Journal of neurotrauma
-
Journal of neurotrauma · Aug 2022
Protective effect of extended laminectomy on spinal cord injury induced by spinal shortening.
This study investigates the effect of extended laminectomy (EL) on spinal cord injury (SCI) caused by spinal shortening, and further, the timing and the optimal length of removal. Dogs received spinal column shortening at T13 segment, following which the control group underwent regular laminectomy while other groups underwent laminectomy with an additional 1-lamina length removed 6h after shortening ("1-lamina EL 6 h"), an extra 1.5-lamina length resected at 6 h or 12 h after shortening ("1.5-lamina EL 6 h" and "1.5-lamina EL 12 h"), and an extra 2-lamina length removed at 6 or 12 h after shortening ("2-lamina EL 6 h" and 2-lamina EL 12 h"), respectively. Somatosensory evoked potential (SSEP) and neurological function were recorded periodically; spinal cord blood flow (SCBF) and nerve cell apoptosis were detected. ⋯ The "2-lamina EL 6 h" group, in particular, showed the most prominent recovery. In conclusion, an additional resection of two laminae at 6 h after shortening showed the best effect in alleviating SCI. Timely and adequately extended laminectomy could be a potential therapeutic strategy for SCI attributable to spinal shortening.
-
Journal of neurotrauma · Aug 2022
ReviewAdvances in Epidural Spinal Cord Stimulation to Restore Function after Spinal Cord Injury: History and Systematic Review.
Epidural spinal cord stimulation (eSCS) has been recently recognized as a potential therapy for chronic spinal cord injury (SCI). eSCS has been shown to uncover residual pathways within the damaged spinal cord. The purpose of this review is to summarize the key findings to date regarding the use of eSCS in SCI. Searches were carried out using MEDLINE, EMBASE, and Web of Science database and reference lists of the included articles. ⋯ The wide range of included outcomes demonstrates the effectiveness of eSCS in treating a diverse SCI population. However, the current studies cannot definitively conclude which patients benefit the most from this intervention. Further study in this area is needed to allow improvement of the eSCS technology and allow it to be more widely available for chronic SCI patients.
-
Journal of neurotrauma · Aug 2022
Appendicular fracture and polytrauma correlate with outcome of spinal cord injury (SCI): A TRACK-SCI study.
Spinal cord injuries (SCIs) frequently occur in combination with other major organ injuries, such as traumatic brain injury (TBI) and injuries to the chest, abdomen, and musculoskeletal system (e.g., extremity, pelvic, and spine fractures). However, the effects of appendicular fractures on SCI recovery are poorly understood. We investigated whether the presence of SCI-concurrent appendicular fractures is predictive of a less robust SCI recovery. ⋯ Secondary analyses suggested that appendicular fractures also increased hospital length of stay. Our study indicated that SCI-associated polytrauma is important for predicting SCI functional outcomes. Further statistical evaluation is required to disentangle the effects of appendicular fractures, non-fracture solid organ injury, and SCI physiology to improve health outcomes among SCI patients.
-
Journal of neurotrauma · Aug 2022
Hybrid Functional Electrical Stimulation improves anaerobic threshold in first three years following spinal cord injury.
The purpose of the present investigation was to assess the effects of whole-body exercise on the anaerobic threshold in individuals with spinal cord injury (SCI). Maximal oxygen uptake (VO2max) and oxygen uptake at anaerobic threshold (AT) were measured before and after six months of hybrid functional electrical stimulation row training in 47 participants with SCI aged 19-63, neurological levels of injury C4-L1, American Spinal Injury Association Impairment Scale grades A-D, and time since injury at enrollment from three months to 40 years. Changes in VO2max differed with time since injury, with greater increases earlier post-injury. ⋯ Consistent with VO2max changes, AT increased in the early chronic group (1.03 ± 0.31 to 1.20 ± 0.40 L/min, p < 0.05) and did not change in the late chronic group (0.99 ± 0.31 to 0.99 ± 0.26 L/min, p = 0.92). Cumulative duration of exercise training was positively correlated to change in VO2max (r = 0.475, p < 0.05) but not to change in AT. Hybrid functional electrical stimulation row training is effective for increasing aerobic capacity and anaerobic threshold in individuals with SCI; however, these fitness benefits are only significant in individuals initiating the exercise intervention within three years of injury.