Pub Date : 2025-11-05DOI: 10.1038/s41393-025-01141-6
Samuel David Williamson, Anders Orup Aaby, Anine Overgaard Ejersbo, Marianne Rahbek Vestergaard, Sophie Lykkegaard Ravn
Scoping review. Spasticity is a common and often challenging sequela of spinal cord injury (SCI) associated with pain, contractures, and reduced quality of life. While passive movement (PM) is primarily used to maintain joint mobility, clinical observations and participant reports suggest that both manual and automated techniques can contribute to the management of spasticity in SCI. However, the evidence base concerning PM’s impact on spasticity outcomes in SCI populations remains unclear. This review aims to identify the scope and synthesize the empirical evidence of PM interventions for managing spasticity in individuals with SCI. Seven databases (Embase, Medline, PsycInfo, Web of Science, Scopus, CENTRAL, and CINAHL) were systematically searched. Eligible studies were peer-reviewed, reported original data, included adult participants (≥18 years) with SCI, presented a therapeutic intervention consisting solely of PM techniques, and reported any spasticity outcome. Data were extracted and analyzed by two independent reviewers. The initial search identified 1628 unique studies, of which 13 were included for analysis. The PM interventions included passive cycling and robotic PM interventions (n = 8), continuous passive motion (n = 4), and manual passive range of motion (PROM) (n = 1). While a minority of studies demonstrated sustained improvements in spasticity outcomes, the majority reported short-term reductions observed in small sample groups, single-session experiments, or using suboptimal research designs. This review assembled the existing evidence on PM interventions for managing spasticity in individuals with SCI. Despite finding consistent short-term improvements, further high-quality research is needed to determine clinical efficacy and inform future rehabilitation practices.
研究设计：范围审查。目的：痉挛是脊髓损伤（SCI）的一种常见且具有挑战性的后遗症，与疼痛、挛缩和生活质量下降有关。虽然被动运动（PM）主要用于维持关节活动，但临床观察和参与者报告表明，手动和自动技术都有助于脊髓损伤痉挛的管理。然而，关于PM对脊髓损伤人群痉挛结果影响的证据基础仍不清楚。本综述旨在确定PM干预治疗脊髓损伤患者痉挛的范围和综合经验证据。方法：系统检索Embase、Medline、PsycInfo、Web of Science、Scopus、CENTRAL、CINAHL 7个数据库。符合条件的研究经过同行评审，报告了原始数据，包括SCI的成年参与者（≥18岁），提出了仅由PM技术组成的治疗干预，并报告了任何痉挛结果。数据由两名独立审稿人提取和分析。结果：最初的搜索确定了1628个独特的研究，其中13个被纳入分析。PM干预包括被动骑车和机器人PM干预（n = 8），连续被动运动（n = 4）和手动被动运动范围（n = 1）。虽然少数研究表明痉挛结果持续改善，但大多数研究报告在小样本组，单次实验或使用次优研究设计中观察到短期减少。结论：本综述收集了PM干预治疗脊髓损伤患者痉挛的现有证据。尽管发现了持续的短期改善，但需要进一步的高质量研究来确定临床疗效并为未来的康复实践提供信息。
{"title":"Passive movement interventions and spasticity outcomes in individuals with spinal cord injury during rehabilitation: a scoping review","authors":"Samuel David Williamson, Anders Orup Aaby, Anine Overgaard Ejersbo, Marianne Rahbek Vestergaard, Sophie Lykkegaard Ravn","doi":"10.1038/s41393-025-01141-6","DOIUrl":"10.1038/s41393-025-01141-6","url":null,"abstract":"Scoping review. Spasticity is a common and often challenging sequela of spinal cord injury (SCI) associated with pain, contractures, and reduced quality of life. While passive movement (PM) is primarily used to maintain joint mobility, clinical observations and participant reports suggest that both manual and automated techniques can contribute to the management of spasticity in SCI. However, the evidence base concerning PM’s impact on spasticity outcomes in SCI populations remains unclear. This