Journal of Spinal Cord Medicine最新文献

{"title":"Impact of age in the healing time in myocutaneous and perforator flaps for pelvic pressure ulcers in patients with spinal cord injury.","authors":"L Lepoittevin, M Le Fort, F Bellier-Waast, P Kieny, J Aubrit, B Perrouin-Verbe, C Lefèvre","doi":"10.1080/10790268.2025.2488568","DOIUrl":"https://doi.org/10.1080/10790268.2025.2488568","url":null,"abstract":"<p><strong>Introduction: </strong>Specific management of people with spinal cord injury has allowed to improve their life expectancy. The objective of this study was to analyze if age was a factor affecting the healing time of surgery for pelvic pressure ulcers in patients with spinal cord injury.</p><p><strong>Methods: </strong>Retrospective, monocentric study, enrolling all consecutive spinal cord injury participants admitted into a specialized Neurological Physical Medicine and Rehabilitation department for surgery for pelvic pressure ulcers during a 5-year period. Participants were divided into two groups, \"Young group\" patients aged between 18 and 64 years and \"Senior group\" patients over 65 years of age. Healing time was defined as the time required for complete closure, allowing mobilization of the lower limbs. Data related to the complication rate (dehiscence, hematoma, infection, flap necrosis), medical or psychiatric decompensation, length of stay and time to rehabilitation were collected.</p><p><strong>Results: </strong>One hundred and fourteen participants were recruited, including 77 participants in the \"Young group\" and 37 in the \"Senior group\". In total, 131 pressure ulcers were operated. The median of the healing time was 46 [32.0;68.8] days, with a minimum of 20 days and a maximum of 694 days. Seven participants were considered as healing failures. There was no significant statistical difference between the two groups with 43 days [35.0;52.0] for the \"Young group\" and 56 days [40.0;80.0] for the \"Senior group\" (p = 0.44).</p><p><strong>Discussion: </strong>This study demonstrated no significant difference in postoperative healing time of flaps for pelvic pressure ulcers between participant below and above 65 years of age.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-8"},"PeriodicalIF":1.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reported shoulder pain assessment in adults with spinal cord injury who use a manual wheelchair: A scoping review.","authors":"Wendy Hurd, Meegan Van Straaten, Saloni Patel, Alison Hansen, Omid Jahanian, Stephen Cain, Ryan Pontiff, Chih-Ying Li, Melissa Morrow","doi":"10.1080/10790268.2025.2483075","DOIUrl":"https://doi.org/10.1080/10790268.2025.2483075","url":null,"abstract":"<p><strong>Context: </strong>For individuals living with spinal cord injury (SCI), a deep understanding of their shoulder pain experience is crucial to guide equipment prescription/design, mobility training, exercise, recreation, and pain education. Standardization in pain assessment methods is necessary for cross-study comparisons and meta-analyses. No previous studies describe the spectrum of shoulder pain assessment measures applied to adults with SCI who use MWCs for mobility.</p><p><strong>Objective: </strong>This scoping review aimed to determine the measurement instruments and methods of shoulder pain assessment used in peer-reviewed, published literature in studies focused on individuals with SCI who use MWCs.</p><p><strong>Methods: </strong>A literature search was performed using multiple databases on February 23, 2023. Data extraction elements included study design type, inclusion/exclusion criteria, sample size, and pain measurement instrument. Participant characteristics were also extracted including age, sex, time since SCI, level of SCI, and MWC use.</p><p><strong>Results: </strong>This scoping review identified over 20 instruments used in 133 studies that focused on reported shoulder pain in studies of this population. Thirty percent of the studies performed shoulder pain assessment for more than one purpose (screening, baseline, outcome), and 56% used more than one assessment measurement. The Wheelchair Users Shoulder Pain Index was the most commonly used instrument.