Journal of Spinal Cord Medicine最新文献

{"title":"How does the rehabilitation environment influence quality of life in people with newly acquired spinal cord injury or disorder during acute-inpatient rehabilitation? A mixed methods study.","authors":"Maren Westphal, Seraina Notter, Priyanka Walavalkar, Jürgen Pannek, Marcel Post, Sara Rubinelli, Anke Scheel-Sailer","doi":"10.1080/10790268.2026.2715236","DOIUrl":"10.1080/10790268.2026.2715236","url":null,"abstract":"<p><strong>Context/objectives: </strong>To explore how the rehabilitation environment influences quality of life (QoL) during acute-inpatient rehabilitation after spinal cord injury (SCI).</p><p><strong>Design: </strong>Mixed methods.</p><p><strong>Setting: </strong>Specialized SCI Center.</p><p><strong>Participants: </strong>Individuals aged 18 or older with newly acquired SCI (<i>N</i> = 20).</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Outcome measure: </strong>International SCI Quality of Life Basic Data Set (SCI QoL-BDS) with an extra item on environmental QoL and qualitative semi-structured face-to-face interviews.</p><p><strong>Methods: </strong>Interviews were conducted at least three months after the onset of SCI and two weeks before discharge from acute inpatient rehabilitation. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed according to thematic content analysis.</p><p><strong>Results: </strong>Environment-related QoL was rated high (Mdn  =  9, IQR =    7-9) and strongly correlated with psychological health-related QoL. Interpersonal and physical environmental factors emerged as main themes from interviews examining influences on environment-related QoL. Participants reported higher QoL when healthcare providers were empathic, understanding, motivated, kind, optimistic, transparent, encouraging, attentive, respectful, and had a sense of humor. Empowering behaviors, such as involving patients in decision-making and including family members and friends in the rehabilitation process, also contributed to higher QoL. Institutional factors such as understaffing, noise, and lack of privacy lowered QoL, while physical environmental factors such as wheelchair accessibility, access to a meditation room, beautiful landscape, food quality, cleanliness, and accommodation increased QoL.</p><p><strong>Conclusion: </strong>Findings highlight the importance of client-centered care for QoL during acute-inpatient rehabilitation and psychosocial benefits of a rehabilitation environment design that includes wheelchair accessibility on rehabilitation grounds, proximity to nature, and a space for socializing.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":1.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801014","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":"Off-target effects of percutaneous epidural spinal cord and dorsal root ganglion stimulation with task-specific training on lower urinary tract function in individuals with chronic spinal cord injury.","authors":"Christina Soong, Daniel D Veith, Megan L Gill, Lisa A Beck, Julie B Block, Anders J Asp, K A Fernandez, Margaux B Linde, Candee J Mills, Tyson L Scrabeck, Omid Jahanian, Peter J Grahn, Kristin D Zhao, Ryan Solinsky","doi":"10.1080/10790268.2026.2703371","DOIUrl":"10.1080/10790268.2026.2703371","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the off-target effects of motor-optimized SCS-enabled task-specific training (SCS-TST) on lower urinary tract function through self-reported data from individuals with chronic spinal cord injury (SCI), using the Neurogenic Bladder Symptom Score (NBSS). A secondary objective was to explore whether participant characteristics or bladder treatments were associated with changes in NBSS outcomes.</p><p><strong>Design: </strong>Datasets from two prospective pilot trials using percutaneous spinal cord stimulation (SCS) to enable motor function were analyzed and reported.</p><p><strong>Setting: </strong>Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota.</p><p><strong>Participants: </strong>Adults ≥ 1-year post traumatic SCI.</p><p><strong>Interventions: </strong>Participants received either 12 days of epidural stimulation (ES) or 10 days of ES and dorsal root ganglion stimulation (ESDRS), each coupled with 6-8 SCS-TST sessions.</p><p><strong>Outcome measures: </strong>NBSS was administered pre- and post-intervention.</p><p><strong>Results: </strong>Analysis of 23 participants (ES, n = 3; ESDRS, n = 20) showed no significant group-level changes in total NBSS (<i>p</i> = 0.49) or functional domains (<i>p</i> = 0.56-0.85). Individually, 83% demonstrated no clinically meaningful change, while 9% improved and 9% worsened. Exploratory analyses identified that symptom change was associated with neurological level of injury (<i>p</i> = 0.017), age (<i>p</i> = 0.026), and marginally associated with injury severity (<i>p</i> = 0.055). Oxybutynin use was associated with lower symptom variability, without statistical significance (<i>p</i> = 0.074).