review aims to identify the scope and synthesize the empirical evidence of PM interventions for managing spasticity in individuals with SCI. Seven databases (Embase, Medline, PsycInfo, Web of Science, Scopus, CENTRAL, and CINAHL) were systematically searched. Eligible studies were peer-reviewed, reported original data, included adult participants (≥18 years) with SCI, presented a therapeutic intervention consisting solely of PM techniques, and reported any spasticity outcome. Data were extracted and analyzed by two independent reviewers. The initial search identified 1628 unique studies, of which 13 were included for analysis. The PM interventions included passive cycling and robotic PM interventions (n = 8), continuous passive motion (n = 4), and manual passive range of motion (PROM) (n = 1). While a minority of studies demonstrated sustained improvements in spasticity outcomes, the majority reported short-term reductions observed in small sample groups, single-session experiments, or using suboptimal research designs. This review assembled the existing evidence on PM interventions for managing spasticity in individuals with SCI. Despite finding consistent short-term improvements, further high-quality research is needed to determine clinical efficacy and inform future rehabilitation practices.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 12","pages":"633-641"},"PeriodicalIF":2.2,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41393-025-01141-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453194","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 : 2025-11-04DOI: 10.1038/s41393-025-01136-3
Samantha J. Borg, Victoria McCreanor, Timothy Geraghty, Karen Luetsch, Steven M. McPhail, Susanna Cramb, Rania Shibl, Melanie Proper, Bill Loveday, Cate M. Cameron
Population-based data linkage of state-based opioid dispensing, hospital administrative and death registry data. This study aimed to provide a detailed overview of opioid dispensing in the 2-years following SCI. Community. Linked data were obtained for adults admitted to Queensland hospitals with a newly diagnosed traumatic or non-traumatic SCI from 1 January 2014–31 December 2017. Community opioid dispensing data was obtained for 3 months pre-SCI and up to two years after their Index Hospital Admission for SCI. Chronic dispensing (≥90 cumulative dispensing days) and high end dose (median daily dose of 50 or more oral morphine equivalents in the last 3 months of dispensing) were calculated from dispensing data. Of the 298 included cases (180 traumatic; 118 non-traumatic), 1 or more opioids were dispensed to 19% of the cohort in the 3 months pre-SCI (40% non-traumatic SCI; 6% traumatic SCI) and to 53% post-SCI (56% non-traumatic SCI; 52% traumatic SCI). Those who were dispensed opioids pre-SCI were 3.7 times more likely to have been dispensed opioids in the observation period (95% confidence interval: 1.90, 7.24, p < 0.001). Thirty percent of the cohort have been dispensed opioids chronically. High opioid end doses were significantly more likely among those with non-traumatic SCI. Whilst it was positive that many were not dispensed an opioid post-SCI, the high prevalence of high opioid doses and chronic duration is concerning. The reliance on opioids for pain management suggests stronger approaches to coordinated and improved multi-disciplinary long-term pain management is needed.
