Traumatic and Nontraumatic Spinal Cord Injuries

Ge, Laurence; Arul, Karan; Ikpeze, Tochukwu; Baldwin, Avionna; Nickels, Jean L.; Mesfin, Addisu

doi:10.1016/j.wneu.2017.12.008

Cited by 70 publications

(49 citation statements)

References 25 publications

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“… 2 , 8 Unsurprisingly, mortality in the cord infarct patients is greater than that of the overall SCI population. 11 …”

Section: Discussionmentioning

confidence: 99%

“… 9 , 10 Cord injuries of both traumatic and nontraumatic etiologies are anticipated to increase. 11 , 12 Risk factors for spinal cord infarcts are undoubtedly changing as well, as the prevalence of abdominal aortic aneurysm (AAA) in patients older than 65 years and in particular those with a cigarette smoking history have increased. 13 There has also been an increase in both elective and rupture repair in the elderly population.…”

Section: Introductionmentioning

confidence: 99%

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Etiology and Outcomes of Spinal Cord Infarct: A Case Series From a Level 1 Trauma Center

Arul

Stoner

et al. 2019

Global Spine Journal

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Study Design: Retrospective study. Objectives: To evaluate the demographics, prevalence, etiology, severity, and outcomes of spinal cord injuries (SCIs) resulting from ischemic infarction. Methods: All patients with SCI and a diagnosis of cord infarct who were admitted to the inpatient rehabilitation unit at a level 1 trauma center from January 2003 to January 2014 were identified using an administrative billing database. Outcomes measures were evaluated. Results: Among 685 unique SCI patients who were identified, 30 (4.4%) had SCI due to spinal ischemic infarction. The mean age was 59 years (range 17-80 years). Fifty percent of patients had ASIA (American Spinal Injury Association) A and B severity. Most common causes were the following: 6 (20%) abdominal aortic aneurysm (AAA) repairs, 6 (20%) arteriovenous fistulas, and 6 (20%) with an unknown cause. Surgical complications led to 4 (13.3%) cord infarcts and was associated with a higher severity of injury ( P = .02) compared with other etiologies. Other causes included systemic hypotension, AAA rupture, trauma, diabetic ketoacidosis, and after radiation therapy. At follow-up, 6 (20%) of patients were able to ambulate normally without assistance, 7 (23.3%) were ambulating with assistance, and 17 (56.7%) were still wheelchair bound. Clinical improvement in ambulatory status was noted in 6 (20%) patients and was associated with less severe initial injury ( P = .02). Conclusions: While the existing literature associates spinal cord infarction with aortic pathologies and surgery, these caused less than 30% of cases, while nonaortic surgical complications were associated with the most severe injuries. Outcomes were worse than previously reported in the literature.

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“… 2 , 8 Unsurprisingly, mortality in the cord infarct patients is greater than that of the overall SCI population. 11 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Etiology and Outcomes of Spinal Cord Infarct: A Case Series From a Level 1 Trauma Center

Arul

Stoner

et al. 2019

Global Spine Journal

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“…These may in turn lead to movement disorders, serious complications, and a high mortality rate during both acute and chronic stages of SCI [3]. Almost 17,500 new SCI occur in the United States each year [4].…”

Section: Introductionmentioning

confidence: 99%

“…The mechanisms of these injuries may be traumatic or nontraumatic [4]. The three most common causes of traumatic SCI are transportation (especially road traffic crashes), falls, and violence (including self-harm), respectively.…”

Section: Introductionmentioning

confidence: 99%

Traumatic Spinal Cord Injuries Due to Motor Vehicle Accidents

Andalib

Mohtasham-Amiri

Yousefzadeh-Chabok

et al. 2019

Iran. J. Neurosurg.

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Background and Aim: Spine trauma is an important health problem. Traumatic Spinal Cord Injury (SCI) due to Motor Vehicle Accident (MVA) might have a different epidemiologic pattern in Guilan province of Iran owing to its geographical characteristics. Therefore, the present study was conducted to the study epidemiology of SCI injuries due to road accidents in a trauma referral center in Guilan. Methods and Materials/Patients: In this cross-sectional study, we used data SCI registry of Poursina Hospital. All the patients with spine trauma, due to MVA, hospitalized in the trauma center of Poursina Hospital, Rasht, Guilan, Iran between March 2015 and March 2018 were studied. Results: A total of 127 patients with spine trauma due to MVA were reviewed. The Mean±SD age of patients was 38.27±16.22 years. We observed that 93.7%, 1.6%, and 4.7% of the patients had initial Glasgow Comma Scale (GCS ≥13, 9 ≤GCS ≤12, and GCS<9, respectively). SCIs were found several anatomical regions including cervical (n=54, 42.5%), lumbar (n=39, 30.7%), thoracic (n=23, 18.1%), thoracic and lumbar (n=7, 5.5%), thoracic and cervical (n=3, 2.4%), and lumbar and cervical (n=1, 0.8%) regions. Evaluated by Glasgow Outcome Scale (GOS), good recovery, moderate disability, severe disability, vegetative state, and death were found in 114(91.2%), 4 (3.1%), 4(3.1%), 1(0.8%), 2(1.6%) of the patients, respectively. Two patients were discharged by their personal contest. Conclusion: Spine trauma due to MVA is mostly seen in the young. SCI due to such trauma is mostly found in the cervical region. Good recovery was seen in most of the subjects.

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“…В более чем половине случаев позвоночно-спинномозговая травма (ПСМТ) возникает вследствие дорожно-транспортных происшествий. Другими распространенными причинами являются падения (25%), огнестрельные ранения (15%) и спортивные травмы (10%) [7]. Пожилые люди более склонны к травматическому повреждению СМ при воздействии травмирующего фактора низкой интенсивности.…”

Section: Introductionunclassified

The classifications of subaxial cervical spine traumatic injuries. Part 1. General principles

2019

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http://theunj.org patients with spinal cord injury determine the progressively increasing costs for medical and social life support expenses. A large number of experimental and clinical studies, improvement of methods for surgical correction and stabilization of the damaged vertebral motor segment undoubtedly dictate certain changes in the tactics of treatment. The classification of traumatic spinal injuries is of key importance in determining the approaches, timing and volume of surgical intervention. Following the care algorithms helps to minimize the negative effects of traumatic damage to both the spine and the spinal cord and contributes to the maximum possible recovery of neurological functions. The last few decades have been characterized by the gradual replacement of the previously widely used "morphological" classifications of traumatic injuries of the cervical spine to "clinical" ones, based on an analysis of some heterogeneous factors determining treatment tactics. The first part of the review deals with a detailed description of the main criteria used in developing modern "clinical" classifications of subaxial cervical spine traumatic injuries. Besides, modern views on imaging methods and algorithms for determining the need to perform diagnostic procedures at primary hospitalization in patients with suspected cervical spine traumatic injury are presented.

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Traumatic and Nontraumatic Spinal Cord Injuries

Cited by 70 publications

References 25 publications

Etiology and Outcomes of Spinal Cord Infarct: A Case Series From a Level 1 Trauma Center

Etiology and Outcomes of Spinal Cord Infarct: A Case Series From a Level 1 Trauma Center

Traumatic Spinal Cord Injuries Due to Motor Vehicle Accidents

The classifications of subaxial cervical spine traumatic injuries. Part 1. General principles

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