首页 > 最新文献

Spinal Cord Series and Cases最新文献

英文 中文
Effectiveness of virtual-walking intervention combined with exercise on improving pain and function in incomplete spinal cord injury: a feasibility study. 虚拟行走干预结合运动对改善不完全脊髓损伤患者疼痛和功能的效果:一项可行性研究。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-22 DOI: 10.1038/s41394-024-00675-w
Sara Mollà-Casanova, Elena Muñoz-Gómez, Marta Aguilar-Rodríguez, Marta Inglés, Núria Sempere-Rubio, Noemí Moreno-Segura, Pilar Serra-Añó

Study design: A feasibility pilot study.

Objective: To assess the feasibility a full-scale Randomized Controlled Trial aimed at assessing the beneficial effect of a Virtual Walking (VW)-based (Experimental intervention (EI)) on neuropathic pain and functionality in people with incomplete spinal cord injury (SCI).

Setting: A hospital service (Hospital Universitario y Politécnico La Fe) and disability associations (TetraSport, CODIFIVA and ASPAYM).

Methods: Twelve people with chronic incomplete SCI were randomized to EI (VW plus therapeutic exercise program (TE)) -or Control Intervention (CI (placebo VW and TE)) groups. A six-week intervention (3 sessions/week) was carried out. To assess feasibility, the following outcomes were used: level of restriction and validity of inclusion and exclusion criteria, participants' compliance, accessibility and acceptability of the intervention for participants, adequate pre-training time of physiotherapists. To explore therapy effectiveness, pain severity, and interference, mean and maximum isometric strength, walking speed, and walking ability were assessed before (Time 1, T1) and after (Time 2, T2) the intervention.

Results: 20% of the participants initially recruited did not meet inclusion criteria. In addition, all participants completed at least 80% of the intervention sessions and none of the participants dropped out before T2. No serious adverse event was found. Moreover, 91.67% of participants were willing to perform the intervention again and all therapists involved were adequately pre-trained. Finally, our preliminary results suggest that the proposed EI is effective.

Conclusion: A full-scale RCT is feasible and preliminary results suggest that VW with TE could have a beneficial impact on pain and functionality in this population.

研究设计可行性试点研究:评估全面随机对照试验的可行性,旨在评估基于虚拟行走(VW)的实验干预(EI)对不完全脊髓损伤(SCI)患者的神经性疼痛和功能性的有益影响:环境:医院服务机构(拉斐大学和理工医院)和残疾人协会(TetraSport、CODIFIVA 和 ASPAYM):12 名慢性不完全 SCI 患者被随机分为 EI 组(VW 加治疗性运动计划 (TE))和对照干预组(CI(安慰剂 VW 和 TE))。干预为期六周(每周三次)。为评估可行性,采用了以下结果:纳入和排除标准的限制程度和有效性、参与者的依从性、干预措施对参与者的可及性和可接受性、物理治疗师的充分预培训时间。为了探讨治疗效果、疼痛严重程度和干扰情况,在干预前(时间 1,T1)和干预后(时间 2,T2)对平均和最大等长肌力、行走速度和行走能力进行了评估。此外,所有参与者都完成了至少80%的干预课程,没有人在T2前退出。没有发现严重的不良事件。此外,91.67%的参与者愿意再次进行干预,所有参与的治疗师都经过了充分的前期培训。最后,我们的初步结果表明,建议的 EI 是有效的:全面的 RCT 是可行的,初步结果表明,使用 TE 的 VW 可以对这一人群的疼痛和功能产生有益的影响。
{"title":"Effectiveness of virtual-walking intervention combined with exercise on improving pain and function in incomplete spinal cord injury: a feasibility study.","authors":"Sara Mollà-Casanova, Elena Muñoz-Gómez, Marta Aguilar-Rodríguez, Marta Inglés, Núria Sempere-Rubio, Noemí Moreno-Segura, Pilar Serra-Añó","doi":"10.1038/s41394-024-00675-w","DOIUrl":"10.1038/s41394-024-00675-w","url":null,"abstract":"<p><strong>Study design: </strong>A feasibility pilot study.</p><p><strong>Objective: </strong>To assess the feasibility a full-scale Randomized Controlled Trial aimed at assessing the beneficial effect of a Virtual Walking (VW)-based (Experimental intervention (EI)) on neuropathic pain and functionality in people with incomplete spinal cord injury (SCI).</p><p><strong>Setting: </strong>A hospital service (Hospital Universitario y Politécnico La Fe) and disability associations (TetraSport, CODIFIVA and ASPAYM).</p><p><strong>Methods: </strong>Twelve people with chronic incomplete SCI were randomized to EI (VW plus therapeutic exercise program (TE)) -or Control Intervention (CI (placebo VW and TE)) groups. A six-week intervention (3 sessions/week) was carried out. To assess feasibility, the following outcomes were used: level of restriction and validity of inclusion and exclusion criteria, participants' compliance, accessibility and acceptability of the intervention for participants, adequate pre-training time of physiotherapists. To explore therapy effectiveness, pain severity, and interference, mean and maximum isometric strength, walking speed, and walking ability were assessed before (Time 1, T1) and after (Time 2, T2) the intervention.</p><p><strong>Results: </strong>20% of the participants initially recruited did not meet inclusion criteria. In addition, all participants completed at least 80% of the intervention sessions and none of the participants dropped out before T2. No serious adverse event was found. Moreover, 91.67% of participants were willing to perform the intervention again and all therapists involved were adequately pre-trained. Finally, our preliminary results suggest that the proposed EI is effective.</p><p><strong>Conclusion: </strong>A full-scale RCT is feasible and preliminary results suggest that VW with TE could have a beneficial impact on pain and functionality in this population.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reviewer Recognition. 评审员表彰。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-21 DOI: 10.1038/s41394-024-00672-z
{"title":"Reviewer Recognition.","authors":"","doi":"10.1038/s41394-024-00672-z","DOIUrl":"10.1038/s41394-024-00672-z","url":null,"abstract":"","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is deformity correction essential in a "Myelopathic Cord"? - A case series. 髓鞘病性脊柱炎 "患者是否必须进行畸形矫正?- 一个病例系列。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-20 DOI: 10.1038/s41394-024-00676-9
Rajat Mahajan, Ganesh Kumar

