MyMedR

Fulltext Spinal Cord Injury: Pathophysiology, Multimolecular Interactions, and Underlying Recovery Mechanisms

Anjum A, Yazid MD, Fauzi Daud M, Idris J, Ng AMH, Selvi Naicker A, et al.

Int J Mol Sci, 2020 Oct 13;21(20).

PMID: 33066029 DOI: 10.3390/ijms21207533

Spinal cord injury (SCI) is a destructive neurological and pathological state that causes major motor, sensory and autonomic dysfunctions. Its pathophysiology comprises acute and chronic phases and incorporates a cascade of destructive events such as ischemia, oxidative stress, inflammatory events, apoptotic pathways and locomotor dysfunctions. Many therapeutic strategies have been proposed to overcome neurodegenerative events and reduce secondary neuronal damage. Efforts have also been devoted in developing neuroprotective and neuro-regenerative therapies that promote neuronal recovery and outcome. Although varying degrees of success have been achieved, curative accomplishment is still elusive probably due to the complex healing and protective mechanisms involved. Thus, current understanding in this area must be assessed to formulate appropriate treatment modalities to improve SCI recovery. This review aims to promote the understanding of SCI pathophysiology, interrelated or interlinked multimolecular interactions and various methods of neuronal recovery i.e., neuroprotective, immunomodulatory and neuro-regenerative pathways and relevant approaches.

Matched MeSH terms: Spinal Cord/metabolism*; Spinal Cord/pathology; Spinal Cord/physiology; Spinal Cord Injuries/metabolism*; Spinal Cord Injuries/pathology; Spinal Cord Injuries/therapy; Spinal Cord Regeneration*

Non-invasive electromyography as a disease biomarker: Are we only scratching the surface?

Shahrizaila N

Clin Neurophysiol, 2021 03;132(3):808-809.

PMID: 33558128 DOI: 10.1016/j.clinph.2021.01.008

Matched MeSH terms: Spinal Cord*

Fulltext Spinal cord injury without radiological abnormality (SCIWORA)

Izma MKO, Zulkharnain I, Ramli B, Muhamad AR, Harwant S

Med J Malaysia, 2003 Mar;58(1):105-10.

PMID: 14556334

SCIWORA or Spinal Cord Injury Without Radiological Abnormality; is a pre-MRI term that includes injuries to the spinal cord in the absence of radiological (plain radiographs, tomographs and CT scans) evidence of injury to the spinal column or cord. It occurs in skeletally immature spines because of the inherent plasticity of the bony structures in this age group. The prognosis is dependent on the extent of cord damage, and the role of active management is limited. A high index of suspicion is needed to establish a diagnosis. This diagnostic accuracy can be improved with the free availability of MRI scanning for the spines. We describe three cases of SCIWORA with a minimum follow-up of three years and a review of current literature.

Matched MeSH terms: Spinal Cord Injuries/pathology*; Spinal Cord Injuries/radiography*; Spinal Cord Injuries/therapy

Fulltext Notes on two cases of spinal concussion

Hoad W

Journal of the Straits Medical Association, 1894;5:66-7.

Matched MeSH terms: Spinal Cord Injuries

Short-tailed Murrah buffaloes

Fischer H

Zentralbl Veterinarmed A, 1966 Jun;13(4):352-5.

PMID: 4961318

Matched MeSH terms: Spinal Cord/abnormalities*; Spinal Cord Diseases/genetics

Fulltext Contributions of the Cybathlon championship to the literature on functional electrical stimulation cycling among individuals with spinal cord injury: A bibliometric review

Hamdan PNF, Hamzaid NA, Abd Razak NA, Hasnan N

J Sport Health Sci, 2022 Nov;11(6):671-680.

PMID: 33068748 DOI: 10.1016/j.jshs.2020.10.002

BACKGROUND: Due to its clinically proven safety and health benefits, functional electrical stimulation (FES) cycling has become a popular exercise modality for individuals with spinal cord injury (SCI). Since its inception in 2013, the Cybathlon championship has been a platform for publicizing the potential of FES cycling in rehabilitation and exercise for individuals with SCI. This study aimed to evaluate the contribution of the Cybathlon championship to the literature on FES cycling for individuals with SCI 3 years pre and post the staging of the Cybathlon championship in 2016.

METHODS: Web of Science, Scopus, ScienceDirect, IEEE Xplore, and Google Scholar databases were searched for relevant studies published between January 2013 and July 2019. The quality of the included studies was objectively evaluated using the Downs and Black checklist.