</p><p><strong>Conclusions: </strong>Motor-optimized SCS-TST did not lead to significant group-level changes in patient-reported urinary symptoms. However, a subset of individuals experienced improvement or worsening, suggesting that injury characteristics and medication use may influence urinary outcomes. These preliminary findings warrant confirmation in larger, adequately powered trials.<b>Trial Registration:</b> ClinicalTrials.gov identifiers: NCT05095454, NCT04736849.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":1.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800942","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":"Weight loss strategies used by individuals with spinal cord injuries or disorders: Prevalence and associations with health, dietary, and activity factors.","authors":"Alex W K Wong, Allen W Heinemann, Rena M Steiger-Chadwick, Gary J Farkas, Lorena Reyes, Dan Eisenberg, Jennifer Burns, Myrissa Le, Brian Bartle, Sherri L LaVela","doi":"10.1080/10790268.2026.2709253","DOIUrl":"https://doi.org/10.1080/10790268.2026.2709253","url":null,"abstract":"<p><strong>Context: </strong>Individuals with SCI/D with motor paralysis are at increased risk of obesity. They also experience reduced resting metabolic rate, premature chronic conditions, and secondary complications (<i>e.g.</i> pain) that challenge weight management. As such, careful attention to weight-loss strategies such as exercise and diet is needed. This study aims to identify the prevalence of intentional weight-loss strategies among individuals with SCI/D and to examine associations between their use of these strategies and health, dietary, and activity factors.</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Setting: </strong>National Veterans Health Administration SCI/D Centers, Midwest Regional SCI Model System of Care, and Shirley Ryan AbilityLab.</p><p><strong>Participants: </strong>Veterans and civilians with SCI/D recruited by mailed invitation letters.</p><p><strong>Interventions: </strong>NA.</p><p><strong>Outcome measures: </strong>Questions assessing demographic and injury characteristics, chronic health conditions, secondary complications, and dietary and physical activity factors.</p><p><strong>Results: </strong>301 participants with SCI/D (mean age: 57 years, 67% men, 74% white, and 56% paraplegia) completed the outcome item on weight-loss strategies. 69% of participants reported using weight-loss strategies, with general dieting (40%), restricted-calorie intake (34%), and eliminating specific food categories/types (31%) the most common strategies. Being overweight/obese (OR = 6.93), having diabetes (OR = 7.49), having urinary tract infections (OR = 2.98), preparing meals oneself (OR = 4.01), and having the last eating occasion before 8 pm (OR = 2.52) were associated with the use of weight-loss strategies.</p><p><strong>Conclusion: </strong>Weight-loss strategies for individuals with SCI/D are prevalent and are associated with dietary habits and health conditions. These findings highlight opportunities to improve informed and sustainable weight management practices after SCI/D.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800975","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":"Experiences of participating in a regenerative randomized controlled trial following traumatic spinal cord injury: A longitudinal qualitative process evaluation.","authors":"Ann-Christin von Vogelsang, Mikael Svensson","doi":"10.1080/10790268.2026.2713311","DOIUrl":"https://doi.org/10.1080/10790268.2026.2713311","url":null,"abstract":"<p><p><b>Context:</b> There is a current knowledge gap regarding spinal cord injured patients' motives and expectations when enrolled in regenerative studies. In addition, the impact of trial participation on daily life and perceived intervention effects remains undescribed.<b>Objective:</b> To describe the experiences of participating in a regenerative randomized controlled trial following traumatic spinal cord injury.<b>Design:</b> Longitudinal qualitative process evaluation.<b>Setting:</b> University hospital and rehabilitation center in Sweden.<b>Participants:</b> Nine participants with a complete chronic traumatic thoracic SCI, included in the SC0806 study.<b>Interventions:</b> Participants were in the SC0806 study allocated to one of two treatment arms: surgical implantation of a biodegradable device followed by robot-assisted gait training (RAGT), or RAGT alone.<b>Outcome measures:</b> Semi-structured interviews were performed four times: before randomization, at six months, 18, and 30 months after randomization. Audio-recorded interviews were transcribed and were analyzed with manifest content analysis, following a pattern-oriented longitudinal approach to inductively describe experiences over time.<b>Results:</b> In total, 32 interviews were conducted. Motives for participating were potential functional recovery and altruism. Surgical implantation resulted in physical symptoms that changed over time; for some participants, neurological pain and spasticity were reduced. The RAGT sessions and traveling were time-consuming and affected various aspects of everyday life. Participants completed the study according to the SC0806 protocol, despite the research burden.