Single-institution retrospective study. To assess postoperative functional and quality of life (QOL) outcomes in elderly patients who underwent cervical spinal cord tumor surgery using the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). Single university hospital. This retrospective study included 97 patients who underwent surgery for cervical spinal cord tumors between 2000 and 2016. Patients were divided into two groups: a younger group (patients < 65 years old) and an elderly group (patients ≥ 65 years old). Surgical outcomes were evaluated using JOA scores and JOACMEQ, with statistical comparisons between age (younger vs. elderly) and tumor types (intramedullary vs. extramedullary). Preoperative JOA scores were significantly lower in the elderly group compared to the younger group. Postoperative recovery rates were similar between the two groups. Extramedullary tumor resections in the elderly showed notable functional improvements. Conversely, elderly patients with intramedullary tumors exhibited poorer outcomes in lower extremity function and QOL, as measured by the JOACMEQ. Surgical intervention for cervical spinal cord tumors in elderly patients can yield functional and QOL outcomes similar to those in younger patients, especially for extramedullary tumors. However, intramedullary tumor resections in the elderly may result in less favorable outcomes, particularly in lower limb function and QOL. These findings underscore the importance of thorough preoperative counseling for elderly patients, highlighting potential risks and benefits based on tumor type.
{"title":"Surgical outcomes of cervical spinal cord tumor in elderly patients assessed by the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire","authors":"Shuhei Ito, Narihito Nagoshi, Toshiki Okubo, Masahiro Ozaki, Satoshi Suzuki, Kazuki Takeda, Takahito Iga, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1038/s41393-025-01075-z","DOIUrl":"10.1038/s41393-025-01075-z","url":null,"abstract":"Single-institution retrospective study. To assess postoperative functional and quality of life (QOL) outcomes in elderly patients who underwent cervical spinal cord tumor surgery using the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). Single university hospital. This retrospective study included 97 patients who underwent surgery for cervical spinal cord tumors between 2000 and 2016. Patients were divided into two groups: a younger group (patients < 65 years old) and an elderly group (patients ≥ 65 years old). Surgical outcomes were evaluated using JOA scores and JOACMEQ, with statistical comparisons between age (younger vs. elderly) and tumor types (intramedullary vs. extramedullary). Preoperative JOA scores were significantly lower in the elderly group compared to the younger group. Postoperative recovery rates were similar between the two groups. Extramedullary tumor resections in the elderly showed notable functional improvements. Conversely, elderly patients with intramedullary tumors exhibited poorer outcomes in lower extremity function and QOL, as measured by the JOACMEQ. Surgical intervention for cervical spinal cord tumors in elderly patients can yield functional and QOL outcomes similar to those in younger patients, especially for extramedullary tumors. However, intramedullary tumor resections in the elderly may result in less favorable outcomes, particularly in lower limb function and QOL. These findings underscore the importance of thorough preoperative counseling for elderly patients, highlighting potential risks and benefits based on tumor type.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 5","pages":"239-245"},"PeriodicalIF":2.2,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693357","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}
Animal study. To investigate the influence of lumbar arteries ligation on spinal cord blood flow (SCBF), and to determine by what proportion the SCBF decrease would cause spinal cord ischemia (SCI) in rabbit model. Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. SCI model was established by ligation of lumbar arteries in rabbits. 20 rabbits were divided into four groups: group A, sham surgery without ligation; group B, ligation at 3 levels; group C, ligation at 4 levels; group D, ligation at 5 levels. The SCBF was measured with laser doppler flowmetry, motor function was assessed using modified Tarlov grading system, and neurophysiological integrity was detected with motor-evoked potential (MEP), followed by histological observation on the seventh day after operation. Lumbar arteries ligation at 3 levels led to average 40% decrease of SCBF, and spinal cord remained functional, electrophysiological and histological normal. Lumbar arteries ligation at 4 levels resulted in average 50% decrease of SCBF, slight motor dysfunction, prolonged latency of MEP and decreased cell volume of neuron, rabbits presented mild spinal cord injury. Lumbar arteries ligation at 5 levels caused average 60% decrease of SCBF, complete paraplegia, loss of MEP waveform and neuron karyopyknosis, rabbits presented severe SCI. More ligation of bilateral lumbar arteries leads to lower SCBF and increase the risk of SCI in rabbits, SCBF decreased by more than 50% could cause SCI. MEP associated significantly with SCBF, suggesting the usefulness of MEP to monitoring SCBF in surgery.
