Journal of Spinal Cord Medicine最新文献

{"title":"All day in bed, all night in the wheelchair: Unmet attendant care needs of people with spinal cord injury.","authors":"James S Krause, Philip A Edles, Jon Laursen-Roesler, Melinda Jarnecke","doi":"10.1080/10790268.2024.2362505","DOIUrl":"10.1080/10790268.2024.2362505","url":null,"abstract":"<p><strong>Context: </strong>Having dependable attendant care is essential to the health and well-being of those most severely impacted by a spinal cord injury (SCI). Our objective was to identify how often people with SCI who require assistance for transfers either spend a full day in bed or all night in a wheelchair because they do not have paid or unpaid assistance.</p><p><strong>Findings: </strong>Of the 918 respondents, 319 (34.7%) indicated they needed someone's help for basic activities of daily living and 229 (24.9%) relied on someone's assistance for wheelchair-to-bed transfers. Nearly a quarter of participants (22.2%) reported staying in bed all day for at least one once on during the past year, with a median of 10 times among those with at least one day. Men reported a higher rate than women (25.6%, 13.6%) and nonwhites-Hispanics (33.3%) reported a higher percentage than non-Hispanic whites (18.6%). Just over one in every 20 participants (5.3%) reported staying in the wheelchair at least one night because they did not have attendant care, with a median of 2.5 times among those with at least one night. Over one in 10 (11.7%) nonwhites and Hispanics reported at least one overnight in the wheelchair compared with only (3.1%) for non-Hispanic whites.</p><p><strong>Conclusion/clinical relevance: </strong>Staying in bed all day and staying in the chair all night due to lack of attendant care represents a breakdown in the attendant care system and a threat to the well-being of those with SCI, particularly nonwhites and Hispanics, and men.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"351-356"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307282","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":"Whole-body vibration may not affect bone mineral density and bone turnover in persons with chronic spinal cord injury: A preliminary study.","authors":"Laurent Maïmoun, Anthony Gelis, Chris Serrand, Thibault Mura, Severine Brabant, Patrick Garnero, Denis Mariano-Goulart, Charles Fattal","doi":"10.1080/10790268.2023.2268893","DOIUrl":"10.1080/10790268.2023.2268893","url":null,"abstract":"<p><strong>Context: </strong>Spinal-cord injury (SCI) induces bone loss and dramatically increases the risk of fracture.</p><p><strong>Objectives: </strong>Determine the effects of whole-body vibration (WBV) on areal bone mineral density (aBMD), whole body composition and bone biological parameters in individuals with chronic-state SCI.</p><p><strong>Design: </strong>Randomized study.</p><p><strong>Setting: </strong>Centre Neurologique PROPARA.</p><p><strong>Participants: </strong>Fourteen subjects were randomly assigned to a WBV or a control group.</p><p><strong>Interventions: </strong>WBV (20-45 min, 30-45 Hz, 0.5 g) was performed in verticalized persons twice weekly for 6 months.</p><p><strong>Outcome measures: </strong>aBMD was measured by DXA at baseline and 6 months and bone biological parameters at baseline, 1, 3 and 6 months.</p><p><strong>Results: </strong>No significant aBMD change was found in either the WBV or control group after 6 months of follow-up. Similarly, periostin, sclerostin and bone turnover markers remained relatively stable throughout follow-up and no difference in variation was observed within-group and between groups. Except for whole-body fat mass, which showed a significant decrease in the WBV group compared to controls, no difference in changes was observed, whatever the localization for fat and lean body mass.</p><p><strong>Conclusions: </strong>During the chronic phase, aBMD and bone remodeling reach a new steady state. However, the DXA technique and the bone markers, including sclerostin and periostin, both of which reflect bone cell activity influenced by mechanical strain, showed that the bone tissue of individuals with SCI was insensitive to 6 months of WBV training at the study dose. Nevertheless, results of this preliminary study that was underpowered need to be confirmed and other modalities of WBV may be more effective in improving aBMD of this population.</p><p><strong>Trials registration: </strong>N°IDRCB:2011-A00224-37.