{"title":"Community opioid dispensing prevalence and patterns in adults with spinal cord injury in Queensland: a retrospective data linkage study","authors":"Samantha J. Borg, Victoria McCreanor, Timothy Geraghty, Karen Luetsch, Steven M. McPhail, Susanna Cramb, Rania Shibl, Melanie Proper, Bill Loveday, Cate M. Cameron","doi":"10.1038/s41393-025-01136-3","DOIUrl":"10.1038/s41393-025-01136-3","url":null,"abstract":"Population-based data linkage of state-based opioid dispensing, hospital administrative and death registry data. This study aimed to provide a detailed overview of opioid dispensing in the 2-years following SCI. Community. Linked data were obtained for adults admitted to Queensland hospitals with a newly diagnosed traumatic or non-traumatic SCI from 1 January 2014–31 December 2017. Community opioid dispensing data was obtained for 3 months pre-SCI and up to two years after their Index Hospital Admission for SCI. Chronic dispensing (≥90 cumulative dispensing days) and high end dose (median daily dose of 50 or more oral morphine equivalents in the last 3 months of dispensing) were calculated from dispensing data. Of the 298 included cases (180 traumatic; 118 non-traumatic), 1 or more opioids were dispensed to 19% of the cohort in the 3 months pre-SCI (40% non-traumatic SCI; 6% traumatic SCI) and to 53% post-SCI (56% non-traumatic SCI; 52% traumatic SCI). Those who were dispensed opioids pre-SCI were 3.7 times more likely to have been dispensed opioids in the observation period (95% confidence interval: 1.90, 7.24, p < 0.001). Thirty percent of the cohort have been dispensed opioids chronically. High opioid end doses were significantly more likely among those with non-traumatic SCI. Whilst it was positive that many were not dispensed an opioid post-SCI, the high prevalence of high opioid doses and chronic duration is concerning. The reliance on opioids for pain management suggests stronger approaches to coordinated and improved multi-disciplinary long-term pain management is needed.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 12","pages":"681-689"},"PeriodicalIF":2.2,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446055","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 : 2025-10-29DOI: 10.1038/s41393-025-01127-4
Xing Zhao, Miao Bai, Hang Li, Lili Lian, Qiuru Li
Integrative multi-omics cross-sectional study combining scRNA-seq, bulk transcriptomics, Mendelian randomization, and network pharmacology with molecular docking. To investigate the therapeutic mechanisms of methyl gallate (MG) in spinal cord injury (SCI) through the lens of cell-type-specific pathways and immune regulation. Publicly available SCI transcriptomic datasets and GWAS summary data were analyzed using established bioinformatics platforms. This study integrated single-cell RNA sequencing (scRNA-seq), transcriptomics, genome-wide association study (GWAS)-based Mendelian randomization (MR), and network pharmacology to explore MG’s effects on SCI. Temporal scRNA-seq profiles were analyzed from mice with subacute SCI (days 3 to 14 post-injury) to identify changes in astrocyte dynamics and glia-neuron interactions. Differential gene expression and functional enrichment analyses were performed, followed by drug–target prediction and molecular docking. scRNA-seq revealed a significant reduction in astrocyte populations and disrupted astrocyte–monocyte–neuron communication post-SCI. A total of 959 astrocyte-specific and 1,459 SCI-related differentially expressed genes (DEGs) were identified. Enrichment analyses highlighted neuroimmune and inflammatory pathways. MR indicated a protective association between elevated monocyte count and reduced SCI risk. Network pharmacology and molecular docking demonstrated that MG targets overlapped with astrocyte DEGs, suggesting high binding affinities and regulatory effects on inflammation and neuron–glia signaling. MG may promote recovery from SCI by modulating neuroimmune interactions, particularly through astrocyte and monocyte-mediated pathways. The integrative multi-omics strategy supports MG’s translational potential as a novel therapeutic candidate for SCI.
{"title":"Targeting astrocyte-monocyte-neuron crosstalk in spinal cord injury: therapeutic insights from methyl gallate","authors":"Xing Zhao, Miao Bai, Hang Li, Lili Lian, Qiuru Li","doi":"10.1038/s41393-025-01127-4","DOIUrl":"10.1038/s41393-025-01127-4","url":null,"abstract":"Integrative multi-omics cross-sectional study combining scRNA-seq, bulk transcriptomics, Mendelian randomization, and network pharmacology with molecular docking. To investigate the therapeutic mechanisms of methyl gallate (MG) in spinal cord injury (SCI) through the lens of cell-type-specific pathways and immune regulation. Publicly available SCI transcriptomic datasets and GWAS summary data were analyzed using established bioinformatics platforms. This study integrated single-cell RNA sequencing (scRNA-seq), transcriptomics, genome-wide association study (GWAS)-based Mendelian randomization (MR), and network pharmacology to explore MG’s effects