{"title":"The critical threshold of blood flow associated with spinal cord ischemia in a modified rabbit model developed by ligation of lumbar arteries","authors":"Li-Feng Xing, Ding-Wen Zheng, Yan-Song Miao, Yu-Cai Hong, Wei Xiao","doi":"10.1038/s41393-025-01071-3","DOIUrl":"10.1038/s41393-025-01071-3","url":null,"abstract":"Animal study. To investigate the influence of lumbar arteries ligation on spinal cord blood flow (SCBF), and to determine by what proportion the SCBF decrease would cause spinal cord ischemia (SCI) in rabbit model. Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. SCI model was established by ligation of lumbar arteries in rabbits. 20 rabbits were divided into four groups: group A, sham surgery without ligation; group B, ligation at 3 levels; group C, ligation at 4 levels; group D, ligation at 5 levels. The SCBF was measured with laser doppler flowmetry, motor function was assessed using modified Tarlov grading system, and neurophysiological integrity was detected with motor-evoked potential (MEP), followed by histological observation on the seventh day after operation. Lumbar arteries ligation at 3 levels led to average 40% decrease of SCBF, and spinal cord remained functional, electrophysiological and histological normal. Lumbar arteries ligation at 4 levels resulted in average 50% decrease of SCBF, slight motor dysfunction, prolonged latency of MEP and decreased cell volume of neuron, rabbits presented mild spinal cord injury. Lumbar arteries ligation at 5 levels caused average 60% decrease of SCBF, complete paraplegia, loss of MEP waveform and neuron karyopyknosis, rabbits presented severe SCI. More ligation of bilateral lumbar arteries leads to lower SCBF and increase the risk of SCI in rabbits, SCBF decreased by more than 50% could cause SCI. MEP associated significantly with SCBF, suggesting the usefulness of MEP to monitoring SCBF in surgery.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 4","pages":"233-238"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658715","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}
Pub Date : 2025-03-13DOI: 10.1038/s41393-025-01070-4
Eugen Ulrich, Alexis Brinkemper, Manfred Köller, Ingo Stricker, Astrid Gisevius, Thomas A. Schildhauer, Renate Meindl, Dennis Grasmücke, Sabrina Buche-Lyding, Volkmar Nicolas, Mirko Aach
Clinical prospective study. To histologically examine puncture biopsies of early neurogenic heterotopic ossification (NHO) in spinal cord injured individuals. University of Bochum, Germany. After acute spinal trauma, participants underwent a sonographic examination of the hip joints and a routine laboratory examination. Magnetic resonance imaging (MRI) or computed tomography (CT) of the pelvis was performed if there were clinical and laboratory signs of NHO and sonographic evidence of edema and/or calcifications in the tissue around the hip joint. If NHO were detected, tissue was obtained and preserved for histological examination from the involved tissue around the hip joint affected by NHO and from an unaffected calf as control. Nine participants with a complete spinal cord lesion American Spinal Injury Association Impairment Scale (AIS) grade A and evidence of an acute NHO in the hip joint muscles were recruited for the study. In all sonographic examinations of the hip joint, edematous changes could be detected. In one case, calcifications were detected sonographically. In MRI/CT in six participants, ossification could already be detected. All histological specimens from the NHO-affected gluteal region showed varying degrees of tissue deformation. The unaffected reference samples showed regular muscular structure microscopically. It was possible to show and compare histological changes in NHO-affected tissue with MRI/CT imaging, depending on the stage of NHO. DRKS, DRKS00034049. Registered 12 April 2024 - Retrospectively registered, https://www.drks.de/DRKS00034049 .
{"title":"Histology of neurogenic heterotopic ossification and comparison with its radiological expression in acute spinal cord injured patients","authors":"Eugen Ulrich, Alexis Brinkemper, Manfred Köller, Ingo Stricker, Astrid Gisevius, Thomas A. Schildhauer, Renate Meindl, Dennis Grasmücke, Sabrina Buche-Lyding, Volkmar Nicolas, Mirko Aach","doi":"10.1038/s41393-025-01070-4","DOIUrl":"10.1038/s41393-025-01070-4","url":null,"abstract":"Clinical prospective study. To histologically examine puncture biopsies of early neurogenic heterotopic ossification (NHO) in spinal cord injured individuals. University of Bochum, Germany. After acute spinal trauma, participants underwent a sonographic examination of the hip joints and a routine laboratory examination. Magnetic resonance imaging (MRI) or computed tomography (CT) of the pelvis was performed if there were clinical and laboratory signs of NHO and sonographic evidence of edema and/or calcifications in the tissue around the hip joint. If NHO were detected, tissue was obtained and preserved for histological examination from the involved tissue around the hip joint affected by NHO and from an unaffected calf as control. Nine participants with a complete spinal cord lesion American Spinal Injury Association Impairment Scale (AIS) grade A and evidence of an acute NHO in the hip joint muscles were recruited for the study. In all sonographic examinations of the hip joint, edematous changes could be detected. In one case, calcifications were detected sonographically. In MRI/CT in six participants, ossification could already be detected. All histological specimens from the NHO-affected gluteal region showed varying degrees of tissue deformation. The unaffected reference samples showed regular muscular structure microscopically. It was possible to show and compare histological changes in NHO-affected tissue with MRI/CT imaging, depending on the stage of NHO. DRKS, DRKS00034049. Registered 12 April 2024 - Retrospectively registered, https://www.drks.de/DRKS00034049 .","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 4","pages":"227-232"},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626196","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}