Introduction: The incidence of preoperative neurological deficits in pediatric patients with complex deformities ranges from 15% to 23%. Furthermore, the likelihood of a postoperative neurological deficit can be considerably increased to 83.3% in the presence of a preoperative neurological deficit. Hence, the management of pediatric spinal deformities with neurological deficits is a challenge for every spine surgeon. Here, we describe four consecutive cases of pediatric spinal deformity with myelopathic cord, all of which were managed with decompressive surgery and stabilization without any attempts to correct the deformity. All the patients recovered well neurologically, without any progression of deformity.

Case presentation: The authors obtained the informed written consent from the patient and their parents for the print and electronic publication of the case. All four patients had clinical myelopathy with a progressive, worsening neurological deficit. The pathology was in the thoracic region in all the patients. Of the four cases, two were post-tubercular deformities, and two were congenital deformities. The treatment strategy for all patients was circumferential decompression of the spinal cord with posterior pedicle screw instrumentation. Although all patients had significant neurological deficits (Nurick grade 4 or 5) preoperatively, we used intraoperative neuromonitoring to prevent the worsening of the deficit during the procedure. None of the patients experienced intraoperative signal changes. All patients had significant neurological recovery (Nurick grade 0 to 2) and showed no worsening of deformity at their latest follow-up, up to 4 years. All showed good improvement in all domains of the SRS22r questionnaire.

Discussion: It is challenging for spine surgeons to manage complex spinal abnormalities in pediatric patients with myelopathic cords. Even a minimal manipulation of the cord during surgery might result in severe long-term morbidity. The primary objective in managing such patients should be neurological recovery rather than deformity correction-"First do no harm," and if necessary, the deformity can be corrected at a later stage under neuromonitoring.

简介儿科复杂畸形患者术前神经功能缺损的发生率为 15%至 23%。此外,如果术前存在神经功能缺损,术后出现神经功能缺损的可能性会大大增加,达到 83.3%。因此,小儿脊柱畸形伴神经功能缺损的治疗对每一位脊柱外科医生来说都是一项挑战。在此,我们连续描述了四例伴有脊髓病性脊柱畸形的小儿脊柱畸形病例,所有病例均采用减压手术和稳定术进行治疗,未试图矫正畸形。所有患者的神经系统均恢复良好,畸形没有任何进展:作者获得了患者及其父母的知情同意书,并将病例以印刷版和电子版形式发表。四名患者均患有临床脊髓病,神经功能缺损呈进行性恶化。所有患者的病变均位于胸椎部位。在这四例病例中,两例为结核病后畸形,两例为先天性畸形。所有患者的治疗策略都是通过后椎弓根螺钉器械对脊髓进行环绕减压。虽然所有患者术前都有明显的神经功能缺损(Nurick 4级或5级),但我们在术中使用了神经监测仪,以防止缺损在术中恶化。没有一名患者在术中出现信号变化。所有患者的神经功能都得到了明显恢复(Nurick 分级 0 至 2),并且在最近 4 年的随访中畸形没有恶化。所有患者在SRS22r问卷调查的所有方面都有良好的改善:讨论:脊柱外科医生在处理脊髓病索小儿患者的复杂脊柱畸形时面临挑战。即使在手术过程中对脊髓进行最小程度的操作,也可能导致严重的长期发病率。处理这类患者的首要目标应该是神经功能的恢复,而不是畸形矫正--"首先不要伤害",如有必要,可在神经监测的后期阶段矫正畸形。
{"title":"Is deformity correction essential in a \"Myelopathic Cord\"? - A case series.","authors":"Rajat Mahajan, Ganesh Kumar","doi":"10.1038/s41394-024-00676-9","DOIUrl":"10.1038/s41394-024-00676-9","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of preoperative neurological deficits in pediatric patients with complex deformities ranges from 15% to 23%. Furthermore, the likelihood of a postoperative neurological deficit can be considerably increased to 83.3% in the presence of a preoperative neurological deficit. Hence, the management of pediatric spinal deformities with neurological deficits is a challenge for every spine surgeon. Here, we describe four consecutive cases of pediatric spinal deformity with myelopathic cord, all of which were managed with decompressive surgery and stabilization without any attempts to correct the deformity. All the patients recovered well neurologically, without any progression of deformity.</p><p><strong>Case presentation: </strong>The authors obtained the informed written consent from the patient and their parents for the print and electronic publication of the case. All four patients had clinical myelopathy with a progressive, worsening neurological deficit. The pathology was in the thoracic region in all the patients. Of the four cases, two were post-tubercular deformities, and two were congenital deformities. The treatment strategy for all patients was circumferential decompression of the spinal cord with posterior pedicle screw instrumentation. Although all patients had significant neurological deficits (Nurick grade 4 or 5) preoperatively, we used intraoperative neuromonitoring to prevent the worsening of the deficit during the procedure. None of the patients experienced intraoperative signal changes. All patients had significant neurological recovery (Nurick grade 0 to 2) and showed no worsening of deformity at their latest follow-up, up to 4 years. All showed good improvement in all domains of the SRS22r questionnaire.</p><p><strong>Discussion: </strong>It is challenging for spine surgeons to manage complex spinal abnormalities in pediatric patients with myelopathic cords. Even a minimal manipulation of the cord during surgery might result in severe long-term morbidity. The primary objective in managing such patients should be neurological recovery rather than deformity correction-\"First do no harm,\" and if necessary, the deformity can be corrected at a later stage under neuromonitoring.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of the pandemic on physical and functional disabilities in children and adolescents with spina bifida. 大流行对脊柱裂儿童和青少年身体和功能残疾的影响。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-19 DOI: 10.1038/s41394-024-00674-x
Ester da Silva Estevam, Camila Scarpino Barboza Franco, Emanuela Juvenal Martins, Danila Cristina Petian-Alonso, Karoliny Lisandra Teixeira Cruz, Ana Claudia Mattiello-Sverzut

