Spinal Cord Series and Cases最新文献

{"title":"Abdominal functional electrical stimulation and binder to reduce orthostatic hypotension in individuals with a subacute spinal cord injury.","authors":"Chiettha Prajnadewie, Lynn Blecher, Keith Md McNaughton, Claire L Boswell-Ruys, Billy L Luu, Harrison T Finn, Elizabeth A Bye, Bonsan B Lee, Jane E Butler, Anne E Palermo, Euan J McCaughey","doi":"10.1038/s41394-026-00757-x","DOIUrl":"https://doi.org/10.1038/s41394-026-00757-x","url":null,"abstract":"<p><strong>Study design: </strong>Repeated measures comparative study.</p><p><strong>Objectives: </strong>Compare acute effects of 4 treatment conditions: (i) abdominal binder (Binder), (ii) abdominal functional electrical stimulation (AFES), (iii) AFES and binder (AFES-Binder), and (iv) no intervention (Control), on signs of orthostatic hypotension (OH) and blood pressure (BP) maintenance in individuals with acute and subacute spinal cord injury (SCI).</p><p><strong>Setting: </strong>Spinal injury inpatient ward.</p><p><strong>Methods: </strong>Eleven participants with SCI (C3-T5) with at least one sign or symptom of OH underwent a passive sit-up test on 4 days with the 4 treatment conditions. Non-invasive continuous recordings of systolic BP, diastolic BP and calculated mean arterial pressure (MAP) were measured during 4 periods: (1) supine without treatment (5 min); (2) supine with treatment (5 min); (3) upright with treatment (up to 15 min); and (4) supine post-treatment (10 min).</p><p><strong>Results: </strong>Largest drops in BP still resulted in OH in all conditions (p < 0.001), with the largest instantaneous change in MAP in the Binder condition (-41 mmHg [95% CI, -47 to -34]). AFES-Binder condition maintained mean upright MAP relative to supine (-1 mmHg [95% CI, -5 to 2], p = 0.291). Mean upright MAP decreased in all other conditions [Control: (-4 mmHg [95% CI, -7 to -1], p = 0.002); Binder: (-7 mmHg [-10 to -4], p < 0.001); AFES: (-6 mmHg [95% CI, -9 to -2], p < 0.001)]. Mean upright MAP was highest in the AFES-Binder condition.</p><p><strong>Conclusions: </strong>No single treatment condition prevented OH completely. While AFES with abdominal binder does not eliminate OH, it shows potential to mitigate BP instability during postural transitions in acute and subacute SCI.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery to treat autonomic dysreflexia due to cubital tunnel syndrome in cervical spinal cord injury: a case report.","authors":"Kevin He, Brian Chin, Jonah P Orr, Lucas Rohrer, Ida K Fox","doi":"10.1038/s41394-026-00750-4","DOIUrl":"10.1038/s41394-026-00750-4","url":null,"abstract":"<p><strong>Introduction: </strong>Autonomic dysreflexia (AD) is a potentially fatal syndrome in people with spinal cord injury (SCI) marked by episodic hypertension with flushing, diaphoresis, and bradycardia. Common etiologies include bladder distension and bowel impaction. Compressive neuropathies lack attention as a potential precipitant of AD. This report describes an individual with cervical SCI and with recurrent AD treated with ulnar nerve decompression surgery.</p><p><strong>Case presentation: </strong>A 74-year-old woman with a remote history of C6 SCI (American Spinal Injury Association Impairment Scale Grade B) presented to clinic with recurrent episodes of AD that had been refractory to standard treatment measures. History and clinical examination were suggestive of ulnar nerve compressive neuropathy at the elbow - cubital tunnel syndrome. The diagnosis was confirmed with electrodiagnostic studies and neuromuscular ultrasound. Treatment with surgery successfully resolved her episodes of AD.</p><p><strong>Discussion: </strong>This case identifies compressive neuropathy as a treatable cause of AD in individuals with cervical SCI. When more common etiologies of AD are excluded, clinicians should consider compressive peripheral neuropathies as potential causes of AD. Surgical decompression may alleviate symptoms of AD in select cases. Further research should investigate the prevalence and optimal management of compressive neuropathy in people with SCI.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and neurological profiling of vertebral tumors in Mexico: a five-year review from a tertiary referral center.","authors":"Rogelio J Solano-Pérez, Yuridia Fombona-Hernández, Rafael Juárez-Torres, Juan E Ciprés-Aguilar, Rubén A Amaya-Zepeda, Isela B Negrete-Calzada, Hannia F González-Morales, José D Carrillo-Ruiz","doi":"10.1038/s41394-026-00755-z","DOIUrl":"https://doi.org/10.1038/s41394-026-00755-z","url":null,"abstract":"<p><strong>Study design: </strong>Observational, descriptive and retrospective study.</p><p><strong>Objectives: </strong>This article's objective is to analyze the epidemiological characteristics, anatomical distribution, and functional status of persons with vertebral tumors treated at a tertiary care center in an emerging country between 2019 and 2023.