' disease was controlled through use of other medical treatments or adjuvant treatments. There were 3 repeated recurrences and 7 repeated surgical procedures were performed in 5 patients. There were 6 intralesional excisions and 1 decompression surgery. The mean relapse‐free time after the first surgery was 32.3 months (range, 10.5–62.6 months). The overall mean relapse‐free time was 40.2 months (range, 10.5–157 months). No distant metastasis was found in our series. At the final follow‐up, 4 patients were disease free, 3 patients' disease was under control, 2 has progressive disease aggravation, while 1 patient died as a result of progression of disease 133.9 months after first surgery.ConclusionIntralesional excision for recurrent spinal giant cell tumors is an effective option that may have satisfactory prognosis. However, the excision and the inactivation of the lesion should be carried out carefully and thoroughly without missing any corners. Early diagnosis of recurrence may be associated with better prognosis. Adjuvant treatments perioperatively and systemic medical treatments can decrease recurrence rates and can have therapeutic effects in the recurrent SGCT.

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“…Clinical information from patient files included: age, gender, mechanism of injury, clinical examination findings, and the Frankel grading [8] of neurological deficit.…”

Section: Methodsmentioning

confidence: 99%

AO-classification of thoracic and lumbar fractures—reproducibility utilizing radiographs and clinical information

Kriek

Govender

2005

Eur Spine J

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This study was designed to assess the inter-observer reliability and intra-observer reproducibility of standard radiographic evaluation of 150 thoraco-lumbar fractures using the AO-classification. The influence of clinical information on agreement levels was also evaluated. Six observers (two junior and four senior residents) evaluated the radiographic images. The injuries were classified by each observer as either type A, B or C according to the AOclassification system and the levels of agreement were documented. After 3 months the injuries were again classified with the addition of the clinical findings of each patient and the level of agreement evaluated. The level of agreement was measured using Cohen's j-test. The overall inter-observer agreement was rated as fair (0.291) in the first session and moderate (0.403) in the second. Intra-observer values ranged from slight (0.181) to moderate (0.488). The increased level of agreement in the second session was attributed to the value of additional clinical information, the learning curve of the junior residents and the simplicity of the classification.

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The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia

Cited by 1,710 publications

References 4 publications

Sleep disturbances in the spinal cord injured: an epidemiological questionnaire investigation, including a normal population

Sleep disturbances in the spinal cord injured: an epidemiological questionnaire investigation, including a normal population

Recurrence of Giant Cell Tumor of the Spine after Resection: A Report of 10 Cases

AO-classification of thoracic and lumbar fractures—reproducibility utilizing radiographs and clinical information

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