on SCI. Temporal scRNA-seq profiles were analyzed from mice with subacute SCI (days 3 to 14 post-injury) to identify changes in astrocyte dynamics and glia-neuron interactions. Differential gene expression and functional enrichment analyses were performed, followed by drug–target prediction and molecular docking. scRNA-seq revealed a significant reduction in astrocyte populations and disrupted astrocyte–monocyte–neuron communication post-SCI. A total of 959 astrocyte-specific and 1,459 SCI-related differentially expressed genes (DEGs) were identified. Enrichment analyses highlighted neuroimmune and inflammatory pathways. MR indicated a protective association between elevated monocyte count and reduced SCI risk. Network pharmacology and molecular docking demonstrated that MG targets overlapped with astrocyte DEGs, suggesting high binding affinities and regulatory effects on inflammation and neuron–glia signaling. MG may promote recovery from SCI by modulating neuroimmune interactions, particularly through astrocyte and monocyte-mediated pathways. The integrative multi-omics strategy supports MG’s translational potential as a novel therapeutic candidate for SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"64 2","pages":"199-207"},"PeriodicalIF":2.2,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401992","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}
Retrospective comparative study. To compare surgical and clinical outcomes of thoracic intradural extramedullary (IDEM) meningiomas based on tumor location, specifically between ventral and dorsal/lateral lesions. This study retrospectively analyzed 60 consecutive patients who underwent posterior surgical resection for thoracic IDEM meningiomas at a single institution between 2007 and 2022. Patients were stratified into two groups according to tumor location on preoperative MRI: Ventral group (n = 23) and Dorsal/Lateral group (n = 37). Clinical outcomes were assessed using the modified McCormick scale (MMCS). Surgical parameters and complications were also compared. Patients in the Ventral group had significantly larger sagittal tumor diameters and higher spinal canal occupancy rates than those in the Dorsal/Lateral group (p < 0.05). Preoperative motor deficits were more frequent in the Ventral group (86.9 vs. 51.3%, p < 0.01). Estimated blood loss was greater in the Ventral group (p = 0.01). Intraoperative motor evoked potential deterioration occurred more often (p = 0.04). Although both groups showed neurological improvement postoperatively, the percentage of patients reaching MMCS Grade I at final follow-up was significantly lower in the Ventral group (17.3 vs. 54.0%, p < 0.01). No tumor recurrence was observed in either group during the follow-up period (mean: 61.4 months). Ventrally located thoracic IDEM meningiomas are associated with more severe preoperative motor dysfunction and inferior postoperative neurological recovery compared to dorsal/lateral lesions. These findings highlight the importance of early surgical intervention and tailored surgical planning for ventral tumors to optimize functional outcomes.
{"title":"Comparison of surgical and clinical outcomes between ventral and dorsal/lateral thoracic intradural extramedullary meningiomas: a retrospective study","authors":"Yu Suematsu, Narihito Nagoshi, Toshiki Okubo, Masahiro Ozaki, Satoshi Suzuki, Kazuki Takeda, Takahito Iga, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1038/s41393-025-01132-7","DOIUrl":"10.1038/s41393-025-01132-7","url":null,"abstract":"Retrospective comparative study. To compare surgical and clinical outcomes of thoracic intradural extramedullary (IDEM) meningiomas based on tumor location, specifically between ventral and dorsal/lateral lesions. This study retrospectively analyzed 60 consecutive patients who underwent posterior surgical resection for thoracic IDEM meningiomas at a single institution between 2007 and 2022. Patients were stratified into two groups according to tumor location on preoperative MRI: Ventral group (n = 23) and Dorsal/Lateral group (n = 37). Clinical outcomes were assessed using the modified McCormick scale (MMCS). Surgical parameters and complications were also compared. Patients in the Ventral group had significantly larger sagittal tumor diameters and higher spinal canal occupancy rates than those in the Dorsal/Lateral group (p < 0.05). Preoperative motor deficits were more frequent in the Ventral group (86.9 vs. 51.3%, p < 0.01). Estimated blood loss was greater in the Ventral group (p = 0.01). Intraoperative motor evoked potential deterioration occurred more often (p = 0.04). Although both groups showed neurological improvement postoperatively, the percentage of patients reaching MMCS Grade I at final follow-up was significantly lower in the Ventral group (17.3 vs. 54.0%, p < 0.01). No tumor recurrence was observed in either group during the follow-up period (mean: 61.4 months). Ventrally located thoracic IDEM meningiomas are associated with more severe preoperative motor dysfunction and inferior postoperative neurological recovery compared to dorsal/lateral lesions. These findings highlight the importance of early surgical intervention and tailored surgical planning for ventral tumors to optimize functional outcomes.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"64 2","pages":"186-191"},"PeriodicalIF":2.2,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41393-025-01132-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378780","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 : 2025-10-26DOI: 10.1038/s41393-025-01133-6