</p><p><strong>Settings: </strong>January 1, 2019, to December 31, 2023 (5 years), at the Department of Peripheric Nerve, Traumatology and Orthopedic Hospital \"Dr. Victorio de la Fuente Narváez\", Mexico City, Mexico.</p><p><strong>Methods: </strong>It was conducted an observational descriptive and retrospective study analyzing 358 persons with confirmed vertebral tumors. All cases were evaluated using the ASIA/ISCoS International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) worksheet at admission. Histopathological diagnosis, anatomical location, healthcare level at diagnosis, and ASIA Impairment Scale (AIS) were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Of the 358 cases analyzed, 88% were malignant lesions, with metastatic tumors-especially from breast, prostate, and kidney-being the most common. The thoracic spine was the most frequently affected region (47.2%). AIS D (moderate motor deficit) was the most prevalent classification (46.6%). Emergency department diagnoses increased over the study period, from 24.4% in 2019 to 57% in 2023, while referrals from primary and secondary care declined. Malignant tumors predominated in persons aged 41-80, while benign tumors were more frequent in younger persons.</p><p><strong>Conclusions: </strong>Most vertebral tumors were diagnosed at advanced stages and in emergency settings, suggesting a need to improve early detection and referral systems. Enhanced training and integration across healthcare levels are essential to optimize outcomes in individuals with vertebral tumors in resource-limited settings.</p><p><strong>Sponsorship: </strong>No funding sources influenced the design, execution, or interpretation of the research presented in this article.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of continuous passive motion in alleviating neuropathic pain in people with spinal cord injury: a pilot study.","authors":"Won Jae Cho, Hyung-Ik Shin, Min-Yong Lee","doi":"10.1038/s41394-026-00754-0","DOIUrl":"10.1038/s41394-026-00754-0","url":null,"abstract":"<p><strong>Study design: </strong>Single-arm prospective pilot study.</p><p><strong>Objectives: </strong>Chronic neuropathic pain (NP) following spinal cord injury (SCI) is often refractory to standard treatments. Sensorimotor activity has been proposed to counteract maladaptive plasticity associated with NP. This pilot study explored whether continuous passive motion (CPM) may have analgesic effects on chronic below-level NP in people with SCI.</p><p><strong>Setting: </strong>Incheon Workers' Compensation Hospital, South Korea.</p><p><strong>Methods: </strong>A total of 15 inpatients with chronic SCI and below-level NP underwent 10 sessions of knee CPM (60 minutes/day) over 2 weeks. Clinical assessments were performed at baseline (T1), immediately post-intervention (T2), and at a 1-week follow-up (T3). The primary outcome was below-level NP intensity measured using the Numeric Rating Scale (NRS). Secondary outcomes included the Neuropathic Pain Symptom Inventory (NPSI), Short-form McGill Pain Questionnaire (SF-MPQ), Patient Global Impression of Change score (PGIC), and Patient Health Questionnaire-9 (PHQ-9).</p><p><strong>Results: </strong>All participants completed the study without adverse events. NRS scores significantly decreased from T1 to T2 (p = 0.021). While total NPSI scores showed a decreasing trend (p = 0.067), the dysesthesia subscore demonstrated a significant improvement at follow-up compared to baseline scores (p = 0.009).</p><p><strong>Conclusions: </strong>CPM is associated with a reduction of chronic below-level NP intensity in individuals with SCI. The significant amelioration of dysesthesia at follow-up may reflect neuroplastic changes, although, given the uncontrolled design, this remains hypothesis-generating. Larger randomized controlled trials are needed to confirm these preliminary findings and establish CPM as an adjunctive therapy to detect a clinically meaningful reduction in below-level NP intensity.</p><p><strong>Clinical trial registration: </strong>Registered at the Clinical Research Information Service of the Republic of Korea (Identifier: KCT0007501).</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postural changes and motor evoked potentials following percutaneous spinal cord epidural stimulation in spinal cord injury.","authors":"Sohale Hessavi, Will Schroeder, Ahmad Alazzam, Muhammad Uzair Rehman, Robert Trainer, Ashraf S Gorgey","doi":"10.1038/s41394-026-00753-1","DOIUrl":"10.1038/s41394-026-00753-1","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous spinal cord epidural stimulation (pSCES) is an effective modality for managing pain. However, the use of pSCES in restoration of motor control after SCI is still under research exploration. Today, the effects of postural changes on pSCES-motor control are still controversial.