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"259-271"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488209","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":"Gait training using a wearable robotic hip device for incomplete spinal cord injury: A preliminary study.","authors":"Kenichi Yoshikawa, Hirotaka Mutsuzaki, Kazunori Koseki, Koichi Iwai, Ryoko Takeuchi, Yutaka Kohno","doi":"10.1080/10790268.2023.2273587","DOIUrl":"10.1080/10790268.2023.2273587","url":null,"abstract":"<p><strong>Context/objective: </strong>To explore changes in gait functions for patients with chronic spinal cord injury (SCI) before and after standard rehabilitation and rehabilitation with a wearable hip device, explore the utility of robot-assisted gait training (RAGT), and evaluate the safety and dose of RAGT.</p><p><strong>Design: </strong>Single-arm, open-label, observational study.</p><p><strong>Setting: </strong>A rehabilitation hospital.</p><p><strong>Participants: </strong>Twelve patients with SCI.</p><p><strong>Interventions: </strong>Standard rehabilitation after admission in the first phase. RAGT for two weeks in the second phase.</p><p><strong>Outcome measures: </strong>Self-selected walking speed (SWS), step length, cadence, and the 6-minute walking distance were the primary outcomes. Walking Index for SCI score, lower extremity motor score, and spasticity were measured. Walking abilities were compared between the two periods using a generalized linear mixed model (GLMM). Correlations between assessments and changes in walking abilities during each period were analyzed.</p><p><strong>Results: </strong>After standard rehabilitation for 66.1 ± 36.9 days, a period of 17.6 ± 3.3 days of RAGT was safely performed. SWS increased during both periods. GLMM showed that the increase in cadence was influenced by standard rehabilitation, whereas the limited step length increase was influenced by RAGT. During RAGT, the increase in step length was related to an increase in hip flexor function.</p><p><strong>Conclusions: </strong>Gait speed in patients with SCI increased after rehabilitation, including RAGT, in the short-term. This increase was associated with improved muscle function in hip flexion at the start of RAGT.<b>Trial Registration:</b> This study was registered with the UMIN Clinical Trials Registry (UMIN-CTR; UMIN000042025).</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"208-220"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488207","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":"Adherence and perceptions of a home sports video gaming program in persons with spinal cord injuries: A pilot study.","authors":"Jeffrey P Jaramillo, M Elise Johanson, B Jenny Kiratli","doi":"10.1080/10790268.2023.2268328","DOIUrl":"10.1080/10790268.2023.2268328","url":null,"abstract":"<p><strong>Objective: </strong>Sports video-gaming can facilitate increased activity levels in persons with limited exercise options. Understanding how persons with spinal cord injuries (SCI) participate in home-based video-gaming and its potential impact on maintaining or enhancing physical function remains largely unexplored. The purpose of this study was to evaluate adherence, perceptions, and potential physical effects of a home sports video-game program for persons with chronic SCI.</p><p><strong>Participants: </strong>Fourteen individuals with chronic SCI (9 tetraplegia, 5 paraplegia).</p><p><strong>Design: </strong>This was a prospective study. Wii video-gaming systems that included four sports games were provided to participants for home use. Participants were instructed to play for 8 weeks 3-4 days/week. The video consoles recorded the time and number of sessions played.</p><p><strong>Outcome measures: </strong>At baseline and at the conclusion of the program, measurements were made of upper extremity strength, perceived exertion, active heart rate, pain, balance, and a functional upper extremity (UE) test. The total time and number of sessions were compared to the prescribed game play as a measure of adherence. Scores from a self-reported survey were used to gauge participants' satisfaction and perceptions of their gaming experience.</p><p><strong>Results: </strong>Overall mean gaming adherence was 85% during the first 4 weeks and 69% for the second 4 weeks. There were no significant changes in upper extremity strength, active heart rate, balance, pain, or functional UE test for either group. All of the participants rated video gaming as enjoyable and 85.7% perceived that it could be used as a form of exercise.</p><p><strong>Conclusion: </strong>The Wii sports home video-gaming intervention elicited overall high adherence rates and was well received by study participants indicating that it may have value as an adjunctive tool for increasing physical activity for individuals with SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"272-282"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400094","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":"Prevalence of opioid use in adults with spinal cord injury: A systematic review and meta-analysis.","authors":"Samantha J Borg, Cate M Cameron, Karen Luetsch, Adam Rolley, Timothy Geraghty, Steven McPhail, Victoria McCreanor","doi":"10.1080/10790268.2024.2319384","DOIUrl":"10.1080/10790268.2024.2319384","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence, reported harms and factors associated with opioid use among adults with spinal cord injury (SCI) living in the community.