<b>Conclusions:</b> Study participation involved a substantial research burden; however, acceptability within the treatment arms, as well as sustainability and participant retention, were satisfactory. None of the participants who underwent surgical implantation experienced neurological deterioration.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800949","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":"Cardiometabolic factors in middle-aged people with long-term cervical and upper thoracic spinal cord injuries.","authors":"Mattias Hill, Sophie Jörgensen, Gunnar Engström, Jan Lexell","doi":"10.1080/10790268.2026.2709252","DOIUrl":"https://doi.org/10.1080/10790268.2026.2709252","url":null,"abstract":"<p><strong>Objective: </strong>To describe arterial stiffness, ankle-brachial index (ABI), advanced glycation end products (AGE) and glycosylated hemoglobin (HbA1c) in middle-aged people with cervical and upper thoracic SCI, and compare findings with the general population.</p><p><strong>Design: </strong>Cross-sectional study with matched controls.</p><p><strong>Setting: </strong>Tertiary outpatient SCI unit in southern Sweden.</p><p><strong>Participants: </strong>Participants (n = 25) in the Swedish Spinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA) (20% women, mean age 58 years, mean time since injury 28 years, injury levels C2-T6, American Spinal Injury Association Impairment Scale A-C). Controls (n = 250; ratio 10:1) from the general population were obtained from the Swedish CArdioPulmonary bioImage Study (SCAPIS).</p><p><strong>Outcome measures: </strong>Aortic augmentation index at heart rate of 75 bpm (Aortic Aix@75), pulse wave velocity, ABI, AGE, HbA1c and anthropometry.</p><p><strong>Results: </strong>The participants had significantly higher measures of Aortic Aix@75 (mean 35 vs 21, P = 0.004) and AGE (mean 2.6 vs 2.1, P < 0.001), and lower ABI (mean 1.07 vs 1.26, P < 0.001) and HbA1c (mean 36 vs 37, P = 0.007) than the controls. An abnormal HbA1c level (<31 or >46) was present in eight (32%) and 23 (9%) of the participants with SCI and controls, respectively (P = 0.003). Pulse wave velocity was similar between participants with SCI and controls (mean 8.6 m/s vs 8.5 m/s, P = 0.53).</p><p><strong>Conclusions: </strong>The difference in cardiometabolic factors between middle-aged people with long-term cervical and upper thoracic SCI and the general population implies that their cardiometabolic health is compromised. Further studies are needed to determine the prognostic significance of these differences.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT03515122.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800946","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":"An evaluation of pressure injury associated pelvic osteomyelitis in patients with spinal cord injuries in a Veterans Affairs population.","authors":"Esther H Kanner, Jaclyn A Cusumano, Olga Sherman, Swapna Johnson-Kunjukutty, Kirsten Vest","doi":"10.1080/10790268.2026.2667033","DOIUrl":"https://doi.org/10.1080/10790268.2026.2667033","url":null,"abstract":"<p><strong>Context: </strong>Pressure injury (PI)-related pelvic osteomyelitis in patients with spinal cord injuries (SCI) is associated with significant morbidity and mortality. Limited data are available to dictate optimal management. The presented work describes the management of patients with SCI and PI-related osteomyelitis managed by a multidisciplinary Veterans Affairs team.</p><p><strong>Methods: </strong>A descriptive retrospective chart review of patients ≥ 18 years of age with a culture-positive clinical diagnosis of PI-associated pelvic osteomyelitis between January 2018 and October 2023 was conducted. Baseline demographics, SCI injury characteristics, treatment regimens, and surgical interventions were collected. Treatment failure was defined as relapse, need for chronic suppressive therapy, or death due to osteomyelitis. Differences in patient characteristics and treatments received between those that experienced treatment success and failure were compared using Fisher's exact test.</p><p><strong>Results: </strong>A total of 31 patients were identified, with a median age of 66 years; the majority were male (97%). Cultures were predominantly polymicrobial (81%) and grew multidrug-resistant organisms (62%). Nineteen patients (61%) had a surgical intervention performed, which was primarily debridement. Eight patients (26%) met the criteria for treatment failure. Patients in the treatment success group were more likely to receive a non-beta-lactam-containing regimen (57% vs. 0%, p = 0.0096). The median treatment durations were 63 vs 57 days in the treatment success and failure groups respectively.</p><p><strong>Conclusion: </strong>In this review of PI-associated osteomyelitis, most patients had polymicrobial infections caused by multidrug resistant organisms. Choice of a non-beta-lactam regimen was associated with treatment success. Larger studies are needed to adequately describe optimal management of these patients.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":1.