Pub Date : 2025-03-06DOI: 10.1038/s41393-025-01067-z
Carlos Leonardo Cano-Herrera, Gita Manhas, Matthew Querée, Bob Hoogenes, Emma A. Bateman, Eldon Loh, William C. Miller, W. Ben Mortenson, Andrea Townson, Janice J. Eng, the SCIRE Research Team
Systematic Review and Meta-analysis. Canada. Fatigue is one of the most common consequences of spinal cord injury (SCI). In this systematic review and meta-analysis, we examined interventions for fatigue in SCI and evaluated their effectiveness. MEDLINE, EMBASE, CINAHL, and PsycINFO databases were searched up to January 2024 inclusive. Randomized controlled trials (RCTs) that assessed any intervention for at least one fatigue outcome in people with SCI were included. Study quality was assessed using the Cochrane Risk of Bias Tool. Initial screening identified 282 studies from which six RCTs were included in the review (N = 249). One study found that moderate-intensity arm-crank exercise significantly improved fatigue compared to a control group (p = 0.036) with a large effect size (standard mean difference [SMD] = 1.05; 95% confidence interval [CI], 0.10–2.00). Two studies assessing behavioral interventions found a moderate effect on fatigue (SMD = 0.46; 95% CI, −0.00–0.92; p = 0.05). Two studies did not find an effect of massage therapy on fatigue (SMD = 0.06; 95% CI, −0.38–0.50; p = 0.80). The risk of bias was classified as High for all but two of the RCTs. These findings suggest that exercise and behavioral interventions promoting an active lifestyle may have a positive effect on fatigue. More research with larger sample sizes, including controls for co-morbid conditions like pain and depression, is needed to establish evidence-based treatments for reducing fatigue in people with SCI.
{"title":"Treatments of fatigue after spinal cord injury: a systematic review and meta-analysis","authors":"Carlos Leonardo Cano-Herrera, Gita Manhas, Matthew Querée, Bob Hoogenes, Emma A. Bateman, Eldon Loh, William C. Miller, W. Ben Mortenson, Andrea Townson, Janice J. Eng, the SCIRE Research Team","doi":"10.1038/s41393-025-01067-z","DOIUrl":"10.1038/s41393-025-01067-z","url":null,"abstract":"Systematic Review and Meta-analysis. Canada. Fatigue is one of the most common consequences of spinal cord injury (SCI). In this systematic review and meta-analysis, we examined interventions for fatigue in SCI and evaluated their effectiveness. MEDLINE, EMBASE, CINAHL, and PsycINFO databases were searched up to January 2024 inclusive. Randomized controlled trials (RCTs) that assessed any intervention for at least one fatigue outcome in people with SCI were included. Study quality was assessed using the Cochrane Risk of Bias Tool. Initial screening identified 282 studies from which six RCTs were included in the review (N = 249). One study found that moderate-intensity arm-crank exercise significantly improved fatigue compared to a control group (p = 0.036) with a large effect size (standard mean difference [SMD] = 1.05; 95% confidence interval [CI], 0.10–2.00). Two studies assessing behavioral interventions found a moderate effect on fatigue (SMD = 0.46; 95% CI, −0.00–0.92; p = 0.05). Two studies did not find an effect of massage therapy on fatigue (SMD = 0.06; 95% CI, −0.38–0.50; p = 0.80). The risk of bias was classified as High for all but two of the RCTs. These findings suggest that exercise and behavioral interventions promoting an active lifestyle may have a positive effect on fatigue. More research with larger sample sizes, including controls for co-morbid conditions like pain and depression, is needed to establish evidence-based treatments for reducing fatigue in people with SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"149-158"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573865","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}
Pub Date : 2025-02-26DOI: 10.1038/s41393-025-01068-y
Mengqi Li, Wing Yiu Lo, Yule Hu, Shanshan Wang, Tsz-Ching Sun, Worku Animaw Temesgen, Mengting He, Yan Li
Scoping review. To synthesize the effects of mindfulness- and acceptance-based interventions (MABIs) on health-related outcomes of individuals with spinal cord injury. The included studies were conducted across four countries: The United States, Iran, China, and The United Kingdom. This review followed the Arksey and O’Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline. Seven databases were searched until November 2024 to identify studies published in English-language that evaluated MABIs’ effects on health-related outcomes in people with spinal cord injury. Literature screening, data extraction, and quality assessment were conducted by two reviewers independently. A narrative data synthesis was conducted. Of 2389 records, nine studies were included with designs of randomized controlled trials (n = 4), quasi-experimental studies (n = 3), and case studies (n = 2). Acceptance commitment therapy (n = 4) and mindfulness-based interventions (n = 5) were employed. MABIs demonstrated significant improvements in psychological health outcomes (depression, n = 3; anxiety, n = 3; stress, n = 2) with medium-to-large effect sizes ( $${{{{rm{eta }}}}}_{{{{rm{p}}}}}^{2}=0.112-0.223$$ ) and other health-related outcomes (chronic pain, n = 1; functional independence, n = 1; engagement in meaningful activities, n = 1; and quality of life, n = 1). Participants found the MABIs to be acceptable and satisfactory. Study quality varied from weak (n = 6) to strong (n = 2). The findings generally support the acceptability and effectiveness of MABIs for improving the overall well-being of individuals with SCI. Future research directions regarding designing MABIs and exploring effectiveness mechanisms were recommended for maximizing its benefits.