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>Comprehensive literature searches were conducted in PubMed (MEDLINE), EMBASE, CINAHL, Web of Science and Scopus for articles published between 2000 and 2023. Risk of bias was assessed using a prevalence-specific tool. Random-effects meta-analyses were conducted to pool prevalence data for any context of opioids. Sensitivity and subgroup analyses were also performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study protocol was registered via Prospero (CRD42022350768).</p><p><strong>Results: </strong>Of the 4969 potential studies, 38 were included in the review. Fifty-three percent of studies had a low risk of bias, with a high risk of bias in 5% of studies. The pooled prevalence for the 38 studies included in the meta-analysis (total cohort size of 50,473) across any opioid context was 39% (95% confidence interval [CI], 32-47). High heterogeneity was evident, with a prediction interval twice as wide as the 95% CI (prediction interval, 7-84%). Mean or median opioid dose was unreported in 95% of studies. Opioid dose and factors related to opioids were also rarely explored in the SCI populations.</p><p><strong>Conclusions: </strong>Results should be interpreted with caution based on the high heterogeneity and imprecise pooled prevalence of opioids. Contextual details including pain, cohort-specific injury characteristics and opioid dosage were inconsistently reported, indicating a clear need for additional studies in a population at greater risk of experiencing opioid-related adverse effects.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"170-188"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102719","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":"Tuberculous longitudinal extensive transverse myelitis: 2 cases and literature review.","authors":"Si Tian, Nannan Dong, Mengru Li, Shefali Yadav, Siyi Cheng, Bo Wang, Kebin Zeng","doi":"10.1080/10790268.2024.2426315","DOIUrl":"10.1080/10790268.2024.2426315","url":null,"abstract":"<p><strong>Context: </strong>This study aimed to investigate the characteristics, diagnosis, and management of tuberculous longitudinally extensive transverse myelitis (TB-LETM), a rare manifestation of tuberculosis.</p><p><strong>Findings: </strong>We analyzed two rare cases of TB-LETM and discussed their clinical manifestations and imaging findings in the context of the relevant literature. Patient 1, a 23-year-old female, presented with quadriplegia and dysuria, and spinal magnetic resonance imaging (MRI) revealed lesions extending from C1 to T3. Patient 2, an 18-year-old female, reported acute-onset numbness and weakness in both lower limbs, with MRI showing lesions from T1 to T4, along with multiple intracranial leptomeningeal enhancements. Both patients had elevated cerebrospinal fluid (CSF) cell counts and protein levels, and positive blood T-cell spot test (T-SPOT.TB), but no microbiological evidence of <i>Mycobacterium tuberculosis</i> was found. Diagnosis was based on clinical presentation, medical history, chest computed tomography (CT) findings, and CSF analysis. Over the past decade, 14 cases of TB-LETM have been reported. Common symptoms include fever, acute paralysis, sensory deficits in the lower limbs, and dysuria. Elevated CSF protein, lymphocytosis, and decreased glucose levels are essential for differentiating TB-LETM from autoimmune disorders.</p><p><strong>Conclusion: </strong>Longitudinally extensive transverse myelitis (LETM), especially when involving the cervical and thoracic cords, should be considered a potential manifestation of tuberculosis infection. Analysis of cerebrospinal fluid, MRI findings, and T-SPOT testing can provide crucial diagnostic insights. A combination of anti-tuberculosis therapy and corticosteroids has proven clinically effective in managing this condition.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"189-198"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973032","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":"Do individuals from an SCI-specialized rehabilitation facility have fewer secondary health conditions than those from a non-SCI-specialized rehabilitation facility? Analysis of the InSCI database from a middle-income country.","authors":"Sintip Pattanakuhar, Pratchayapon Kammuang-Lue, Napasakorn Komaratat, Chayaporn Chotiyarnwong, Apichana Kovindha, Armin Gemperli","doi":"10.1080/10790268.2023.2289690","DOIUrl":"10.1080/10790268.2023.2289690","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether attending an SCI-specialized rehabilitation facility (SSRF) is independently associated with having fewer secondary health conditions (SHCs) in middle-income country contexts.