Study design: Retrospective and cross-sectional study.

Objectives: The study aimed to carry out telemonitoring to identify the impact of the pandemic on physical and functional disabilities in children and adolescents with SB, as reported by their caregivers, and to investigate adherence to a teleservice.

Setting: Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP).

Methods: Retrospective and cross-sectional study. Fifty-three patients with SB (mean age 12.0 (4.0) years; 23 males) participated in the telemonitoring. A questionnaire - 'Health management, health conditions, rehabilitation, interest in teleservice, and the well-being of the main caregiver' - investigated the clinical impact of the coronavirus pandemic. Only three caregivers participated in the teleservice (video call).

Results: According to telemonitoring, 62% of the patients discontinued physiotherapy sessions, and 69% reported needing adjustments in locomotion devices. The main complaints were muscle weakness and pain.

Conclusion: We monitored general health and identified demands related to physical rehabilitation using telemonitoring in 42.4% of children and adolescents with SB monitored at the HCFMRP-USP. Telemonitoring and teleservice may be methods used for monitoring health conditions in patients with SB.

研究设计回顾性横断面研究:该研究旨在通过远程监测来确定大流行对患有SB的儿童和青少年的身体和功能障碍的影响(由其照顾者报告),并调查对远程服务的依从性:地点:圣保罗大学里贝朗普雷图医学院附属医院(HCFMRP-USP):回顾性横断面研究。53 名 SB 患者(平均年龄 12.0 (4.0) 岁;23 名男性)参与了远程监控。一份名为 "健康管理、健康状况、康复、对远程服务的兴趣以及主要护理人员的幸福感 "的问卷调查了冠状病毒大流行对临床的影响。只有三名护理人员参加了远程服务(视频通话):根据远程监控结果,62%的患者中断了物理治疗,69%的患者表示需要调整运动装置。主要主诉是肌肉无力和疼痛:我们通过远程监控监测了42.4%在HCFMRP-USP接受监控的患有SB的儿童和青少年的总体健康状况,并确定了与身体康复相关的需求。远程监测和远程服务可用于监测 SB 患者的健康状况。
{"title":"The impact of the pandemic on physical and functional disabilities in children and adolescents with spina bifida.","authors":"Ester da Silva Estevam, Camila Scarpino Barboza Franco, Emanuela Juvenal Martins, Danila Cristina Petian-Alonso, Karoliny Lisandra Teixeira Cruz, Ana Claudia Mattiello-Sverzut","doi":"10.1038/s41394-024-00674-x","DOIUrl":"10.1038/s41394-024-00674-x","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective and cross-sectional study.</p><p><strong>Objectives: </strong>The study aimed to carry out telemonitoring to identify the impact of the pandemic on physical and functional disabilities in children and adolescents with SB, as reported by their caregivers, and to investigate adherence to a teleservice.</p><p><strong>Setting: </strong>Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP).</p><p><strong>Methods: </strong>Retrospective and cross-sectional study. Fifty-three patients with SB (mean age 12.0 (4.0) years; 23 males) participated in the telemonitoring. A questionnaire - 'Health management, health conditions, rehabilitation, interest in teleservice, and the well-being of the main caregiver' - investigated the clinical impact of the coronavirus pandemic. Only three caregivers participated in the teleservice (video call).</p><p><strong>Results: </strong>According to telemonitoring, 62% of the patients discontinued physiotherapy sessions, and 69% reported needing adjustments in locomotion devices. The main complaints were muscle weakness and pain.</p><p><strong>Conclusion: </strong>We monitored general health and identified demands related to physical rehabilitation using telemonitoring in 42.4% of children and adolescents with SB monitored at the HCFMRP-USP. Telemonitoring and teleservice may be methods used for monitoring health conditions in patients with SB.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spinal cord injury in high-risk complex adult spinal deformity surgery: review of incidence and outcomes from the Scoli-RISK-1 study. 高风险复杂成人脊柱畸形手术中的脊髓损伤:Scoli-RISK-1 研究的发病率和结果回顾。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-17 DOI: 10.1038/s41394-024-00673-y
Fan Jiang, Hetshree Joshi, Jetan H Badhiwala, Jamie R F Wilson, Lawrence G Lenke, Christopher I Shaffrey, Kenneth M C Cheung, Leah Y Carreon, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Khaled M Kebaish, Christopher P Ames, Sigurd H Berven, Yong Qiu, Yukihiro Matsuyama, Benny T Dahl, Hossein Mehdian, Ferran Pellisé, Stephen J Lewis, Michael G Fehlings

Study design: Clinical case series.

Objective: To describe the cause, treatment and outcome of 6 cases of perioperative spinal cord injury (SCI) in high-risk adult deformity surgery.