{"title":"Mindfulness- and acceptance-based interventions for people with spinal cord injury: a scoping review","authors":"Mengqi Li, Wing Yiu Lo, Yule Hu, Shanshan Wang, Tsz-Ching Sun, Worku Animaw Temesgen, Mengting He, Yan Li","doi":"10.1038/s41393-025-01068-y","DOIUrl":"10.1038/s41393-025-01068-y","url":null,"abstract":"Scoping review. To synthesize the effects of mindfulness- and acceptance-based interventions (MABIs) on health-related outcomes of individuals with spinal cord injury. The included studies were conducted across four countries: The United States, Iran, China, and The United Kingdom. This review followed the Arksey and O’Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline. Seven databases were searched until November 2024 to identify studies published in English-language that evaluated MABIs’ effects on health-related outcomes in people with spinal cord injury. Literature screening, data extraction, and quality assessment were conducted by two reviewers independently. A narrative data synthesis was conducted. Of 2389 records, nine studies were included with designs of randomized controlled trials (n = 4), quasi-experimental studies (n = 3), and case studies (n = 2). Acceptance commitment therapy (n = 4) and mindfulness-based interventions (n = 5) were employed. MABIs demonstrated significant improvements in psychological health outcomes (depression, n = 3; anxiety, n = 3; stress, n = 2) with medium-to-large effect sizes ( $${{{{rm{eta }}}}}_{{{{rm{p}}}}}^{2}=0.112-0.223$$ ) and other health-related outcomes (chronic pain, n = 1; functional independence, n = 1; engagement in meaningful activities, n = 1; and quality of life, n = 1). Participants found the MABIs to be acceptable and satisfactory. Study quality varied from weak (n = 6) to strong (n = 2). The findings generally support the acceptability and effectiveness of MABIs for improving the overall well-being of individuals with SCI. Future research directions regarding designing MABIs and exploring effectiveness mechanisms were recommended for maximizing its benefits.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"159-170"},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516684","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}
Pub Date : 2025-02-26DOI: 10.1038/s41393-025-01065-1
Suhani Sharma, Alisha Sial, Stone Sima, Ashish Diwan
Scoping Review. Degenerative cervical myelopathy (DCM) is a leading cause of chronic spinal cord dysfunction, with diverse clinical presentations that complicate diagnosis. Therefore, it is important to identify the signs and symptoms of DCM that demonstrate high diagnostic accuracy. This review aims to evaluate the sensitivity and specificity of signs and symptoms in diagnosing DCM. Articles up to June 2024 were retrieved from PubMed, EMBASE, and Cochrane databases using search terms like “degenerative cervical myelopathy”, “cervical spondylotic myelopathy”, “sensitivity”, “specificity”, and related signs and symptoms. Studies were screened based on selection criteria assessing the sensitivity and specificity of signs or symptoms using an appropriate control group. Sixteen studies were included. The most sensitive signs were Tromner sign (93–97%) and hyperreflexia (15–85%). Specific signs included the Babinski sign (93–100%), Tromner sign (79–100%), clonus (96–99%), and inverted supinator sign (78–99%). Neck pain had a sensitivity of 76–94% and specificity of 11–73%. Hand incoordination showed 52% sensitivity and 92% specificity. Altered hand sensation had 76% sensitivity and 90% specificity. Upper extremity weakness had 51–75% sensitivity and 18–95% specificity. Gait imbalance exhibited 56–63% sensitivity and 52–95% specificity. Sensitive signs like the Tromner sign and hyperreflexia are useful for screening, while specific signs such as Babinski, clonus, and the inverted supinator sign aid in confirmation of DCM. Symptoms like neck pain, hand incoordination, and altered hand sensation should heighten suspicion and guide differential diagnosis. Early and accurate diagnosis using these indicators can improve patient outcomes and reduce diagnostic delays.