RESULTS: A total of 129 articles on FES cycling were retained for analysis. A total of 51 articles related to Cybathlon were reviewed, and 14 articles were ultimately evaluated for the quality. In 2017, the year following the Cybathlon championship, Web of Science cited 23 published studies on the championship, which was almost 5-fold more than that in 2016 (n = 5). Training was most often reported as a topic of interest in these studies, which mostly (76.7%) highlighted the training parameters of interest to participating teams in their effort to maximize their FES cycling performance during the Cybathlon championship.

CONCLUSION: The present study indicates that the Cybathlon championship in 2016 contributed to the number of literature published in 2017 on FES cycling for individuals with SCI. This finding may contribute to the lessons that can be learned from participation in the Cybathlon and potentially provide additional insights into research in the field of race-based FES cycling.

Matched MeSH terms: Spinal Cord Injuries*

Fulltext Spinal cryptoccoma mimicking a spinal cord tumor complicated by cryptococcal meningitis in an immunocompetent patient

Carol L, Tai MS, Yusoff SM, Rose N, Rafia MH, Viswanathan S

Neurol India, 2018 7 25;66(4):1181-1183.

PMID: 30038119 DOI: 10.4103/0028-3886.237012

Matched MeSH terms: Spinal Cord Diseases/complications*; Spinal Cord Diseases/diagnosis*; Spinal Cord Diseases/surgery; Spinal Cord Neoplasms/diagnosis

Spinal pseudomeningocoele: a diagnostic dilemma

Julia PE, Nazirah H

Spinal Cord, 2007 Dec;45(12):804-5.

PMID: 17710102

Case report.

Matched MeSH terms: Spinal Cord Compression/complications; Spinal Cord Compression/pathology; Spinal Cord Diseases/cerebrospinal fluid; Spinal Cord Diseases/diagnosis*; Spinal Cord Diseases/pathology; Spinal Cord Injuries/complications; Spinal Cord Injuries/pathology

Fulltext New clinical sign of cervical myelopathy: Wazir hand myelopathy sign

Wazir NN, Kareem BA

Singapore Med J, 2011 Jan;52(1):47-9.

PMID: 21298241

Cervical spondylotic myelopathy (CSM) represents a spectrum of pathologies with progressive compression of the spinal cord. The clinical signs and symptoms play a key role in diagnosis. The characteristic hand myelopathy signs are of significant clinical importance. The aim of this descriptive study was to report a relatively easy to elicit new hand myelopathy sign. The basis for this is finger and wrist flexor disinhibition, which is used for the spinal specificity of cord compression at or above the C5/6 level.

Matched MeSH terms: Spinal Cord/pathology; Spinal Cord Compression/diagnosis*; Spinal Cord Diseases/diagnosis*; Spinal Cord Diseases/physiopathology*

Fulltext The effectiveness of FES-evoked EMG potentials to assess muscle force and fatigue in individuals with spinal cord injury

Ibitoye MO, Estigoni EH, Hamzaid NA, Wahab AK, Davis GM

Sensors (Basel), 2014;14(7):12598-622.

PMID: 25025551 DOI: 10.3390/s140712598

The evoked electromyographic signal (eEMG) potential is the standard index used to monitor both electrical changes within the motor unit during muscular activity and the electrical patterns during evoked contraction. However, technical and physiological limitations often preclude the acquisition and analysis of the signal especially during functional electrical stimulation (FES)-evoked contractions. Hence, an accurate quantification of the relationship between the eEMG potential and FES-evoked muscle response remains elusive and continues to attract the attention of researchers due to its potential application in the fields of biomechanics, muscle physiology, and rehabilitation science. We conducted a systematic review to examine the effectiveness of eEMG potentials to assess muscle force and fatigue, particularly as a biofeedback descriptor of FES-evoked contractions in individuals with spinal cord injury. At the outset, 2867 citations were identified and, finally, fifty-nine trials met the inclusion criteria. Four hypotheses were proposed and evaluated to inform this review. The results showed that eEMG is effective at quantifying muscle force and fatigue during isometric contraction, but may not be effective during dynamic contractions including cycling and stepping. Positive correlation of up to r = 0.90 (p < 0.05) between the decline in the peak-to-peak amplitude of the eEMG and the decline in the force output during fatiguing isometric contractions has been reported. In the available prediction models, the performance index of the eEMG signal to estimate the generated muscle force ranged from 3.8% to 34% for 18 s to 70 s ahead of the actual muscle force generation. The strength and inherent limitations of the eEMG signal to assess muscle force and fatigue were evident from our findings with implications in clinical management of spinal cord injury (SCI) population.