Setting: Adult spinal deformity patients were enrolled in the multi-center Scoli-RISK-1 cohort study.

Methods: A total of 272 patients who underwent complex adult deformity surgery were enrolled in the prospective, multi-center Scoli-RISK-1 cohort study. Clinical follow up data were available up to a maximum of 2 years after index surgery. Cases of perioperative SCI were identified and an extensive case review was performed.

Results: Six individuals with SCI were identified from the Scoli-RISK-1 database (2.2%). Two cases occurred intraoperatively and four cases occurred postoperatively. The first case was an incomplete SCI due to a direct intraoperative insult and was treated postoperatively with Riluzole. The second SCI case was caused by a compression injury due to overcorrection of the deformity. Three cases of incomplete SCI occurred; one case of postoperative hematoma, one case of proximal junctional kyphosis (PJK) and one case of adjacent segment disc herniation. All cases of post-operative incomplete SCI were managed with revision decompression and resulted in excellent clinical recovery. One case of incomplete SCI resulted from infection and PJK. The patient's treatment was complicated by a delay in revision and the patient suffered persistent neurological deficits up to six weeks following the onset of SCI.

Conclusion: Despite the low incidence in high-risk adult deformity surgeries, perioperative SCI can result in devastating consequences. Thus, appropriate postoperative care, follow up and timely management of SCI are essential.

研究设计临床病例系列:描述高风险成人畸形手术中 6 例围手术期脊髓损伤(SCI)的原因、治疗和结果:多中心斯科利-RISK-1队列研究中的成人脊柱畸形患者:前瞻性多中心Scoli-RISK-1队列研究共纳入了272名接受复杂成人畸形手术的患者。临床随访数据最长可追溯到指数手术后两年。研究人员确定了围手术期 SCI 病例,并进行了广泛的病例回顾:结果:从Scoli-RISK-1数据库中发现了6例SCI患者(2.2%)。其中两例发生在术中,四例发生在术后。第一例是由于术中直接损伤导致的不完全 SCI,术后接受了利鲁唑治疗。第二例 SCI 是由于过度矫正畸形造成的压迫性损伤。有三例不完全脊柱损伤:一例为术后血肿,一例为近端交界性脊柱后凸(PJK),一例为邻近节段椎间盘突出。所有术后不完全脊髓损伤病例都进行了翻修减压,临床恢复良好。一例不完全脊柱损伤是由感染和 PJK 引起的。该患者的治疗因翻修延迟而变得复杂,在出现 SCI 后长达六周的时间里,患者一直存在神经功能缺损:结论:尽管高风险成人畸形手术的发生率较低,但围手术期 SCI 可导致破坏性后果。因此,适当的术后护理、随访和及时处理 SCI 至关重要。
{"title":"Spinal cord injury in high-risk complex adult spinal deformity surgery: review of incidence and outcomes from the Scoli-RISK-1 study.","authors":"Fan Jiang, Hetshree Joshi, Jetan H Badhiwala, Jamie R F Wilson, Lawrence G Lenke, Christopher I Shaffrey, Kenneth M C Cheung, Leah Y Carreon, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Khaled M Kebaish, Christopher P Ames, Sigurd H Berven, Yong Qiu, Yukihiro Matsuyama, Benny T Dahl, Hossein Mehdian, Ferran Pellisé, Stephen J Lewis, Michael G Fehlings","doi":"10.1038/s41394-024-00673-y","DOIUrl":"10.1038/s41394-024-00673-y","url":null,"abstract":"<p><strong>Study design: </strong>Clinical case series.</p><p><strong>Objective: </strong>To describe the cause, treatment and outcome of 6 cases of perioperative spinal cord injury (SCI) in high-risk adult deformity surgery.</p><p><strong>Setting: </strong>Adult spinal deformity patients were enrolled in the multi-center Scoli-RISK-1 cohort study.</p><p><strong>Methods: </strong>A total of 272 patients who underwent complex adult deformity surgery were enrolled in the prospective, multi-center Scoli-RISK-1 cohort study. Clinical follow up data were available up to a maximum of 2 years after index surgery. Cases of perioperative SCI were identified and an extensive case review was performed.</p><p><strong>Results: </strong>Six individuals with SCI were identified from the Scoli-RISK-1 database (2.2%). Two cases occurred intraoperatively and four cases occurred postoperatively. The first case was an incomplete SCI due to a direct intraoperative insult and was treated postoperatively with Riluzole. The second SCI case was caused by a compression injury due to overcorrection of the deformity. Three cases of incomplete SCI occurred; one case of postoperative hematoma, one case of proximal junctional kyphosis (PJK) and one case of adjacent segment disc herniation. All cases of post-operative incomplete SCI were managed with revision decompression and resulted in excellent clinical recovery. One case of incomplete SCI resulted from infection and PJK. The patient's treatment was complicated by a delay in revision and the patient suffered persistent neurological deficits up to six weeks following the onset of SCI.</p><p><strong>Conclusion: </strong>Despite the low incidence in high-risk adult deformity surgeries, perioperative SCI can result in devastating consequences. Thus, appropriate postoperative care, follow up and timely management of SCI are essential.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Venous thromboembolism: exploring incidence and utility of screening in individuals with dual diagnosis. 静脉血栓栓塞症:探讨双重诊断患者的发病率和筛查效用。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-09 DOI: 10.1038/s41394-024-00670-1
Christina Draganich, Andrew Park, Mitch Sevigny, Susan Charlifue, David Coons, Michael Makley, Raul Alvarez, James Fenton, Jeffrey Berliner

Objectives: The development of venous thromboembolism (VTE) is a common complication following spinal cord injury (SCI) and brain injury (BI), leading to significant morbidity and mortality. The purpose of this study was to explore the incidence of VTE in patients with the dual diagnosis (DD) of SCI and concomitant BI using ultrasonography.