{"title":"Clinical signs and symptoms for degenerative cervical myelopathy: a scoping review of case-control studies to facilitate early diagnosis among healthcare professionals with stakeholder engagement","authors":"Suhani Sharma, Alisha Sial, Stone Sima, Ashish Diwan","doi":"10.1038/s41393-025-01065-1","DOIUrl":"10.1038/s41393-025-01065-1","url":null,"abstract":"Scoping Review. Degenerative cervical myelopathy (DCM) is a leading cause of chronic spinal cord dysfunction, with diverse clinical presentations that complicate diagnosis. Therefore, it is important to identify the signs and symptoms of DCM that demonstrate high diagnostic accuracy. This review aims to evaluate the sensitivity and specificity of signs and symptoms in diagnosing DCM. Articles up to June 2024 were retrieved from PubMed, EMBASE, and Cochrane databases using search terms like “degenerative cervical myelopathy”, “cervical spondylotic myelopathy”, “sensitivity”, “specificity”, and related signs and symptoms. Studies were screened based on selection criteria assessing the sensitivity and specificity of signs or symptoms using an appropriate control group. Sixteen studies were included. The most sensitive signs were Tromner sign (93–97%) and hyperreflexia (15–85%). Specific signs included the Babinski sign (93–100%), Tromner sign (79–100%), clonus (96–99%), and inverted supinator sign (78–99%). Neck pain had a sensitivity of 76–94% and specificity of 11–73%. Hand incoordination showed 52% sensitivity and 92% specificity. Altered hand sensation had 76% sensitivity and 90% specificity. Upper extremity weakness had 51–75% sensitivity and 18–95% specificity. Gait imbalance exhibited 56–63% sensitivity and 52–95% specificity. Sensitive signs like the Tromner sign and hyperreflexia are useful for screening, while specific signs such as Babinski, clonus, and the inverted supinator sign aid in confirmation of DCM. Symptoms like neck pain, hand incoordination, and altered hand sensation should heighten suspicion and guide differential diagnosis. Early and accurate diagnosis using these indicators can improve patient outcomes and reduce diagnostic delays.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"171-180"},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-025-01065-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516763","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}
A cross-sectional validation study. The aim of the study was to create a Turkish version of the Spinal Cord Independence Measure Self-Report (SCIM-SR) scale and verify its validity and reliability. Rehabilitation Department at Istanbul Physical Medicine and Rehabilitation and Training Research Hospital. The Turkish version of SCIM-SR was translated from English using forward and backward translation in accordance with standard guidelines and 90 participants completed the SCIM-SR Turkish form. At the same time, a Spinal Cord Independence Measure III (SCIM III) was administered to the participants by a health professional through observation. Cronbach’s alpha, Pearson and Spearman correlation coefficients were used to evaluate the internal consistency and concurrent validity. The Cronbach’s α coefficients for the total scale was 0.883. For the subscales, it was 0.929 for self-care, 0.571 for respiration and sphincter management and 0.885 for mobility. Test-retest reliability after two weeks yielded Spearman coefficients above 0.92 for the total scale and all subscales. When analyzing the correlation between SCIM-SR and SCIM III, the intraclass correlation average and its lower and upper bound values were as follows: 0.984 (0.976–0.990) for self-care; 0.970 (0.955–0.980) for respiration and sphincter management; 0.968 (0.951–0.979) for mobility and 0.980 (0.969–0.987) for the total. There was good agreement between SCIM-SR and SCIM III when evaluating the total score in Bland-Altman graphs. The Bland–Altman analysis revealed no significant proportional bias (0.76; 95% CI [−21.34, 22.87]), but a significant fixed bias was observed. The Turkish version of SCIM-SR demonstrated excellent internal consistency and good validity in Turkish individuals with spinal cord injury.