</p><p><strong>Case presentation: </strong>Two participants with complete SCI underwent implantation of pSCES. The motor recruitment curves of motor units of two different agonist-antagonist muscle groups were captured in a supine position and in a standing position using a standing frame. The amplitudes of the motor evoked response were presented in absolute or relative to the maximum response. Both narrow and wide field pSCES configurations elicited intensity-dependent EMG responses across lower-limb muscles, with substantially greater amplitudes in supine compared to standing. Transitioning to standing produced marked bilateral attenuation of raw responses across muscles and configurations, although relative recruitment patterns were partially preserved following EMG normalization. Increasing pulse duration broadened relative muscle recruitment and enhanced distal muscle activation, but posture remained the dominant determinant of overall response magnitude.</p><p><strong>Discussion: </strong>Standing posture was associated with substantial attenuation of pSCES-evoked responses across muscles and stimulation parameters, indicating posture-dependent modulation of evoked muscle activation following pSCES implantation in persons with SCI.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unusual case of paraparesis due to hypertrophy of posterior longitudinal ligament at thoracic and lumbar spine with long-term follow-up: a case report and literature review.","authors":"Basit A Syed, Jimena Gonzalez-Salido, Naveen Arunachalam Sakthiyendran, Martina Stippler, Efstathios Papavassiliou, Ehud Mendel, Ziev B Moses","doi":"10.1038/s41394-026-00752-2","DOIUrl":"10.1038/s41394-026-00752-2","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertrophy of the posterior longitudinal ligament (HPLL) is a rare cause of spinal cord compression, most commonly affecting the cervical spine. Thoracic and lumbar involvement are exceptional, and the natural history of HPLL, particularly its relationship to ossification of the PLL (OPLL), remains unclear. To our knowledge, this is the first reported case of diffuse thoracolumbar HPLL presenting with unusual features and showing no ossification at long-term follow-up.</p><p><strong>Case presentation: </strong>We present a 50-year-old man with rapidly progressive paraparesis and gait disturbance. Imaging revealed a continuous, non-ossified, intraspinal, ventral lesion from T5 to L4, with severe cord compression at T10-L1, hypointense signaling on T1W and T2W images, and progression compared with the MRI performed 7 years earlier, suggestive of HPLL. The patient underwent anterior T10-L1 HPLL resection with fusion and posterior L1-L3 decompression, resulting in full neurological recovery. Histopathology demonstrated hyalinized collagenous tissue with chronic inflammatory infiltrates. After 13 years of follow-up, the patient remained ambulatory, with imaging showing persistent non-ossified HPLL in the thoracic and lumbar unresected regions, no recurrence at the resected region, and new thoracic anterior longitudinal ligament hypertrophy (HALL).</p><p><strong>Discussion: </strong>This case illustrates a rare form of diffuse thoracolumbar HPLL with long-term stability and no transition to ossification, suggesting distinct biological pathways for HPLL and OPLL with the additional novel finding of HALL. The presence of chronic inflammation supports a potential role for inflammation-driven fibrosis in ligamentous hypertrophy. Tailored surgical strategies and vigilant long-term follow-ups are essential in managing HPLL.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting falls in spinal cord injured in-patients during rehabilitation, a retrospective matched pair case-control study.","authors":"Fatma Kumbara, Aslı Turan, Berna Orhan, Özge Tezen, Zuhal Özişler, Elif Yalçın","doi":"10.1038/s41394-026-00748-y","DOIUrl":"10.1038/s41394-026-00748-y","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective matched-pair case-control study.</p><p><strong>Objectives: </strong>The aim of this study was to investigate the risk factors associated with in-hospital falls among individuals with spinal cord injury (SCI) during rehabilitation, and to evaluate whether the presence of a caregiver was associated with fall risk.</p><p><strong>Setting: </strong>Rehabilitation unit, Ankara Bilkent City Hospital, Turkey.