Design: Retrospective study.

Setting: Acute rehabilitation hospital.

Participants: Thirty-one individuals admitted for DD rehabilitation who were routinely screened for VTE with ultrasound on admission.

Interventions: Not applicable.

Main outcome measures: Retrospective chart review was performed to identify whether patients were found to have DVT or PE at the following three time points: in acute care prior to admission to rehabilitation, at time of admission diagnosed via screening examination, and after admission to rehabilitation during the inpatient stay via post screening examinations. Retrospective chart review was also performed to identify incidence of bleeding.

Results: 67.7% of individuals were found to have DVTs at any timepoint. Of these DVTs, 22.6% were identified in acute care, 48.4% on admission to rehabilitation, and 16.1% during the course of rehabilitation stay. Of those who were placed on therapeutic anticoagulation due to admission diagnosis of VTE, 25% developed recurrent DVT and 12.5% had bleeding complications. No cases of PE were observed in this study population.

Conclusions: This study found a high incidence of DVT for the DD population at all three timepoints with a high proportion identified via screening ultrasonography on admission to rehabilitation. Further research is needed to investigate the incidence of VTE and utility of screening ultrasonography in this population.

目的:静脉血栓栓塞症(VTE)是脊髓损伤(SCI)和脑损伤(BI)后常见的并发症,可导致严重的发病率和死亡率。本研究的目的是利用超声波检查法探讨脊髓损伤和脑损伤双重诊断(DD)患者的 VTE 发生率:设计:回顾性研究:参与者干预措施:不适用:主要结果测量对病历进行回顾性分析,以确定患者是否在以下三个时间点被发现患有深静脉血栓或血小板增多症:入院康复治疗前的急性期、入院时通过筛查诊断出的深静脉血栓或血小板增多症,以及入院康复治疗后住院期间通过筛查后检查发现的深静脉血栓或血小板增多症。此外,还进行了回顾性病历审查,以确定出血的发生率:结果:67.7%的患者在任何时间点都被发现患有深静脉血栓。在这些深静脉血栓中,22.6%是在急性期发现的,48.4%是在入院康复时发现的,16.1%是在康复期间发现的。因入院诊断为 VTE 而接受抗凝治疗的患者中,有 25% 复发了深静脉血栓,12.5% 出现了出血并发症。本研究中未发现 PE 病例:这项研究发现,在所有三个时间点上,深静脉血栓的发生率都很高,其中很大一部分是在康复入院时通过筛查超声波检查发现的。需要进一步研究该人群中 VTE 的发生率和超声波筛查的实用性。
{"title":"Venous thromboembolism: exploring incidence and utility of screening in individuals with dual diagnosis.","authors":"Christina Draganich, Andrew Park, Mitch Sevigny, Susan Charlifue, David Coons, Michael Makley, Raul Alvarez, James Fenton, Jeffrey Berliner","doi":"10.1038/s41394-024-00670-1","DOIUrl":"10.1038/s41394-024-00670-1","url":null,"abstract":"<p><strong>Objectives: </strong>The development of venous thromboembolism (VTE) is a common complication following spinal cord injury (SCI) and brain injury (BI), leading to significant morbidity and mortality. The purpose of this study was to explore the incidence of VTE in patients with the dual diagnosis (DD) of SCI and concomitant BI using ultrasonography.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Acute rehabilitation hospital.</p><p><strong>Participants: </strong>Thirty-one individuals admitted for DD rehabilitation who were routinely screened for VTE with ultrasound on admission.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Retrospective chart review was performed to identify whether patients were found to have DVT or PE at the following three time points: in acute care prior to admission to rehabilitation, at time of admission diagnosed via screening examination, and after admission to rehabilitation during the inpatient stay via post screening examinations. Retrospective chart review was also performed to identify incidence of bleeding.</p><p><strong>Results: </strong>67.7% of individuals were found to have DVTs at any timepoint. Of these DVTs, 22.6% were identified in acute care, 48.4% on admission to rehabilitation, and 16.1% during the course of rehabilitation stay. Of those who were placed on therapeutic anticoagulation due to admission diagnosis of VTE, 25% developed recurrent DVT and 12.5% had bleeding complications. No cases of PE were observed in this study population.</p><p><strong>Conclusions: </strong>This study found a high incidence of DVT for the DD population at all three timepoints with a high proportion identified via screening ultrasonography on admission to rehabilitation. Further research is needed to investigate the incidence of VTE and utility of screening ultrasonography in this population.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes 10-years after traumatic spinal cord injury in Botswana - a long-term follow-up study. 博茨瓦纳创伤性脊髓损伤 10 年后的结果--一项长期跟踪研究。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-07 DOI: 10.1038/s41394-024-00671-0
Inka Löfvenmark, Wame Mogome, Kobamelo Sekakela

Study design: Prospective follow-up study.

Objectives: To describe outcomes, survival, and attendance to routine follow-up visits 10 years post-SCI.

Setting: The national SCI-rehabilitation center in Botswana.

Methods: All persons who were admitted with traumatic SCI during a 2-year period, 2011-2013, and survived up to 2 years post-injury were included. Data were collected from the medical records from the follow-up assessment closest to 10 years post-SCI and included demographic and clinical characteristics, functional outcomes, and secondary complications. Data regarding mortalities were received from relatives. Statistical comparisons were made, when possible, between those who attend follow-up assessment and those who did not, and between those who survived up to 10 years post-SCI and those who died.