Jingchi Li, Tianshun Chen, Xuyan Yan, Lin Luo
This paper systematically analyzes literature from PubMed, MEDLINE, Embase, and Cochrane databases over the past 10 years (up to May 25, 2025). It employs defined search terms, inclusion/exclusion criteria, and a documented search flow to evaluate mechanisms, efficacy, challenges, and future directions of neuromodulation technologies for spinal cord injury rehabilitation. The results synthesize findings from clinical trials, and representative papers. This review aims to evaluate the mechanisms and clinical applications of device-based neuromodulation technologies in spinal cord injury (SCI) rehabilitation, focusing on their efficacy, challenges, and future directions. The countries and regions worldwide participating in neuromodulation. We systematically analyzed advancements in neuromodulation over the past decade, including brain-spinal interfaces (BSI), brain-computer interfaces (BCI), cranial stimulation techniques (DBS, TMS, tDCS), spinal cord stimulation (SCS), robotic exoskeletons. The review integrates findings from clinical trials. Neuromodulation technologies demonstrate significant potential in restoring motor and sensory function post-SCI. BSI and BCI improve mobility but face infection and cybersecurity risks. Cranial stimulation techniques enhance neuroplasticity, with DBS and TMS showing efficacy, while tDCS requires further validation. Epidural SCS enables motor recovery in complete paralysis but has high infection rates. Robotic exoskeletons benefit younger patients. Neuromodulation technologies represent promising interventions for SCI, yet challenges remain in precision, safety, and efficacy. Future research should prioritize AI-driven parameter optimization, wearable device development, and multicenter randomized trials to establish these methods as core treatments, ultimately improving patient outcomes and quality of life.
{"title":"The effect of device-based neuromodulation on the motor recovery of patients with spinal cord injury","authors":"Jingchi Li, Tianshun Chen, Xuyan Yan, Lin Luo","doi":"10.1038/s41393-025-01133-6","DOIUrl":"10.1038/s41393-025-01133-6","url":null,"abstract":"This paper systematically analyzes literature from PubMed, MEDLINE, Embase, and Cochrane databases over the past 10 years (up to May 25, 2025). It employs defined search terms, inclusion/exclusion criteria, and a documented search flow to evaluate mechanisms, efficacy, challenges, and future directions of neuromodulation technologies for spinal cord injury rehabilitation. The results synthesize findings from clinical trials, and representative papers. This review aims to evaluate the mechanisms and clinical applications of device-based neuromodulation technologies in spinal cord injury (SCI) rehabilitation, focusing on their efficacy, challenges, and future directions. The countries and regions worldwide participating in neuromodulation. We systematically analyzed advancements in neuromodulation over the past decade, including brain-spinal interfaces (BSI), brain-computer interfaces (BCI), cranial stimulation techniques (DBS, TMS, tDCS), spinal cord stimulation (SCS), robotic exoskeletons. The review integrates findings from clinical trials. Neuromodulation technologies demonstrate significant potential in restoring motor and sensory function post-SCI. BSI and BCI improve mobility but face infection and cybersecurity risks. Cranial stimulation techniques enhance neuroplasticity, with DBS and TMS showing efficacy, while tDCS requires further validation. Epidural SCS enables motor recovery in complete paralysis but has high infection rates. Robotic exoskeletons benefit younger patients. Neuromodulation technologies represent promising interventions for SCI, yet challenges remain in precision, safety, and efficacy. Future research should prioritize AI-driven parameter optimization, wearable device development, and multicenter randomized trials to establish these methods as core treatments, ultimately improving patient outcomes and quality of life.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 12","pages":"621-632"},"PeriodicalIF":2.2,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373037","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 : 2025-10-21DOI: 10.1038/s41393-025-01128-3
Chien-Po Liu, Shin-Liang Pan