</p><p><strong>Study design: </strong>Cross-sectional observational study.</p><p><strong>Setting: </strong>Four rehabilitation facilities in Thailand (one SSRF and three non-SSRF).</p><p><strong>Methods: </strong>Data from a Thai arm of the International Spinal Cord Injury Community Survey (InSCI) were analyzed. SHCs occurring within the last three months were evaluated using the Spinal Cord Injury Secondary Condition Scale. A causal diagram was applied to create a multivariable regression model to determine the independent effect of attending in the SSRF on having SHC as a single condition and as a sum score.</p><p><strong>Results: </strong>Three hundred and thirteen individuals with chronic SCI were included in this study. Two hundred and nineteen participants (70%) were recruited from the SSRF. Being recruited from the SSRF was an independent negative correlating factor of the SHC sum score with an unstandardized coefficient of -1.12 (95% CI: -2.00-0.24). Being recruited from the SSRF was also an independent negative correlating factor of having bladder dysfunction, sexual dysfunction, and pressure ulcer SHC with an odds ratio of 0.32 (95% CI: 0.16-0.59), 0.43 (95% CI: 0.22-0.84), and 0.46 (95% CI: 0.24-0.89), respectively.</p><p><strong>Conclusion: </strong>Attending an SSRF was significantly associated with having fewer SHCs, specifically, bladder dysfunctions, sexual dysfunctions, and pressure ulcers. These results suggest the importance of having SSRF in middle-income countries for delivering effective care to people with SCI and standardized education to health care providers.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"290-299"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513333","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":"Comparison of intermittent theta burst stimulation and high-frequency repetitive transcranial magnetic stimulation on spinal cord injury-related neuropathic pain: A sham-controlled study.","authors":"Jong Keun Kim, JaeIn You, Sangpil Son, InHyuk Suh, Jong Youb Lim","doi":"10.1080/10790268.2023.2277964","DOIUrl":"10.1080/10790268.2023.2277964","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effects of intermittent theta burst stimulation (iTBS) and high-frequency repetitive transcranial magnetic stimulation (rTMS) on spinal cord injury-related neuropathic pain with sham controls, using neuropathic pain-specific evaluation tools.</p><p><strong>Design: </strong>A randomized, double-blind, sham-controlled trial.</p><p><strong>Setting: </strong>Rehabilitation medicine department of a university hospital.</p><p><strong>Participants: </strong>Thirty-three patients with spinal cord injury-related neuropathic pain.</p><p><strong>Interventions: </strong>Patients were randomly allocated to one of three groups (real iTBS, real rTMS, and sham rTMS). Each patient underwent five sessions of assigned stimulation.</p><p><strong>Outcome measures: </strong>Before and after completion of the five sessions, patients were evaluated using the self-completed Leeds Assessment of Neuropathic Symptoms and Signs, Numeric Rating Scale, Neuropathic Pain Symptom Inventory, and Neuropathic Pain Scale.</p><p><strong>Results: </strong>Real iTBS and real rTMS reduced pain levels after stimulation according to all the evaluation tools, and the changes were significant when compared to the values of the sham rTMS group. No significant differences were found between the real iTBS and real rTMS groups.</p><p><strong>Conclusion: </strong>Both iTBS and rTMS were effective in reducing spinal cord injury-related neuropathic pain. When safety, convenience, and compliance are considered, iTBS would have an advantage over rTMS in clinical situations with spinal cord injury-related neuropathic pain.<b>Trial Registration:</b> This trial was registered with the Clinical Research Information Service (registration no. KCT0004976).</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"241-247"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048369","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":"Epidemiological age-based differences in traumatic spinal cord injury patients: A multicenter study based on 13,334 inpatients.","authors":"Chaoyu Wang, Shenghui Shang, Mengfan Hou, Jinghua Wang, Yi Kang, Yongfu Lou, Wei Wang, Hua Zhao, Lingxiao Chen, Hengxing Zhou, Shiqing Feng","doi":"10.1080/10790268.2024.2309716","DOIUrl":"10.1080/10790268.2024.2309716","url":null,"abstract":"<p><strong>Context: </strong>Compared with younger traumatic spinal cord injury (TSCI) patients, the elderly had longer delays in admission to surgery, higher proportion of incomplete injury, and longer hospital stays. However, in China, the country with the largest number of TSCI patients, there have been no large-scale reports on their age differences.