Matched MeSH terms: Spinal Cord Injuries/diagnosis; Spinal Cord Injuries/physiopathology*; Spinal Cord Stimulation/methods*

Spontaneous, extra-dural haematoma causing spinal cord compression

Mustafa M, Subramanian N

Int Orthop, 1996;20(6):383-4.

PMID: 9049770

We describe a patient with acute compression of the spinal cord by a spontaneous extra-dural haematoma. This rare condition is often misdiagnosed. We believe that an urgent MRI scan is indicated in patients presenting with progressive neurological deficit following spinal trauma. This allows the diagnosis of extra-dural haematoma to be made rapidly and for prompt decompression of the cord.

Matched MeSH terms: Spinal Cord/pathology; Spinal Cord Compression/diagnosis; Spinal Cord Compression/etiology*

Fulltext Case report: a rare case of pediatric conus medularis glioblastoma multiforme

Gee TS, Ghani ARI, Idris B, Awang MS

Med J Malaysia, 2012 Aug;67(4):438-41.

PMID: 23082462 MyJurnal

Matched MeSH terms: Spinal Cord Neoplasms/diagnosis*; Spinal Cord Neoplasms/surgery

Fulltext A freak accidental injury to the spinal cord

Koh KB, Vaikunthan R, Sengupta S

Med J Malaysia, 1988 Sep;43(3):246-9.

PMID: 3241584

Matched MeSH terms: Spinal Cord Injuries/etiology*; Spinal Cord Injuries/radiography

Cervical myelopathy caused by an exostosis of the posterior arch of C1

Chooi YS, Siow YS, Chong CS

J Bone Joint Surg Br, 2005 Feb;87(2):257-9.

PMID: 15736753

We report a case of vertebral osteochondroma of C1 causing cord compression and myelopathy in a patient with hereditary multiple exostosis. We highlight the importance of early diagnosis and the appropriate surgery in order to obtain a satisfactory outcome.

Matched MeSH terms: Spinal Cord Compression/etiology; Spinal Cord Compression/surgery; Spinal Cord Diseases/etiology*; Spinal Cord Diseases/surgery

Fulltext Postoperative intraspinal subdural collections after pediatric posterior fossa tumor resection: incidence, imaging, and clinical features

Harreld JH, Mohammed N, Goldsberry G, Li X, Li Y, Boop F, et al.

AJNR Am J Neuroradiol, 2015 May;36(5):993-9.

PMID: 25614472 DOI: 10.3174/ajnr.A4221

Postoperative intraspinal subdural collections in children after posterior fossa tumor resection may temporarily hinder metastasis detection by MR imaging or CSF analysis, potentially impacting therapy. We investigated the incidence, imaging and clinical features, predisposing factors, and time course of these collections after posterior fossa tumor resection.

Matched MeSH terms: Spinal Cord/pathology*; Spinal Cord Diseases/etiology*; Spinal Cord Diseases/epidemiology*; Spinal Cord Diseases/pathology

Spinal cord injury rehabilitation: which way forward?

Karimi M, Omar AH, Fatoye F

NeuroRehabilitation, 2014 Jan 1;35(2):325-40.

PMID: 24990035 DOI: 10.3233/NRE-141124

Spinal cord injury (SCI), damage to spinal cord, influences the ability of the subjects to stand and walk. Moreover, they have some problems such as osteoporosis, muscle spasm, joint contracture and bowel and bladder function. These subjects use various orthoses and undergo different rehabilitation programmes to restore their ability. It is controversial whether use of aforementioned methods improves the physiological health of SCI individuals and improves their ability to ambulate or not. Therefore, the aim of this review was to investigate the effectiveness of assistive devices to restore their physiological health and their functional ability in patients with SCI.

Matched MeSH terms: Spinal Cord Injuries/rehabilitation*

Feasibility of successful pregnancies in women with spinal injury

Nor Azlin MI, Abd Rahman R, Abdul Karim AK, Sulaiman AS, Mahdy ZA

J Obstet Gynaecol, 2013 Aug;33(6):631-2.