</p><p><strong>Conclusion: </strong>An in-depth understanding of pain requires measurement within a biopsychosocial framework and likely involves multiple instruments. Overall, investigators are challenged to select valid, reliable instruments that fulfill the demands of study design and questions of interest. Guiding questions are provided to assist investigators in their choice of pain instruments.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-15"},"PeriodicalIF":1.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photobiomodulation (PBM) therapy for functional recovery using an experimental model of spinal cord injury in rats.","authors":"Paula Del Campo, Lívia Assis, Suellen Veronez Silva, Raquel de Paula Carvalho, Julia Risso Parisi, Alessandra Mussi Ribeiro, Flávia de Oliveira, Gláucia Castro, Thatiane Izabele Ribeiro Santos, Ana Muniz Renno, Carla Christina Medalha","doi":"10.1080/10790268.2025.2488571","DOIUrl":"https://doi.org/10.1080/10790268.2025.2488571","url":null,"abstract":"<p><strong>Context: </strong>Traumatic spinal cord injury (SCI) is characterized by damage in the spinal cord, which can result in a permanent or temporary disability and different degrees of paralysis, sensory loss, and bladder/bowel dysfunction. It represents an important cause of morbidity and mortality in the affected individuals. Based on the need to develop more effective treatments for SCI, authors have been investigating the effects of photobiomodulation (PBM) therapy on this injury.</p><p><strong>Objective: </strong>In this context, the present study aimed to evaluate the long-term effect (follow-up) of PBM using a model of SCI in rats.</p><p><strong>Results: </strong>For this, 33 rats were randomly divided into two experimental groups: the control group and the laser group, and sub-divided into two sub-groups (with two different periods of euthanasia post-injury, 4 and 8 weeks). PBM treatment was performed for 14 days (daily, 808 nm, continuous output, 30 mW, 0.028 cm², 1.07 W/cm², 1000 J/cm², 4 min and 42 secs). Animals were euthanized 4 and 8 weeks after the surgical procedure. For analysis, motor function and tactile sensitivity analysis were performed on days 1 and 7 post-surgery. Moreover, after euthanasia, samples were retrieved for histological and immunohistochemistry analysis. The results of the present study demonstrated that PBM improved function and motor behavior. Furthermore, irradiated animals demonstrated a decreased injury volume and decreased GFAP immunolabelling. These results suggest that PBM presented a long-term positive effect on the morphological aspects at the site of the injury and in the modulation of GFAP immunoexpression, which culminates in the improvement of the function behavior.</p><p><strong>Conclusion: </strong>It may be suggested that PBM therapy in the parameters used, was able to modulate the inflammatory process, regulate the secondary lesion, decreasing cell apoptosis and edema in the earlier phases of recovery, which resulted in long-term positive effects (4 and 8 weeks). Further investigations are necessary to investigate the possible mechanisms that may explain the positive effects of PBM irradiation in SCI, which may contribute to a better understanding of the efficacy of PBM therapy and the development of more effective and safer treatments.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous neuromodulation for bladder management after spinal cord injury: The Ernest Bors, MD Award for Scientific Development.","authors":"Florian P Thomas, Carol Ann Murphy","doi":"10.1080/10790268.2025.2491256","DOIUrl":"https://doi.org/10.1080/10790268.2025.2491256","url":null,"abstract":"","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":"48 3","pages":"365-366"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Priorities and opportunities for advocacy in SCI: An international web-based review.","authors":"Vyshnavi Manohara, Anna Nuechterlein, Tanya A Barretto, Judy Illes","doi":"10.1080/10790268.2024.2369736","DOIUrl":"10.1080/10790268.2024.2369736","url":null,"abstract":"<p><strong>Context: </strong>For the growing number of people with spinal cord injuries worldwide, advocacy organizations are an invaluable resource of information and education during recovery and rehabilitation.</p><p><strong>Objective: </strong>To examine the structure, information, and accessibility of websites from international organizations that serve and advocate for individuals with SCI.