Results: The follow-up rate was 76% (19/25) of known survivors. No statistically significant factors were found to affect the follow-up rate. Secondary complications rates were for pressure ulcers and urinary tract infections 21%. Self-catheterisation and suprapubic catheter were the preferred methods to manage neurogenic bladder dysfunction. Ten persons (26%) had deceased since 2nd follow-up assessment. The causes of death were probably SCI-related in more than half of the cases.

Conclusions: This was a follow-up study at year 10 after acute TSCI in Botswana conducted at the national SCI-rehabilitation center. The study supports previous reports regarding the importance of that having specialized SCI units and the need of structured follow-ups, a responsible person in charge of scheduling, and updated patient registers. We found high follow-up rate, low rates of complications and of patients being lost to follow-up.

研究设计前瞻性随访研究:描述SCI术后10年的疗效、存活率和接受常规随访的情况:博茨瓦纳国家 SCI 康复中心:方法:纳入所有在2011-2013年两年期间因外伤性SCI入院并在伤后存活两年的患者。数据收集自创伤性脊髓损伤后最接近 10 年的随访评估病历,包括人口统计学和临床特征、功能结果和继发性并发症。有关死亡的数据来自亲属。在可能的情况下,对参加随访评估和未参加随访评估的患者进行统计比较,并对手术后存活 10 年的患者和死亡患者进行统计比较:已知幸存者的随访率为 76%(19/25)。没有发现影响随访率的有统计学意义的因素。二次并发症的发生率为压疮和尿路感染 21%。自我导尿和耻骨上导尿是治疗神经源性膀胱功能障碍的首选方法。10人(26%)在第二次随访评估后死亡。半数以上患者的死因可能与 SCI 有关:这是一项在博茨瓦纳国家 SCI 康复中心进行的急性 TSCI 术后第 10 年随访研究。这项研究支持了之前的报告,这些报告指出了设立 SCI 专科的重要性,以及进行结构化随访、安排负责人和更新患者登记册的必要性。我们发现随访率很高,并发症发生率和失去随访的病人比率都很低。
{"title":"Outcomes 10-years after traumatic spinal cord injury in Botswana - a long-term follow-up study.","authors":"Inka Löfvenmark, Wame Mogome, Kobamelo Sekakela","doi":"10.1038/s41394-024-00671-0","DOIUrl":"10.1038/s41394-024-00671-0","url":null,"abstract":"<p><strong>Study design: </strong>Prospective follow-up study.</p><p><strong>Objectives: </strong>To describe outcomes, survival, and attendance to routine follow-up visits 10 years post-SCI.</p><p><strong>Setting: </strong>The national SCI-rehabilitation center in Botswana.</p><p><strong>Methods: </strong>All persons who were admitted with traumatic SCI during a 2-year period, 2011-2013, and survived up to 2 years post-injury were included. Data were collected from the medical records from the follow-up assessment closest to 10 years post-SCI and included demographic and clinical characteristics, functional outcomes, and secondary complications. Data regarding mortalities were received from relatives. Statistical comparisons were made, when possible, between those who attend follow-up assessment and those who did not, and between those who survived up to 10 years post-SCI and those who died.</p><p><strong>Results: </strong>The follow-up rate was 76% (19/25) of known survivors. No statistically significant factors were found to affect the follow-up rate. Secondary complications rates were for pressure ulcers and urinary tract infections 21%. Self-catheterisation and suprapubic catheter were the preferred methods to manage neurogenic bladder dysfunction. Ten persons (26%) had deceased since 2<sup>nd</sup> follow-up assessment. The causes of death were probably SCI-related in more than half of the cases.</p><p><strong>Conclusions: </strong>This was a follow-up study at year 10 after acute TSCI in Botswana conducted at the national SCI-rehabilitation center. The study supports previous reports regarding the importance of that having specialized SCI units and the need of structured follow-ups, a responsible person in charge of scheduling, and updated patient registers. We found high follow-up rate, low rates of complications and of patients being lost to follow-up.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Restoring initial steps by intermittent theta burst stimulation in complete spinal cord injury patient: a case report. 通过间歇性θ脉冲刺激恢复完全性脊髓损伤患者的初始步骤:病例报告。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-04 DOI: 10.1038/s41394-024-00669-8
Deeksha Patel, Rohit Banerjee, Kamran Farooque, Deepak Gupta, Bhavuk Garg, Nand Kumar, Gita H Thukral, Kanwal Preet Kochhar, Suman Jain

Introduction: Spinal cord injury (SCI) causes damage to neurons and results in motor and sensory dysfunction. Intermittent theta burst stimulation (iTBS) has been used to induce neuronal and synaptic plasticity by applying a magnetic field in the brain. The plasticity induced in the cortex has an imperative role in the recovery of motor and sensory functioning. However, the effect of iTBS in complete SCI patients is still elusive.

Case presentation: We report here the case of a 27-year-old female who sustained an L1 complete spinal cord injury (SCI) with an ASIA score of A. The patient lost all the sensory and motor functions below the level of injury. Intermittent theta burst stimulation (iTBS) was administered at 80% of the resting motor threshold over the M1 motor cortex, along with intensive rehabilitation training to promote sensorimotor function.

Discussion: There was a partial recovery in functional, electrophysiological, and neurological parameters. The case report also demonstrates the safety and efficacy of iTBS in complete SCI patients. No adverse event has been observed in the patient during intervention sessions.