{"title":"Reply to the comment on \"increased risk of osteoarthritis in persons with spinal cord injury: a population-based longitudinal follow-up study in Taiwan\".","authors":"Chien-Po Liu, Shin-Liang Pan","doi":"10.1038/s41393-025-01128-3","DOIUrl":"https://doi.org/10.1038/s41393-025-01128-3","url":null,"abstract":"","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347478","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 : 2025-10-21DOI: 10.1038/s41393-025-01130-9
Yue Cao, Noelle Forcier, James S. Krause
Cohort study. To identify the self-reported pneumonia history since spinal cord injury (SCI) onset and the self-reported period prevalence of pneumonia in the past 12 months, and to investigate the relationship between a history of pneumonia (measured at time 1) and health conditions five years later (time 2). Medical University in the Southeastern United States. Participants (N = 768) met the following inclusion criteria: traumatic SCI of at least 1-year duration, minimum of 18 years of age, and residual impairment from SCI. Of these, 554 (72%) were successfully followed up, who comprised of our final sample. We used the Poisson regression model to examine the association between pneumonia history at time 1 with the self-reported health conditions at time 2. At time 1 measurement, 29% of participants reported pneumonia history since SCI onset. Among them, 14% had pneumonia once, and 15% experienced pneumonia more than once. After controlling for other independent variables, participants who reported multiple episodes of pneumonia at time 1 had a 22% higher likelihood of experiencing a health problem at time 2 than those without a pneumonia history. The repeated pneumonia history in the past is a significant predictor for future pneumonia episodes and other health conditions. It is important to prevent recurrent pneumonia to enhance both the longevity and quality of life for individuals with SCI.
{"title":"Pneumonia history and long-term impact on people with traumatic spinal cord injury: A 5-year cohort study","authors":"Yue Cao, Noelle Forcier, James S. Krause","doi":"10.1038/s41393-025-01130-9","DOIUrl":"10.1038/s41393-025-01130-9","url":null,"abstract":"Cohort study. To identify the self-reported pneumonia history since spinal cord injury (SCI) onset and the self-reported period prevalence of pneumonia in the past 12 months, and to investigate the relationship between a history of pneumonia (measured at time 1) and health conditions five years later (time 2). Medical University in the Southeastern United States. Participants (N = 768) met the following inclusion criteria: traumatic SCI of at least 1-year duration, minimum of 18 years of age, and residual impairment from SCI. Of these, 554 (72%) were successfully followed up, who comprised of our final sample. We used the Poisson regression model to examine the association between pneumonia history at time 1 with the self-reported health conditions at time 2. At time 1 measurement, 29% of participants reported pneumonia history since SCI onset. Among them, 14% had pneumonia once, and 15% experienced pneumonia more than once. After controlling for other independent variables, participants who reported multiple episodes of pneumonia at time 1 had a 22% higher likelihood of experiencing a health problem at time 2 than those without a pneumonia history. The repeated pneumonia history in the past is a significant predictor for future pneumonia episodes and other health conditions. It is important to prevent recurrent pneumonia to enhance both the longevity and quality of life for individuals with SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 12","pages":"690-694"},"PeriodicalIF":2.2,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347486","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 : 2025-10-15DOI: 10.1038/s41393-025-01129-2
Hirofumi Kusumoto, Isabel M. Alvarez, Dudley Fukunaga, Sean D. Dreyer, Kevin W. Rolfe
Retrospective case-control. To evaluate if early resistance training in the context of gunshot spinal cord injury is associated with neurologic decline or need for secondary surgery for a new neurological deficit or spinal deformity correction. A rehabilitation center in southern California. A retrospective review of 114 patients from a national spinal cord injury rehabilitation center was conducted. Patients were allocated to two groups: those who initiated resistance training exercises (e.g. free weight or weight machine exercises, resistance band exercises, or ergometer use on a resistance setting) within three weeks of date of injury and those who began after three weeks. Primary endpoints included change in American Spinal Injury Association (ASIA) grade and need for spinal surgery for any reason following resistance training exercises completed during the acute inpatient rehabilitation stay. Mean follow up interval was 2.5 ± 0.3 years for the entire study population. No patients sustained a neurologic decline or required secondary surgery for late deformity correction or any other reason regardless of time to resistance training initiation. There was no difference in ASIA grade improvement rates across either group. Immediate resistance training as part of a rehabilitation regimen for gunshot spinal cord injury appears safe.