{"title":"Validity and reliability of the Turkish version of the Spinal Cord Independence Measure (SCIM III) self-report","authors":"Yelda Soluk Özdemir, Cansın Medin Ceylan, Nurdan Paker, Veysel Korkut, Burak Kütük, Kadriye Öneş, Derya Buğdaycı, Fatma N. Kesiktaş","doi":"10.1038/s41393-025-01069-x","DOIUrl":"10.1038/s41393-025-01069-x","url":null,"abstract":"A cross-sectional validation study. The aim of the study was to create a Turkish version of the Spinal Cord Independence Measure Self-Report (SCIM-SR) scale and verify its validity and reliability. Rehabilitation Department at Istanbul Physical Medicine and Rehabilitation and Training Research Hospital. The Turkish version of SCIM-SR was translated from English using forward and backward translation in accordance with standard guidelines and 90 participants completed the SCIM-SR Turkish form. At the same time, a Spinal Cord Independence Measure III (SCIM III) was administered to the participants by a health professional through observation. Cronbach’s alpha, Pearson and Spearman correlation coefficients were used to evaluate the internal consistency and concurrent validity. The Cronbach’s α coefficients for the total scale was 0.883. For the subscales, it was 0.929 for self-care, 0.571 for respiration and sphincter management and 0.885 for mobility. Test-retest reliability after two weeks yielded Spearman coefficients above 0.92 for the total scale and all subscales. When analyzing the correlation between SCIM-SR and SCIM III, the intraclass correlation average and its lower and upper bound values were as follows: 0.984 (0.976–0.990) for self-care; 0.970 (0.955–0.980) for respiration and sphincter management; 0.968 (0.951–0.979) for mobility and 0.980 (0.969–0.987) for the total. There was good agreement between SCIM-SR and SCIM III when evaluating the total score in Bland-Altman graphs. The Bland–Altman analysis revealed no significant proportional bias (0.76; 95% CI [−21.34, 22.87]), but a significant fixed bias was observed. The Turkish version of SCIM-SR demonstrated excellent internal consistency and good validity in Turkish individuals with spinal cord injury.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 4","pages":"222-226"},"PeriodicalIF":2.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504289","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}
Pub Date : 2025-02-20DOI: 10.1038/s41393-025-01063-3
Ali Khodabakhshi Korelaei, Arash Fallahi, Michael R. Hamblin, Fatemeh Ramezani
Systematic review and meta-analysis. In this study, the effects of the antioxidant melatonin on motor function after spinal cord injury were investigated in preclinical studies. IRAN The search strategy was designed based on keywords related to melatonin and spinal cord injury. The primary screening was based on title and abstract, and the secondary screening was based on the full text of the articles. After extracting data from the articles, statistical analysis was performed using STATA software. Standardized mean differences were used to analyze the results of the included studies. Subgroup analysis and quality control of articles were also performed. Based on the results of 29 separate experiments, melatonin showed a significant strong effect compared to the untreated group. The results showed that IP injection and multiple administrations days had the strong effect in the first three days as well as after 3–4 weeks. But more studies are needed to draw conclusions about its longer term effects. The analysis of MDA, SOD and GSH redox factors showed that the amount of MDA decreased and the amount of GSH increased in the treated animals. Also, the inflammatory factors IL-1Β and TNF-α as well as apoptosis and the rate of neuronal cell death, were reduced in animals that received melatonin, while the number of viable neurons was increased in melatonin treated animals. Melatonin is an antioxidant supplement, which can be considered for clinical trials in human SCI patients. IRAN University of medical sciences
{"title":"The effect of melatonin administration on motor recovery after spinal cord injury in animal models: a systematic review and meta-analysis","authors":"Ali Khodabakhshi Korelaei, Arash Fallahi, Michael R. Hamblin, Fatemeh Ramezani","doi":"10.1038/s41393-025-01063-3","DOIUrl":"10.1038/s41393-025-01063-3","url":null,"abstract":"Systematic review and meta-analysis. In this study, the effects of the antioxidant melatonin on motor function after spinal cord injury were investigated in preclinical studies. IRAN The search strategy was designed based on keywords related to melatonin and spinal cord injury. The primary screening was based on title and abstract, and the secondary screening was based on the full text of the articles. After extracting data from the articles, statistical analysis was performed using STATA software. Standardized mean differences were used to analyze the results of the included studies. Subgroup analysis and quality control of articles were also performed. Based on the results of 29 separate experiments, melatonin showed a significant strong effect compared to the untreated group. The results showed that IP injection and multiple administrations days had the strong effect in the first three days as well as after 3–4 weeks. But more studies are needed to draw conclusions about its longer term effects. The analysis of MDA, SOD and GSH redox factors showed that the amount of MDA decreased and the amount of GSH increased in the treated animals. Also, the inflammatory factors IL-1Β and TNF-α as well as apoptosis and the rate of neuronal cell death, were reduced in animals that received melatonin, while the number of viable neurons was increased in melatonin treated animals. Melatonin is an antioxidant supplement, which can be considered for clinical trials in human SCI patients. IRAN University of medical sciences","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"135-148"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469337","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}
Pub Date : 2025-02-17DOI: 10.1038/s41393-025-01066-0
Pavlos Texakalidis, Stavros Matsoukas, Nikhil Murthy, Adenike A. Adewuyi, Nader S. Dahdaleh, Colin K. Franz, Kevin Swong
Systematic review and meta-analysis. Cervical spinal cord injury (SCI) and brachial plexus injury (BPI) can result in hand paralysis. Reconstruction of hand motion is associated with improved functionality and quality of life. We synthesized the outcomes of finger and thumb flexion after various nerve transfers to the anterior interosseous nerve (AIN). A systematic literature review and meta-analysis was performed according to the PRISMA guidelines. Successful finger and thumb flexion recovery was defined as Medical research council (MRC) grade ≥3. In total, 23 studies with 99 patients and 120 nerve transfers to the AIN were performed. The mean interval from injury to surgery was 12.8 months and mean follow-up duration was 24 months. Overall, 81/120 (67.5%) and 68/102 (66.7%) hands achieved successful finger and thumb flexion recovery, respectively. Individual-patient-data were available for 94 nerve transfers. Type of injury (SCI vs BPI/peripheral) did not affect finger flexion outcomes (OR 1.92, 95%CI 0.74–5.0, p = 0.17). On multivariate analysis adjusted for mechanism of injury, timing of injury to surgery and duration of follow-up, utilization of the brachioradialis (BR) branch (25%, 1/4, OR 0.01, 95%CI 0.0006–0.44, p = 0.01) and brachialis (BA) branch (59%, 30/51, OR 0.06, 95%CI 0.006–0.68, p = 0.02) as donors, were associated with statistically significant lower odds of successful finger flexion recovery compared to extensor carpi radialis brevis (ECRB) use (95%, 19/20). Similar outcomes were observed with SCI and BPI/peripheral type injuries. ECRB utilization as a donor was superior to BA or BR branch in terms of successful finger flexion recovery.