</p><p><strong>Methods: </strong>We performed a content analysis of information available from SCI organizations returned from a Google search. We used search terms relevant to SCI and advocacy and applied them to top-level domains for the G20 countries. Organizations that provide services or advocate for people with SCI with English-language websites were included; organizations focused on research, fundraising, clinical care, interprofessional knowledge exchange, or other neurological conditions were excluded. Accessibility, in terms of ease of use to information about participation, was assessed using a 3-point scale.</p><p><strong>Results: </strong>We identified SCI organizations from 27 different countries across six regions: Africa (<i>N</i> = 4), Asia (<i>N</i> = 5), Europe (<i>N</i> = 27), Middle East (<i>N</i> = 1), North America (<i>N</i> = 12), and Oceania (<i>N</i> = 11). Across these, six categories of resources and services are covered: (1) education, (2) physical health, (3) external, (4) peer support, (5) mental health, and (6) financial and legal. Eleven organizations indicate specific engagement with research or clinical trials. Four websites provided highly accessible information (rank = 3) about participation in research.</p><p><strong>Conclusion: </strong>The SCI organizations identified in this study offer resources that largely pertain to education and physical health services and strategies. Information about clinical trials and SCI research studies are easily accessible on the websites of the limited number of organizations offering avenues for participation.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"367-375"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper extremity effort during the sit-to-stand task in able-bodied and in individuals with spinal cord injury: A preliminary study.","authors":"Claudiane Arakaki Fukuchi, Isadora Oliveira Leal, Reginaldo Kisho Fukuchi, Janaina Roland Tancredo, Alberto Cliquet","doi":"10.1080/10790268.2023.2273588","DOIUrl":"10.1080/10790268.2023.2273588","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between the presence of spinal cord injury (SCI) on biomechanical variables by comparing individuals with SCI and able-bodied individuals during the sit-to-stand (STS) task assisted by a walker device. Specifically, we compared the upper-extremity joint angles and moments, trunk forward tilt angle, vertical forces of the instrumented walker, and ground reaction forces between groups.</p><p><strong>Design: </strong>Case-control study.</p><p><strong>Setting: </strong>Department of Orthopedics and Traumatology, UNICAMP-Brazil.</p><p><strong>Participants: </strong>Six individuals with SCI and fourteen able-bodied individuals.</p><p><strong>Main outcome measures: </strong>Kinematics and kinetics of the shoulder, elbow, and wrist joints; trunk forward tilt angle, vertical walker forces, and ground reaction forces (GRF) were analyzed during the STS task in two phases: before and after the seat-off event.</p><p><strong>Results: </strong>A higher peak elbow flexion angle and higher vertical walker forces were observed before the seat-off, whereas the lower peak vertical GRF was found, after the seat-off, in the SCI group compared with the control group.</p><p><strong>Conclusions: </strong>SCI affects kinematics and kinetics variables during the STS task compared to able-bodied controls. Individuals with SCI adopted different standing-up strategies that affected the distribution of the forces in the upper and lower extremities of the human body.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"512-517"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for pressure injuries in individuals with spinal cord injuries who have sarcopenic obesity: A comparison of time-dependent changes in sacral region pressure between individuals with and without sarcopenic obesity.","authors":"Sumin Nam, Hye Yeong Yun, Onyoo Kim","doi":"10.1080/10790268.2024.2379068","DOIUrl":"10.1080/10790268.2024.2379068","url":null,"abstract":"<p><strong>Objective: </strong>To identify the risk factors for pressure injuries in individuals with spinal cord injuries (SCIs) who have sarcopenic obesity, comparing time-dependent changes in sacral region pressure in individuals with and without sarcopenic obesity.</p><p><strong>Design: </strong>An experimental time series study.</p><p><strong>Setting: </strong>Single-center hospital.