{"title":"Immediate supraphysiologic load bearing of the spine appears safe after gunshot-related spinal cord injury: a case-control study","authors":"Hirofumi Kusumoto, Isabel M. Alvarez, Dudley Fukunaga, Sean D. Dreyer, Kevin W. Rolfe","doi":"10.1038/s41393-025-01129-2","DOIUrl":"10.1038/s41393-025-01129-2","url":null,"abstract":"Retrospective case-control. To evaluate if early resistance training in the context of gunshot spinal cord injury is associated with neurologic decline or need for secondary surgery for a new neurological deficit or spinal deformity correction. A rehabilitation center in southern California. A retrospective review of 114 patients from a national spinal cord injury rehabilitation center was conducted. Patients were allocated to two groups: those who initiated resistance training exercises (e.g. free weight or weight machine exercises, resistance band exercises, or ergometer use on a resistance setting) within three weeks of date of injury and those who began after three weeks. Primary endpoints included change in American Spinal Injury Association (ASIA) grade and need for spinal surgery for any reason following resistance training exercises completed during the acute inpatient rehabilitation stay. Mean follow up interval was 2.5 ± 0.3 years for the entire study population. No patients sustained a neurologic decline or required secondary surgery for late deformity correction or any other reason regardless of time to resistance training initiation. There was no difference in ASIA grade improvement rates across either group. Immediate resistance training as part of a rehabilitation regimen for gunshot spinal cord injury appears safe.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 12","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303578","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}
A retrospective comparative study. To clarify the distinctive magnetic resonance imaging (MRI) features and surgical outcomes of intramedullary schwannoma (IMS) compared to extramedullary schwannoma (EMS) in the spinal cord. Hospital in Tokyo, Japan. 19 cases each of IMS and EMS were matched by propensity score from a cohort of spinal cord tumor patients treated between 2008 and 2022. Preoperative MRI images were meticulously analyzed for general values and distinctive features at the tumor-spinal cord interface. Surgical outcomes were assessed based on neurological function, visual analogue scale (VAS), and recurrence rates. IMS and EMS exhibited similar MRI intensity patterns on T1- and T2-weighted images, but differed significantly in features surrounding the tumor, such as rough boarder (IMS: 78.9%, EMS: 5.3%, P value < 0.001) and peritumoral edema (IMS: 57.9%, EMS: 10.5%, P value = 0.005). Postoperatively, IMS cases showed substantial neurological improvement, with no recurrences following gross total resection (GTR). However, residual pain at the segmental level persisted more commonly in IMS compared to EMS (postoperative VAS, IMS: 45.0 ± 34.3, EMS: 19.7 ± 26.8, P value = 0.017). The distinct MRI features identified, particularly the observation of the border with the spinal cord, offer valuable insights for differentiating IMS from EMS preoperatively. Although IMS results in improved neurological function with no recurrence following GTR, attention must be given to residual pain.