导言:脊髓损伤(SCI)会造成神经元损伤,导致运动和感觉功能障碍。间歇θ脉冲刺激(iTBS)已被用于通过在大脑中施加磁场来诱导神经元和突触的可塑性。在大脑皮层诱导的可塑性对运动和感觉功能的恢复起着至关重要的作用。然而,iTBS 对完全性 SCI 患者的影响仍然难以捉摸:我们在此报告了一例 27 岁女性患者的病例,她遭受了 L1 完全性脊髓损伤(SCI),ASIA 评分为 A。在对M1运动皮层进行间歇θ脉冲刺激(iTBS)时,刺激强度为静息运动阈值的80%,同时进行强化康复训练以促进感觉运动功能:讨论:患者的功能、电生理和神经参数得到了部分恢复。本病例报告还证明了 iTBS 对完全性 SCI 患者的安全性和有效性。患者在干预过程中未出现任何不良反应。
{"title":"Restoring initial steps by intermittent theta burst stimulation in complete spinal cord injury patient: a case report.","authors":"Deeksha Patel, Rohit Banerjee, Kamran Farooque, Deepak Gupta, Bhavuk Garg, Nand Kumar, Gita H Thukral, Kanwal Preet Kochhar, Suman Jain","doi":"10.1038/s41394-024-00669-8","DOIUrl":"10.1038/s41394-024-00669-8","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal cord injury (SCI) causes damage to neurons and results in motor and sensory dysfunction. Intermittent theta burst stimulation (iTBS) has been used to induce neuronal and synaptic plasticity by applying a magnetic field in the brain. The plasticity induced in the cortex has an imperative role in the recovery of motor and sensory functioning. However, the effect of iTBS in complete SCI patients is still elusive.</p><p><strong>Case presentation: </strong>We report here the case of a 27-year-old female who sustained an L1 complete spinal cord injury (SCI) with an ASIA score of A. The patient lost all the sensory and motor functions below the level of injury. Intermittent theta burst stimulation (iTBS) was administered at 80% of the resting motor threshold over the M1 motor cortex, along with intensive rehabilitation training to promote sensorimotor function.</p><p><strong>Discussion: </strong>There was a partial recovery in functional, electrophysiological, and neurological parameters. The case report also demonstrates the safety and efficacy of iTBS in complete SCI patients. No adverse event has been observed in the patient during intervention sessions.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11298536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Idiopathic cervical cord infarction in a young girl presenting with acute neck pain and flaccid paralysis: a case report 以急性颈部疼痛和弛缓性瘫痪为主要表现的少女特发性颈脊髓梗死:病例报告
IF 1.2 Q4 CLINICAL NEUROLOGY Pub Date : 2024-08-03 DOI: 10.1038/s41394-024-00659-w
Mohsen Sedighi, Nader Tavakoli, Morteza Taheri, Hamed Basir Ghafouri

Introduction

Spinal cord infarction (SCI) is a rare disease representing nearly 1% of all strokes with a wide variety of symptoms at presentation. SCI diagnosis is very challenging owing to its low incidence and the variety of symptoms, and could be misdiagnosed with neuromyelitis optica spectrum disorders (NMOSD).

Case presentation

We describe the case of an 18-year-old girl who presented to the emergency department with acute neck pain and flaccid paralysis of the left upper and lower extremities. Few hours later, she developed apnea and was endotracheally intubated. Brain MRI was normal but spinal cord MRI revealed non-enhancing longitudinal abnormal high T2 signal intensity extending from C1 to C5. The patient underwent steroid therapy with methylprednisolone (1 g daily for 7 consecutive days) combined with physiotherapy. She was extubated after 3 weeks and discharged after 30 days of hospitalization with a muscle force of 4/5 in her left extremities.

Discussion

Idiopathic SCI in adolescence is a rare but often devastating disorder with unknown pathophysiology, however, some specific conditions in adolescent such as mechanical stresses on the immature spine can be considered as risk factors for SCI development. Early diagnosis and treatment can improve outcomes in SCI.

导言脊髓梗死(SCI)是一种罕见疾病,占所有脑卒中的近 1%,表现症状多种多样。由于其发病率低、症状多样,SCI 的诊断非常具有挑战性,可能会被误诊为神经脊髓炎视网膜频谱疾病(NMOSD)。我们描述了一例 18 岁女孩的病例,她因急性颈部疼痛和左上下肢弛缓性瘫痪而到急诊科就诊。几小时后,她出现呼吸暂停并被气管插管。脑部磁共振成像正常,但脊髓磁共振成像显示从C1延伸至C5的非增强型纵向异常高T2信号强度。患者接受了甲基强的松龙类固醇治疗(每天 1 克,连续 7 天)和物理治疗。讨论青少年特发性 SCI 是一种罕见但往往具有破坏性的疾病,其病理生理学尚不清楚,但青少年的一些特殊情况,如未成熟脊柱所承受的机械应力,可被视为 SCI 发生的危险因素。早期诊断和治疗可改善 SCI 的预后。
{"title":"Idiopathic cervical cord infarction in a young girl presenting with acute neck pain and flaccid paralysis: a case report","authors":"Mohsen Sedighi, Nader Tavakoli, Morteza Taheri, Hamed Basir Ghafouri","doi":"10.1038/s41394-024-00659-w","DOIUrl":"https://doi.org/10.1038/s41394-024-00659-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Spinal cord infarction (SCI) is a rare disease representing nearly 1% of all strokes with a wide variety of symptoms at presentation. SCI diagnosis is very challenging owing to its low incidence and the variety of symptoms, and could be misdiagnosed with neuromyelitis optica spectrum disorders (NMOSD).</p><h3 data-test=\"abstract-sub-heading\">Case presentation</h3><p>We describe the case of an 18-year-old girl who presented to the emergency department with acute neck pain and flaccid paralysis of the left upper and lower extremities. Few hours later, she developed apnea and was endotracheally intubated. Brain MRI was normal but spinal cord MRI revealed non-enhancing longitudinal abnormal high T2 signal intensity extending from C1 to C5. The patient underwent steroid therapy with methylprednisolone (1 g daily for 7 consecutive days) combined with physiotherapy. She was extubated after 3 weeks and discharged after 30 days of hospitalization with a muscle force of 4/5 in her left extremities.</p><h3 data-test=\"abstract-sub-heading\">Discussion</h3><p>Idiopathic SCI in adolescence is a rare but often devastating disorder with unknown pathophysiology, however, some specific conditions in adolescent such as mechanical stresses on the immature spine can be considered as risk factors for SCI development. Early diagnosis and treatment can improve outcomes in SCI.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141883823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study. 神经性脊髓损伤疼痛的虚拟行走疗法:可行性研究。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-07-31 DOI: 10.1038/s41394-024-00667-w
Gunther Landmann, Marina Aerni, Roger Abächerli, Mario Ernst, André Ljutow, Karina Ottiger-Böttger