</p><p><strong>Participants: </strong>Twenty-five adult participants with subacute and chronic paraplegia who visited our rehabilitation center, Republic of Korea, between May 2021 and June 2022.</p><p><strong>Interventions: </strong>Whole-body dual-energy X-ray absorptiometry was performed to diagnose sarcopenic obesity. After the participants were placed in the supine position for 1 hour, the average pressure (mmHg), peak pressure (mmHg), and total contact area (cm²) of the sacral region were measured using the pressure-mapping system.</p><p><strong>Results: </strong>Compared with the non-sarcopenic obesity group, the sarcopenic obesity group showed significant before-and-after differences in peak pressure. Furthermore, the risk factors that were significantly associated with peak pressure in the sarcopenic obesity group were the American Spinal Injury Association Impairment Scale score and the fat mass index.</p><p><strong>Conclusion: </strong>Among participants with SCIs, the risk of pressure injuries is higher in the sarcopenic obesity group than in the non-sarcopenic obesity group. Notably, the risk of pressure injuries increases in participants who have complete injury and an increased fat mass index, indicating the importance of close monitoring and more active management to prevent pressure injuries in this subpopulation.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"438-446"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic prophylaxis with urodynamic studies in spinal cord injury: Assessing practice patterns and outcomes to guide future practice in a single center.","authors":"Du Pham, Bradley Chi, Felicia Skelton, Donna Huang","doi":"10.1080/10790268.2024.2311348","DOIUrl":"10.1080/10790268.2024.2311348","url":null,"abstract":"<p><strong>Context/objective: </strong>Despite urinary tract infections (UTIs) being a common problem in patients with spinal cord injuries (SCIs), and a well-known complication of invasive urologic procedures, little consensus exists regarding the standard of care for peri-procedural antibiotic use for SCI patients undergoing urodynamics studies (UDS). Our research seeks to evaluate local antibiotic prophylaxis pattern in SCI patients undergoing UDS, assess incidence of post-procedural UTI, describe local antibiotic resistance trends, and provide antibiotic stewardship considerations to guide future practice.</p><p><strong>Design/setting/participants: </strong>Retrospective cohort study of SCI patients undergoing UDS from January 2010 to January 2020 at a Veterans Affairs SCI Center. Data on patient demographics, UTI risk factors, pre-procedural urinalysis and culture, and peri-procedural antibiotics was extracted. Incidence of post-procedural UTI was tabulated. Findings were summarized using descriptive statistics.</p><p><strong>Results: </strong>331 patients were studied. Pre-procedural urine culture was done in 73% of cases, with positive results in 49%. <i>E. coli</i> was the most commonly isolated organism (19%). Antibiotics were used in 86% of cases, 26% of which had a negative culture. A onetime dose of intramuscular gentamicin given immediately pre-procedure was the most common practice (53%; <i>N</i> = 152). No cases of post-procedural UTIs were identified during the study period.</p><p><strong>Conclusion: </strong>No post-UDS UTIs occurred under current local practice where most patients received a one-time dose of intramuscular gentamicin as prophylaxis. Though routine gentamicin prophylaxis may play a role in reducing UTI incidence, the low rate of post-UDS UTI in this population, including patients with positive cultures who received no antibiotics, suggests the possibility of refining practice patterns to improve antibiotic stewardship.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"536-541"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of serial muscle ultrasound of rectus femoris and ambulatory recovery in patients with acute incomplete spinal cord injury: A prospective observational study.","authors":"Matthew Rong Jie Tay, Keng He Kong","doi":"10.1080/10790268.2024.2344317","DOIUrl":"10.1080/10790268.2024.2344317","url":null,"abstract":"<p><strong>Context/objective: </strong>To investigate the change in serial muscle ultrasound of rectus femoris of patients with incomplete spinal cord injury (SCI) performed within 2 months after SCI during acute rehabilitation, and the relationship with functional outcomes at 1 year post-injury.