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801031","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":"Bridging clinical capacity and functional performance: Clinical predictors of independence in advanced wheelchair skills after spinal cord injury.","authors":"Eunhye Kim, Hyun-Jin Kim, Areum Jeong, Hyosun Kweon, Jung Hwan Kim","doi":"10.1080/10790268.2026.2697598","DOIUrl":"https://doi.org/10.1080/10790268.2026.2697598","url":null,"abstract":"<p><strong>Context: </strong>Advanced wheelchair skills (ramp, railing, curb, wheelie) are essential for mobility after spinal cord injury (SCI), but predictors of discharge independence remain unclear.</p><p><strong>Objective: </strong>To identify admission predictors of improvement and discharge independence in advanced wheelchair skills after SCI.</p><p><strong>Methods: </strong>We retrospectively analyzed 150 inpatients with SCI (2016-2023) at a single rehabilitation hospital with admission and discharge assessments for four advanced wheelchair skills. For each skill, participants were classified as Group 1 (no improvement or decline and remained dependent), Group 2 (improved but remained dependent), or Group 3 (achieved or maintained independence). Admission variables were compared across groups, and multinomial logistic regression used Group 3 as the reference.</p><p><strong>Results: </strong>In adjusted models, older age increased the odds of Group 1 and Group 2 classifications compared with Group 3; for wheelie, ORs were 1.08 and 1.09 per year, respectively (both P < 0.001). Greater upper-extremity strength was associated with reduced odds of Group 1 classification for wheelie (OR 0.43, 95% CI 0.21-0.87) and ramp (OR 0.44, 95% CI 0.25-0.78), but not for railing or curb. Longer post-injury duration was associated with lower odds of a dependent outcome for curb (OR 0.998 per day, P < 0.05). In unadjusted comparisons, outcome-group distributions differed by age group, neurological level, and AIS grade.</p><p><strong>Conclusions: </strong>Older age was associated with dependent outcomes across skills, whereas upper-extremity strength favored independence in wheelie and ramp only. These findings support incorporating age and task-relevant upper-limb capacity into goal setting and training prioritization; prospective studies should quantify training exposure and goal priorities.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680910","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":"Enhancing practical skills in spinal cord injury physiotherapy education using a case-based mobile virtual patient: A randomized mixed-methods study.","authors":"Levent Çetinkaya, Serkan Yildirim, Ilke Keser, Hafize Keser","doi":"10.1080/10790268.2026.2702191","DOIUrl":"https://doi.org/10.1080/10790268.2026.2702191","url":null,"abstract":"<p><strong>Context: </strong>Developing practical skills and clinical reasoning in complex conditions such as spinal cord injury (SCI) is a central goal of physiotherapy education; however, opportunities for repeated practice with real patients are often limited, highlighting the potential value-based mobile virtual patient applications.</p><p><strong>Objective: </strong>To evaluate whether a case-based mobile virtual patient application, used to supplement traditional teaching, was associated with higher practical examination performance in SCI education, and to explore students' perceptions of usability and educational value.</p><p><strong>Design: </strong>Explanatory sequential mixed-methods study with a randomized post-test-only controlled quantitative phase followed by qualitative analysis of open-ended responses.</p><p><strong>Setting: </strong>Neurological Rehabilitation course in an undergraduate physiotherapy and rehabilitation program.</p><p><strong>Participants: </strong>Eighty-three eligible undergraduate physiotherapy students were randomly assigned to experimental (n = 42) or control (n = 41) groups.</p><p><strong>Interventions: </strong>Both groups received the same face-to-face instruction; only the experimental group had access to the case-based mobile application with interactive decision prompts and structured feedback.</p><p><strong>Outcome measures: </strong>Practical skills were assessed in a post-test-only practical examination using a standardized checklist; Functional Neuroanatomy final exam score served as a contextual indicator of prior academic performance, and open-ended responses from the experimental group were categorized and summarized by frequency.</p><p><strong>Results: </strong>Baseline academic performance did not differ between groups (t(81) = 1.445, P > 0.05). The experimental group achieved significantly higher practical examination scores than the control group (M = 26.57 vs. 22.63; t(81) = 3.741, P < 0.001; Cohen's d = 0.819), indicating a large effect. Qualitative findings indicated perceived benefits for theory-practice integration, learning flexibility, case-based clinical decision-making, and confidence, alongside challenges related to small-screen use and content density.