研究设计：系统评价和荟萃分析。目的：颈脊髓损伤（SCI）和臂丛损伤（BPI）可导致手部瘫痪。手部运动的重建与功能和生活质量的改善有关。我们综合了各种神经转移到前骨间神经（AIN）后手指和拇指屈曲的结果。方法：根据PRISMA指南进行系统的文献综述和meta分析。成功的手指和拇指屈曲恢复定义为医学研究委员会（MRC）分级≥3。结果：共进行了23项研究，99例患者，120例神经转移到AIN。从受伤到手术的平均时间间隔为12.8个月，平均随访时间为24个月。总体而言，81/120（67.5%）和68/102（66.7%）只手分别成功恢复手指和拇指屈曲。94例神经移植的个体患者数据可用。损伤类型（SCI vs BPI/外周）不影响手指屈曲结果（OR 1.92, 95%CI 0.74-5.0, p = 0.17）。在调整损伤机制、手术损伤时间和随访时间的多因素分析中，使用肱桡肌（BR）分支（25%,1/4,OR 0.01, 95% ci 0.0006-0.44, p = 0.01）和肱桡肌（BA）分支（59%,30/51,OR 0.06, 95% ci 0.006-0.68, p = 0.02）作为供体，与使用桡侧短腕伸肌（ECRB）（95%, 19/20）相比，成功恢复手指屈曲的几率具有统计学意义显著性低。结论：脊髓损伤和BPI/外周型损伤的结果相似。ECRB作为供体在成功恢复手指屈曲方面优于BA或BR分支。
{"title":"Nerve transfers to anterior interosseous nerve for restoration of finger flexion in spinal cord and brachial plexus injury: a systematic Review and individual-patient-data meta-analysis","authors":"Pavlos Texakalidis, Stavros Matsoukas, Nikhil Murthy, Adenike A. Adewuyi, Nader S. Dahdaleh, Colin K. Franz, Kevin Swong","doi":"10.1038/s41393-025-01066-0","DOIUrl":"10.1038/s41393-025-01066-0","url":null,"abstract":"Systematic review and meta-analysis. Cervical spinal cord injury (SCI) and brachial plexus injury (BPI) can result in hand paralysis. Reconstruction of hand motion is associated with improved functionality and quality of life. We synthesized the outcomes of finger and thumb flexion after various nerve transfers to the anterior interosseous nerve (AIN). A systematic literature review and meta-analysis was performed according to the PRISMA guidelines. Successful finger and thumb flexion recovery was defined as Medical research council (MRC) grade ≥3. In total, 23 studies with 99 patients and 120 nerve transfers to the AIN were performed. The mean interval from injury to surgery was 12.8 months and mean follow-up duration was 24 months. Overall, 81/120 (67.5%) and 68/102 (66.7%) hands achieved successful finger and thumb flexion recovery, respectively. Individual-patient-data were available for 94 nerve transfers. Type of injury (SCI vs BPI/peripheral) did not affect finger flexion outcomes (OR 1.92, 95%CI 0.74–5.0, p = 0.17). On multivariate analysis adjusted for mechanism of injury, timing of injury to surgery and duration of follow-up, utilization of the brachioradialis (BR) branch (25%, 1/4, OR 0.01, 95%CI 0.0006–0.44, p = 0.01) and brachialis (BA) branch (59%, 30/51, OR 0.06, 95%CI 0.006–0.68, p = 0.02) as donors, were associated with statistically significant lower odds of successful finger flexion recovery compared to extensor carpi radialis brevis (ECRB) use (95%, 19/20). Similar outcomes were observed with SCI and BPI/peripheral type injuries. ECRB utilization as a donor was superior to BA or BR branch in terms of successful finger flexion recovery.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"127-134"},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441990","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}
Systematic Review. To thoroughly assess the existing literature regarding the impact of anti-RhoA/ROCK agents or procedures on functional recovery in animal models of SCI. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences. A comprehensive search was conducted in Ovid MEDLINE, Embase, Scopus, and Web of Science Core Collection utilizing a combination of keywords. All in-vivo animal studies of acute or chronic SCI that evaluated the pharmacological effects of Rho/ROCK inhibitors in English literature were included in this study. Totally, 2320 articles were identified, of which, 60 papers were included for further analysis. A total of 47 (78%) studies were conducted merely on rats, 9 (15%) on mice, 3 (5%) used both, and the remaining used