Study design: A feasibility study.

Objectives: Chronic neuropathic pain is a prevalent comorbidity in patients with spinal cord injury (SCI), and current medical treatments remain unsatisfactory. New developments as virtual walking are emerging which has been established and further developed at our centre. This study aims to investigate the feasibility of our virtual walking setup in a small group of SCI patients.

Setting: The study was conducted at the Swiss Paraplegic Centre in Nottwil, Switzerland.

Methods: Four patients aged 22 to 60 years were observed during and after therapy. Three had complete paraplegia (levels Th4-Th8) with neuropathic at- and below-level pain, while one had incomplete paraplegia (Th10) with at-level pain. The primary outcome measured was satisfaction with acceptance of and adherence to virtual walking therapy, alongside suggestions for therapy improvements. Additionally, patients kept a pain diary and pain drawings to measure the extent of pain distribution and intensity before and after therapy. Therapy schedules included either two sessions per week for five weeks or five sessions per week for two weeks.

Results: There was a sound satisfaction and good acceptance amongst participants. Support, duration, and number of sessions were perceived well and acceptable. Pain as a secondary outcome did not change during or after therapy in all but one patient which improved in pain intensity, pain quality as well as pain distribution.

Conclusion: Results suggest that our virtual walking setting is a feasible tool that should be further studied in patients with SCI-related chronic neuropathic pain.

研究设计可行性研究:慢性神经病理性疼痛是脊髓损伤(SCI)患者的常见并发症,目前的医学治疗效果仍不理想。虚拟行走的新发展正在出现,我们的中心已经建立并进一步发展了虚拟行走。本研究旨在调查我们的虚拟行走装置在一小部分 SCI 患者中的可行性:研究在瑞士诺特威尔的瑞士截瘫中心进行:在治疗期间和治疗后,对四名 22 至 60 岁的患者进行了观察。三名患者完全截瘫(Th4-Th8 级),伴有神经病理性的水平和低水平疼痛,一名患者不完全截瘫(Th10 级),伴有水平疼痛。测量的主要结果是患者对接受和坚持虚拟行走疗法的满意度,以及对改进疗法的建议。此外,患者还记录了疼痛日记并绘制了疼痛图,以测量治疗前后疼痛的分布范围和强度。治疗计划包括每周两次治疗,持续五周或每周五次治疗,持续两周:结果:参与者对治疗非常满意,接受度很高。结果:参与者对治疗的支持、持续时间和疗程次数均表示满意和接受。作为次要结果的疼痛在治疗期间或治疗后都没有变化,只有一名患者的疼痛强度、疼痛质量和疼痛分布有所改善:结果表明,我们的虚拟行走设置是一种可行的工具,应在与 SCI 相关的慢性神经病理性疼痛患者中进一步研究。
{"title":"Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study.","authors":"Gunther Landmann, Marina Aerni, Roger Abächerli, Mario Ernst, André Ljutow, Karina Ottiger-Böttger","doi":"10.1038/s41394-024-00667-w","DOIUrl":"10.1038/s41394-024-00667-w","url":null,"abstract":"<p><strong>Study design: </strong>A feasibility study.</p><p><strong>Objectives: </strong>Chronic neuropathic pain is a prevalent comorbidity in patients with spinal cord injury (SCI), and current medical treatments remain unsatisfactory. New developments as virtual walking are emerging which has been established and further developed at our centre. This study aims to investigate the feasibility of our virtual walking setup in a small group of SCI patients.</p><p><strong>Setting: </strong>The study was conducted at the Swiss Paraplegic Centre in Nottwil, Switzerland.</p><p><strong>Methods: </strong>Four patients aged 22 to 60 years were observed during and after therapy. Three had complete paraplegia (levels Th4-Th8) with neuropathic at- and below-level pain, while one had incomplete paraplegia (Th10) with at-level pain. The primary outcome measured was satisfaction with acceptance of and adherence to virtual walking therapy, alongside suggestions for therapy improvements. Additionally, patients kept a pain diary and pain drawings to measure the extent of pain distribution and intensity before and after therapy. Therapy schedules included either two sessions per week for five weeks or five sessions per week for two weeks.</p><p><strong>Results: </strong>There was a sound satisfaction and good acceptance amongst participants. Support, duration, and number of sessions were perceived well and acceptable. Pain as a secondary outcome did not change during or after therapy in all but one patient which improved in pain intensity, pain quality as well as pain distribution.</p><p><strong>Conclusion: </strong>Results suggest that our virtual walking setting is a feasible tool that should be further studied in patients with SCI-related chronic neuropathic pain.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Spinal Cord Series and Cases
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1