</p><p><strong>Conclusion: </strong>When integrated alongside traditional instruction, a case-based mobile virtual patient application was associated with higher practical examination performance in SCI education and may support skill acquisition and student engagement within physiotherapy curricula.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":1.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664819","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":"Using the SPIKES protocol to deliver prognostic information on ambulation potential after complete spinal cord injury: Effects on coping strategies.","authors":"Zuhal Ozisler, Fatma Kumbara, Asli Turan, Elif Yalcin","doi":"10.1080/10790268.2026.2696688","DOIUrl":"https://doi.org/10.1080/10790268.2026.2696688","url":null,"abstract":"<p><strong>Context/objective: </strong>Delivering prognostic information about ambulation after spinal cord injury (SCI) is a sensitive yet essential responsibility. This study aimed to evaluate the effect of the SPIKES protocol on coping strategies in individuals with neurologically complete SCI, and to explore their experiences and expectations regarding breaking bad news (BBN) in Turkey.</p><p><strong>Design: </strong>Matched comparative study.</p><p><strong>Setting: </strong>Tertiary-level SCI rehabilitation clinic.</p><p><strong>Participants: </strong>Twenty-five individuals with neurologically complete SCI were included in the intervention group and received prognostic information using the SPIKES protocol. Twenty-seven matched controls who had completed inpatient rehabilitation at other centers were included for comparison.</p><p><strong>Interventions: </strong>Structured delivery of ambulation prognosis using the SPIKES protocol.</p><p><strong>Outcome measures: </strong>Coping strategies were assessed using the Spinal Cord Lesion-Related Coping Strategies Questionnaire (SCL-CSQ).</p><p><strong>Results: </strong>94.2% of all participants expressed a desire to receive prognostic information even if unfavorable, with 36.7% preferring to receive it during acute care. Participants' expectations did not differ by demographic characteristics (P > 0.05). Individuals with paraplegia showed a higher preference to receive information regarding ambulation prognosis during acute care than individuals with tetraplegia (45.7% vs. 14.3%; P = 0.039). Participants in the SPIKES group demonstrated higher acceptance, fighting spirit, and total coping scores than controls (P < 0.05), with no significant difference in social reliance.</p><p><strong>Conclusion: </strong>Most individuals with neurologically complete SCI preferred to receive prognostic information, even when unfavorable. In this pilot study, structured communication using the SPIKES protocol was associated with more adaptive coping strategies; further studies are warranted to confirm these findings.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664917","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":"Factors associated with reduced life expectancy in patients aged 65 and older with traumatic spinal cord injury.","authors":"María Urrea-Ballesteros, Joint Guimbard-Pérez, José Ramón Muñoz-Rodríguez, Miguel Peral-Alarma, Andrés Barriga-Martín","doi":"10.1080/10790268.2026.2699544","DOIUrl":"https://doi.org/10.1080/10790268.2026.2699544","url":null,"abstract":"<p><strong>Context/objective: </strong>Traumatic spinal cord injury (TSCI) in older adults is increasingly associated with falls and high mortality. This study aimed to estimate the life expectancy deficit associated with TSCI in patients aged ≥65 years and to identify predictors of mortality.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>National Hospital for Paraplegics (Toledo, Spain).</p><p><strong>Participants: </strong>Consecutive patients aged ≥65 years with TSCI admitted between 2009 and 2024 (n = 369).</p><p><strong>Outcome measures: </strong>Mortality and life expectancy deficit compared with age-matched national life tables, as well as the identification of mortality predictors.</p><p><strong>Results: </strong>The mean age at injury was 73 ± 5.7 years, and 71.5% were men. Falls were the main cause of injury (74.3%), and subaxial cervical lesions were the most frequent (65.6%). Overall mortality was 51.5%, with a mean estimated survival of 7.66 years. In the Cox model, older age at injury (HR = 1.054; P < 0.001), anticoagulant therapy (HR = 1.811; P = 0.002), and COPD (HR = 2.138; P = 0.015) independently increased mortality risk, whereas higher SCIM scores at discharge (HR = 0.975; P < 0.001) were associated with improved survival. Patients with complete and cervical injuries showed the shortest survival times. The life expectancy deficit attributable to TSCI decreased from 13.0 years in patients aged 65-69 years to approximately 3 years in those aged ≥80 years.</p><p><strong>Conclusion: </strong>TSCI in older adults is associated with high mortality and reduced life expectancy, particularly in complete and cervical injuries. Functional independence was associated with improved survival.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664873","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}