other animals. Y-27632, Fasudil, C3 Transferase and its derivatives (C3-05/PEP-C3/CT04/C3bot154–182/C3bot26mer(156–181)), Ibuprofen, Electroacupuncture (EA), SiRhoA, miR-133b, miR-135-5p, miR-381, miR-30b, Statins, 17β-estradiol, β-elemene, Lentivirus-mediated PGC-1a, Repulsive guidance molecule (RGMa), Local profound hypothermia, Jisuikang (JSK), Hyperbaric oxygen (HBO), Lv-shRhoA (Notch-1 inhibitor), Anti-Ryk antibody, LINGO-antagonist, BA-210, p21Cip1/WAF1, ORL-1 antagonist, Epigallocatechin‐3‐gallate (EGCG), Tamsulosin, AAV.ULK1.DN, and Indomethacin were the 28 reported agents/procedures with anti-RhoA/ROCK effects. The pooled SMD for BBB scores was 0.41 (p = 0.048) in the first week, 0.85 (p < 0.001) in the second week, 1.22 (p = 0.010) in the third week, and 1.53 (p = 0.001) in the fourth week. Of the 28 identified anti-RhoA/ROCK agents, all but two (C3bot and its derivatives and EGCG) demonstrated promising results. The results of the meta-analysis cautiously indicate a significant increase in BBB scores over time after SCI.
{"title":"The potential role of RhoA/ROCK-inhibition on locomotor recovery after spinal cord injury: a systematic review of in-vivo studies","authors":"Armin Khavandegar, Negar Sadat Ahmadi, Maryam Alsadat Mousavi, Zahra Ramezani, Elaheh Khodadoust, Mahgol Sadat Hasan Zadeh Tabatabaei, Zahra Hasanpour Segherlou, Arman Zeinaddini-Meymand, Fatemeh Nasehi, Maral Moafi, Kimia RayatSanati, Rasool Masoomi, Sorour Hamidi, Soheila Pourkhodadad, Vafa Rahimi-Movaghar","doi":"10.1038/s41393-025-01064-2","DOIUrl":"10.1038/s41393-025-01064-2","url":null,"abstract":"Systematic Review. To thoroughly assess the existing literature regarding the impact of anti-RhoA/ROCK agents or procedures on functional recovery in animal models of SCI. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences. A comprehensive search was conducted in Ovid MEDLINE, Embase, Scopus, and Web of Science Core Collection utilizing a combination of keywords. All in-vivo animal studies of acute or chronic SCI that evaluated the pharmacological effects of Rho/ROCK inhibitors in English literature were included in this study. Totally, 2320 articles were identified, of which, 60 papers were included for further analysis. A total of 47 (78%) studies were conducted merely on rats, 9 (15%) on mice, 3 (5%) used both, and the remaining used other animals. Y-27632, Fasudil, C3 Transferase and its derivatives (C3-05/PEP-C3/CT04/C3bot154–182/C3bot26mer(156–181)), Ibuprofen, Electroacupuncture (EA), SiRhoA, miR-133b, miR-135-5p, miR-381, miR-30b, Statins, 17β-estradiol, β-elemene, Lentivirus-mediated PGC-1a, Repulsive guidance molecule (RGMa), Local profound hypothermia, Jisuikang (JSK), Hyperbaric oxygen (HBO), Lv-shRhoA (Notch-1 inhibitor), Anti-Ryk antibody, LINGO-antagonist, BA-210, p21Cip1/WAF1, ORL-1 antagonist, Epigallocatechin‐3‐gallate (EGCG), Tamsulosin, AAV.ULK1.DN, and Indomethacin were the 28 reported agents/procedures with anti-RhoA/ROCK effects. The pooled SMD for BBB scores was 0.41 (p = 0.048) in the first week, 0.85 (p < 0.001) in the second week, 1.22 (p = 0.010) in the third week, and 1.53 (p = 0.001) in the fourth week. Of the 28 identified anti-RhoA/ROCK agents, all but two (C3bot and its derivatives and EGCG) demonstrated promising results. The results of the meta-analysis cautiously indicate a significant increase in BBB scores over time after SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"95-126"},"PeriodicalIF":2.1,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433839","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}
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