{"title":"Comparative analysis of MRI features and surgical outcomes between intramedullary and extramedullary schwannomas in the spinal cord","authors":"Takahiro Kitagawa, Narihito Nagoshi, Manabu Hase, Toshiki Okubo, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Osahiko Tsuji, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1038/s41393-025-01125-6","DOIUrl":"10.1038/s41393-025-01125-6","url":null,"abstract":"A retrospective comparative study. To clarify the distinctive magnetic resonance imaging (MRI) features and surgical outcomes of intramedullary schwannoma (IMS) compared to extramedullary schwannoma (EMS) in the spinal cord. Hospital in Tokyo, Japan. 19 cases each of IMS and EMS were matched by propensity score from a cohort of spinal cord tumor patients treated between 2008 and 2022. Preoperative MRI images were meticulously analyzed for general values and distinctive features at the tumor-spinal cord interface. Surgical outcomes were assessed based on neurological function, visual analogue scale (VAS), and recurrence rates. IMS and EMS exhibited similar MRI intensity patterns on T1- and T2-weighted images, but differed significantly in features surrounding the tumor, such as rough boarder (IMS: 78.9%, EMS: 5.3%, P value < 0.001) and peritumoral edema (IMS: 57.9%, EMS: 10.5%, P value = 0.005). Postoperatively, IMS cases showed substantial neurological improvement, with no recurrences following gross total resection (GTR). However, residual pain at the segmental level persisted more commonly in IMS compared to EMS (postoperative VAS, IMS: 45.0 ± 34.3, EMS: 19.7 ± 26.8, P value = 0.017). The distinct MRI features identified, particularly the observation of the border with the spinal cord, offer valuable insights for differentiating IMS from EMS preoperatively. Although IMS results in improved neurological function with no recurrence following GTR, attention must be given to residual pain.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 11","pages":"607-612"},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293618","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}
To assess the test-retest reliability of sympathetic skin response (SSR) using supraorbital nerve stimulation method in individuals with spinal cord injury (SCI). Psychometric property testing. A rehabilitation facility in Chiang Mai, Thailand. SSR was done on two executive days in individuals with SCI, stimulating at supraorbital nerve and recording at the palmar and plantar surface of both hands and feet. Results were reported as hand- and foot-SSR scores. Test-retest reliability was analyzed using intraclass correlation coefficients (ICC). Forty individuals with SCI were recruited. ICC of hand and foot SSR scores were 0.963 (95%CI: 0.888–0.967) and 0.833 (95%CI: 0.707–0.908), indicating excellent and good test-retest reliability, respectively. Subgroup analyses showed a problematic decrease in test-retest reliability to a moderate level of the foot SSR score in the elderly subgroup (age ≥ 60). SSR induced by the supraorbital nerve stimulation showed excellent test-retest reliability for hand SSR and good reliability for foot SSR in the overall SCI population. SSR, induced by supraorbital nerve stimulation method and reported by SSR score, should be a reliable tool for evaluating autonomic functions in individuals with SCI.
{"title":"Reliability of sympathetic skin response in individuals with spinal cord injury: a supraorbital nerve stimulation approach","authors":"Siam Tongprasert, Sintip Pattanakuhar, Thunyaporn Boonjaksilp","doi":"10.1038/s41393-025-01123-8","DOIUrl":"10.1038/s41393-025-01123-8","url":null,"abstract":"To assess the test-retest reliability of sympathetic skin response (SSR) using supraorbital nerve stimulation method in individuals with spinal cord injury (SCI). Psychometric property testing. A rehabilitation facility in Chiang Mai, Thailand. SSR was done on two executive days in individuals with SCI, stimulating at supraorbital nerve and recording at the palmar and plantar surface of both hands and feet. Results were reported as hand- and foot-SSR scores. Test-retest reliability was analyzed using intraclass correlation coefficients (ICC). Forty individuals with SCI were recruited. ICC of hand and foot SSR scores were 0.963 (95%CI: 0.888–0.967) and 0.833 (95%CI: 0.707–0.908), indicating excellent and good test-retest reliability, respectively. Subgroup analyses showed a problematic decrease in test-retest reliability to a moderate level of the foot SSR score in the elderly subgroup (age ≥ 60). SSR induced by the supraorbital nerve stimulation showed excellent test-retest reliability for hand SSR and good reliability for foot SSR in the overall SCI population. SSR, induced by supraorbital nerve stimulation method and reported by SSR score, should be a reliable tool for evaluating autonomic functions in individuals with SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 11","pages":"613-618"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287023","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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