</p><p><strong>Methods: </strong>This retrospective matched case-control study included inpatients with traumatic and non-traumatic spinal cord injury (SCI) who underwent inpatient rehabilitation between January 2020 and December 2023. Patients who experienced at least one fall during the rehabilitation period were compared with non-falling patients matched for age, sex, neurological level, and functional status. Demographic and clinical variables, including the American Spinal Injury Association Impairment Scale (AIS), Walking Index for Spinal Cord Injury (WISCI), Spinal Cord Independence Measure (SCIM), presence of a caregiver, and length of hospital stay, were analyzed. Univariate and multivariate logistic regression analyses were performed to identify factors associated with falls during the rehabilitation process.</p><p><strong>Results: </strong>A total of 98 patients were included in the study (49 fallers and 49 non-fallers). The majority of falls occurred during transfers or bathroom use, most frequently during daytime hours. The presence of a caregiver was not significantly associated with the occurrence of falls (p > 0.05). Patients classified as AIS C demonstrated the highest proportion of falls (68.2%) among all groups. The WISCI score showed a borderline significant association with falls in the univariate analysis (p = 0.050); however, this association was not statistically significant in the multivariate logistic regression model.</p><p><strong>Conclusion: </strong>Falls among inpatients with SCI undergoing rehabilitation most frequently occurred during daytime activities, particularly during transfers and bathroom use. Functional mobility and neurological classification, especially AIS C, appeared to play a more critical role in fall risk than the presence of a caregiver. Preventive strategies should emphasize individualized rehabilitation approaches, environmental modifications, and targeted fall prevention programs for high-risk subgroups.</p><p><strong>Sponsorship: </strong>None.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel classification of patients with cervical spinal cord injury without fracture-dislocation based on imaging features: a multicenter study.","authors":"Jiabao Wu, Yu Zhang, Yu Liu, Xuhong Xue, Chong Chen, Fan Feng, Xu Xiong, Ning Zhang, Rongping Zhou, Shanhu Huang, Zhili Liu, Jiaming Liu","doi":"10.1038/s41394-026-00751-3","DOIUrl":"10.1038/s41394-026-00751-3","url":null,"abstract":"<p><strong>Study design: </strong>A multicenter retrospective study.</p><p><strong>Objective: </strong>Several classifications of cervical spinal cord injury without fracture-dislocation (CSCIWOFD) have been reported during past decades, but no classification propose suggestions for surgical approach decision. In this study, we aimed to establish a new classification of CSCIWOFD based on imaging features of patients, and to determine the surgical outcomes of the different types of CSCIWOFD after different surgical approaches.</p><p><strong>Setting: </strong>Affiliated hospital of University in Nanchang, the Second Hospital of Shanxi Medical University in Taiyuan, Guangdong Provincial People's Hospital in Guangdong and Renji Hospital in Shanghai, China.</p><p><strong>Methods: </strong>The clinical data of patients with CSCIWOFD who received conservative or surgical treatment at participating centers between January 2018 and December 2022 were retrospectively reviewed. Patients were classified into four types based on preoperative cervical spine X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) characteristics. The reliability and reproducibility of the new classification was evaluated by six observers from different centers at an interval of 4 weeks. All patients were followed up at least 2 years, and the surgical outcomes of the different types were analyzed.</p><p><strong>Results: </strong>A total of 300 patients with CSCIWOFD were included. Among these patients, 15 received conservative treatment, 169 underwent anterior cervical surgery, 105 underwent posterior cervical surgery, and 11 underwent posterior combined with anterior surgery. The mean Kappa value for inter-observer reproducibility was 0.811, and for intra-observer reliability was 0.893. For Type II patients, the improvement rate of ASIA grade in anterior surgery was significantly higher than that in posterior surgery (P = 0.009). However, for Type III patients, the improvement rate following posterior surgery was higher than that of those undergoing anterior surgery, though no statistically significant difference was observed. In Type IV patients, the combined anterior and posterior approach resulted in a higher improvement rate compared to either the anterior or posterior surgery alone (63.64% vs. 33.33% vs. 16.67%), but again, no statistically significant difference was found.</p><p><strong>Conclusions: </strong>For patients with CSCIWOFD, a novel classification was developed based on preoperative imaging features, which was proven to be reliable. Type I patients can be treated with conservative treatment or anterior surgery; patients with Type II CSCIWOFD have good neurological outcomes after anterior surgery. For Type III patients, the posterior approach may offer better outcomes, while for Type IV patients, the combined anterior and posterior approach may be more effective.