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Setting: </strong>Inpatient multi-speciality tertiary rehabilitation center in Singapore.</p><p><strong>Participants: </strong>Fifty-four patients with incomplete SCI, defined as American Spinal Injury Association Impairment Scale B-D, with SCI above L2, were recruited from March 2020 to June 2021. Serial muscle ultrasound of the rectus femoris thickness and echo intensity were obtained at 1 week post-injury and after 2 months via standardized protocols.</p><p><strong>Outcome measures: </strong>Functional Independence Measure (FIM) motor score, Lower Extremity Motor Score (LEMS), Spinal Cord Independence Measure III (SCIM III) indoor mobility component and Walking Index for Spinal Cord Injury II (WISCI II) were assessed in the first week post-admission and at 1 year.</p><p><strong>Results: </strong>There was a significant positive correlation between change in rectus femoris muscle thickness over 2 months and FIM motor score (P < 0.001), LEMS (P < 0.001), SCIM III indoor mobility component (P < 0.001) and WISCI II (P < 0.001) at 1 year. For the change in echo intensity over 2 months, there was a significantly negative correlation with FIM motor score (P = 0.002), LEMS (P = 0.002), SCIM III indoor mobility component (P = 0.001) and WISCI II (P = 0.001) at 1 year.</p><p><strong>Conclusion: </strong>The findings suggest that ultrasonographic serial assessment of rectus femoris muscle thickness and echo intensity during rehabilitation may be useful for determining the long-term functional outcomes in patients with incomplete SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"545-551"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and clinical impact of an interdisciplinary tool to promote skin integrity after flap surgery in Veterans with spinal cord injury.","authors":"Byron Eddy, Mary Murphy Kruse, Tina Arneson, Jennifer Hussung, Daniel Greenwood, Crystal Stien, Christie King, Amanda Simone, Gary Goldish, Anjum Kaka, Umar Choudry, Cenk Cayci, Christine M Olney","doi":"10.1080/10790268.2024.2420434","DOIUrl":"10.1080/10790268.2024.2420434","url":null,"abstract":"<p><strong>Context/objective: </strong>Pressure injury (PrI) recurrence is common among persons with spinal cord injury and disorders (SCI/D) who undergo reconstructive flap surgery for pelvic stage 4 PrI (S4PrI). This paper describes the development and implementation of the Minneapolis Spinal Cord Optimization, Rehabilitation and Empowerment (SCORE), a preoperative interdisciplinary tool for risk assessment and mitigation, and reports its effect on the one-year flap failure rate (significant breakdown).</p><p><strong>Design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Minneapolis Veterans Affairs Health Care System (MVAHCS) SCI/D Center, a tertiary care center.</p><p><strong>Participants: </strong>141 Veterans with SCI/D and pelvic S4PrI underwent 204 interdisciplinary assessments for flap surgery.</p><p><strong>Interventions: </strong>The Minneapolis SCORE was developed by the MVAHCS SCI/D Center and first implemented in 2012. The eight domains of the tool and continuous improvements in tool implementation for risk assessment and mitigation are described.</p><p><strong>Outcome measures: </strong>Per-year incidence rate of flap failures within one year of surgery from 2009 to 2019.</p><p><strong>Results: </strong>48.3% (28/58) of S4PrI assessments during 2009-2011 (pre-SCORE) led to flap surgery the same year, increasing to 59.6% (87/146) of assessments after SCORE implementation during 2012-2019. The one-year flap failure rate abruptly decreased from 40.5% (15/37) of the 2009-2012 surgeries to 7.7% (6/78) of the 2013-2019 surgeries (P < .0001). Characteristics of patients by time period, operative status, and flap outcome are presented.</p><p><strong>Conclusion: </strong>After an initial learning curve in tool implementation and subsequent tool refinement, the use of the Minneapolis SCORE before flap surgeries was associated with improved flap integrity at one year. Successful use of the tool requires collaborative problem-solving between the patient and interdisciplinary team.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"415-428"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}