</p><p><strong>Objectives: </strong>To explore the age-based differences among TSCI inpatients, focusing on the demographic and clinical characteristics, treatment status, and economic burden.</p><p><strong>Methods: </strong>We collected the medical records of 13,334 inpatients with TSCI in the 30 hospitals of China, from January 1, 2013 to December 31, 2018. Trends are expressed as annual percentage changes (APCs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of 13,334 inpatients were included. Both the number and proportion of the elderly showed an increasing trend. The APC of the number and proportion in patients ≥85 years were 39.5% (95% CI, 14.3 to 70.3; P<i> </i>< 0.01) and 30.5% (95% CI, 8.6 to 56.9; P<i> </i>< 0.01), respectively. Younger patients were more likely to undergo decompression surgery, and older patients were more likely to receive high-dose methylprednisolone sodium succinate/methylprednisolone (MPSS/MP). Of the patients ≥85 years, none underwent decompression surgery within 8 h, and only 1.4% received a high dose of MPSS/MP within 8 h after injury. Elderly patients had lower hospitalization costs than younger. The total and daily medical costs during hospitalization of patients ≥85 years were 8.06 ± 18.80 (IQR: 5.79) and 0.61 ± 0.73 (IQR: 0.55) thousands dollars, respectively.</p><p><strong>Conclusions: </strong>As the first study to focus on age differences of TSCI patients in China, this study found many differences, in demographic and clinical characteristics, treatment status, and economic costs, between older and younger TSCI patients. The number and proportion of elderly patients increased, and the rate of early surgery for elderly patients is low.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"232-240"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998123","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":"Indications, feasibility safety and efficacy of dorsal rhizotomy at the level of the conus medullaris (conus deafferentation) in individuals with spinal cord injury.","authors":"Ines Kurze, Elena Jakisch, Martin Jakisch, Frank Werner, Birgitt Kowald, Klaus Golka, Ralf Böthig","doi":"10.1080/10790268.2024.2442151","DOIUrl":"https://doi.org/10.1080/10790268.2024.2442151","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective non-controlled intervention study.</p><p><strong>Objectives: </strong>To assess indications, feasibility, safety and efficacy of dorsal rhizotomy at the level of conus medullaris (conus deafferentation - CDAF) in individuals with spinal cord injury/disease (SCI/D).</p><p><strong>Setting: </strong>Two specialized tertiary German centers for spinal cord injuries.</p><p><strong>Methods: </strong>In addition to a detailed description of the surgical procedure (including two technical variants: hemilaminectomy and osteoplastic laminotomy), an analysis of the surgical reports on intra- and postoperative complications and an evaluation of the pre- and postoperative paraplegiologic and neuro-urologic parameters of SCI/D patients with CDAF are presented.</p><p><strong>Results: </strong>A total of 30 patients, 6 of them women, 22 with complete, 8 with incomplete SCI/D underwent CDAF. The most common indications were therapy-refractory detrusor overactivity, spasticity of the lower limbs and autonomic dysreflexia, usually with several simultaneous indications.Except for one antibiotic-treated wound infection, no severe CDAF-associated complications were documented. Urodynamic parameters (maximum detrusor pressure, maximum cystometric capacity) improved significantly (<i>p</i> < .001). In addition, all clinical targets (autonomic dysreflexia, spasticity triggered by bladder and bowel dysfunction, recurrent urinary tract infections, urinary incontinence) were also significantly improved.Quality of life (SCI-QoL-BDS) was significantly improved (<i>p</i> < .001) from 10 (IQR 6-16) to 17 (IQR 9.75-21), while neurogenic bowel dysfunction (NBD) score did not significantly change.</p><p><strong>Conclusions: </strong>The present study identified different indications for the use of CDAF that can be performed safely and efficiently with very few intraoperative and postoperative complications. We see a high potential in this method for the improvement of the paraplegiological and neuro-urological therapy spectrum.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442491","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}