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomised controlled trials of nursing interventions in spinal cord injury: a scoping review.","authors":"Louise C Kelly, Joanne V Glinsky, Lisa A Harvey","doi":"10.1038/s41394-026-00749-x","DOIUrl":"10.1038/s41394-026-00749-x","url":null,"abstract":"<p><strong>Study design: </strong>Scoping Review OBJECTIVES: Randomised controlled trials (RCTs) are considered the gold standard for evaluating the effectiveness of clinical interventions. In spinal cord injury (SCI) care, nurses deliver many interventions, yet the number, quality, and level of nurse involvement in RCTs remains unclear. Poorly designed RCTs can introduce bias, and limited nurse participation may restrict the development of evidence-based nursing practice. This review aimed to determine: 1. The number and topics of RCTs on nurse-related interventions for people with SCI; 2. The extent of nurse leadership and participation in these RCTs; 3. The methodological quality of the RCTs.</p><p><strong>Setting: </strong>Australia METHODS: Three databases were searched over a 20-year period for RCTs involving people with SCI and interventions relevant to nursing practice. Two authors independently screened studies for inclusion. Extracted data included study location, sample size, intervention type, nurse involvement, and authorship by nurses. Methodological quality was assessed using the PEDro scale. The protocol was registered with Open Science Framework ( https://osf.io/k9xde ), and PRISMA-ScR guidelines informed reporting.</p><p><strong>Results: </strong>Forty-six RCTs were included from 29,744 retrieved articles. Five main intervention categories were identified, with most studies focusing on bladder and wound management. Studies were primarily conducted in Europe, Asia, and North America. Sample sizes ranged from 9 to 489 participants, with a median (IQR) of 61 (37-91). Nurses were authors on 29 out of the 46 trials, and 26% were nurse led. PEDro scores ranged from 2 to 9, with a median (IQR) of 5 (5-6.8).</p><p><strong>Conclusions: </strong>Few RCTs have evaluated nursing interventions for people with SCI. Many studies showed susceptibility to selection bias. Greater nurse leadership and participation in high-quality RCTs are needed to strengthen evidence-based SCI nursing care.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in demographic and neurological characteristics in patients of a tertiary spinal cord injury centre with acquired traumatic or non-traumatic spinal cord injury/disease over a 25-year period. Implications for bladder management.","authors":"Ralf Böthig, Ines Kurze, Birgitt Kowald, Roland Thietje, Peter Wolna, Klaus Golka","doi":"10.1038/s41394-026-00741-5","DOIUrl":"10.1038/s41394-026-00741-5","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective data analysis.</p><p><strong>Objective: </strong>To investigate the changes in demographic and neurological characteristics in patients with acquired traumatic or non-traumatic spinal cord injury/disease (SCI/D) over a 25-year period and their implications for rehabilitation and bladder management.</p><p><strong>Setting: </strong>Specialized tertiary German center for spinal cord injury.</p><p><strong>Methods: </strong>We retrospectively evaluated the data of SCI/D patients admitted to initial rehabilitation between January 1995 and December 1999 (1st period, n = 461) and between January 2020 and December 2021 (2nd period, n = 441).</p><p><strong>Results: </strong>In the period from January 2020 to December 2021, SCI/D patients were significantly older at the onset of paralysis and more often female, paralyzed due to a non-traumatic cause or incompletely paralyzed than 25 years ago. The proportion of young adult patients (16-45-year-olds) fell from 61.4 to 23.1%, while the proportion of the over 61-year-olds rose from 14.2 to 49.3%. The proportion of non-traumatic SCI/D rose from 20.8 to 53.1%. The duration of primary rehabilitation decreased significantly from 158 to 85 days. The proportion of SCI/D patients with intermittent catheterisation on discharge from primary rehabilitation decreased from 62.7 to 27.2%, while the proportion of patients with indwelling catheter at the time of discharge from primary rehabilitation increased from 10.8 to 52.4%.</p><p><strong>Conclusion: </strong>The proven demographic changes should lead to considerations about targeted objectives and quality criteria for initial rehabilitation after acquired SCI/D. Further research on this topic should include patient-reported outcome measures. Adequate bladder management of these often elderly patients with non-traumatic SCI/D remains a challenge.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}