PMID: 23919870 DOI: 10.3109/01443615.2013.807781

Matched MeSH terms: Spinal Cord Injuries*

Fulltext A report on an unusual presentation of autonomic dysreflexia

Suhaida SS, Engkasan JP

Med J Malaysia, 2012 Dec;67(6):616-7.

PMID: 23770957 MyJurnal

A 48-year-old male with complete tetraplegia C6 presented with sweating and flushing of the right half of the face and neck that recurred when lying in supine and left lateral positions. The symptoms subsided immediately upon sitting upright or lying in a right lateral position. The symptoms were associated with occasional mild head discomfort rather than headache and were accompanied by marked elevation of blood pressure, which was 190-200/120-130 mmHg compared to his previous baseline blood pressure of 80-90/50-70 mmHg, and he had a heart rate of 60-70 beats per minute. We believe that post-traumatic syringomyelia, found upon further investigation, was the cause of the Autonomic dysreflexia (AD) in this patient. He was advised to avoid the positions causing the symptoms and the progression of symptoms was monitored regularly. AD might not have been diagnosed in this patient because of the atypical and unusual presentations. Therefore, knowledge and a heightened level of awareness of this possible complication are important when treating individuals with spinal cord injury (SCI).

Matched MeSH terms: Spinal Cord Injuries*

Intramedullary spindle cell hemangioendothelioma of the thoracic spinal cord--case report

Abdullah JM, Mutum SS, Nasuha NA, Biswal BM, Ariff AR

Neurol. Med. Chir. (Tokyo), 2002 Jun;42(6):259-63.

PMID: 12116532

A 28-year-old Malay man presented with progressive paraparesis over a period of 6 months. Magnetic resonance imaging of the spine revealed a thoracic intramedullary spinal cord tumor at the T-7 level with homogeneous enhancement following intravenous gadolinium administration. Laminectomy and partial decompression of the tumor was performed. Histological examination of the tumor revealed features of spindle cell hemangioendothelioma. The patient was managed with limited field radiotherapy followed by systemic interferon therapy. Good neurological improvement was seen subsequently. The patient has survived 48 months with growth restraint at the primary site, although residual neurological deficit persists. Immunotherapy should be considered as a treatment modality for intramedullary hemangioendothelioma of the spinal cord after surgery and radiotherapy.

Matched MeSH terms: Spinal Cord Compression/etiology; Spinal Cord Neoplasms/complications; Spinal Cord Neoplasms/drug therapy; Spinal Cord Neoplasms/pathology*; Spinal Cord Neoplasms/radiotherapy; Spinal Cord Neoplasms/surgery

Fulltext Cell viability in three ex vivo rat models of spinal cord injury

Patar A, Dockery P, Howard L, McMahon SS

J Anat, 2019 02;234(2):244-251.

PMID: 30417349 DOI: 10.1111/joa.12909

Spinal cord injury (SCI) is a devastating disorder that has a poor prognosis of recovery. Animal models of SCI are useful to understand the pathophysiology of SCI and the potential use of therapeutic strategies for human SCI. Ex vivo models of central nervous system (CNS) trauma, particularly mechanical trauma, have become important tools to complement in vivo models of injury in order to reproduce the sequelae of human CNS injury. Ex vivo organotypic slice cultures (OSCs) provide a reliable model platform for the study of cell dynamics and therapeutic intervention following SCI. In addition, these ex vivo models support the 3R concept of animal use in SCI research - replacement, reduction and refinement. Ex vivo models cannot be used to monitor functional recovery, nor do they have the intact blood supply of the in vivo model systems. However, the ex vivo models appear to reproduce many of the post traumatic events including acute and secondary injury mechanisms. Several well-established OSC models have been developed over the past few years for experimental spinal injuries ex vivo in order to understand the biological response to injury. In this study, we investigated cell viability in three ex vivo OSC models of SCI: stab injury, transection injury and contusion injury. Injury was inflicted in postnatal day 4 rat spinal cord slices. Stab injury was performed using a needle on transverse slices of spinal cord. Transection injury was performed on longitudinal slices of spinal cord using a double blade technique. Contusion injury was performed on longitudinal slices of spinal cord using an Infinite Horizon impactor device. At days 3 and 10 post-injury, viability was measured using dual staining for propidium iodide and fluorescein diacetate. In all ex vivo SCI models, the slices showed more live cells than dead cells over 10 days in culture, with higher cell viability in control slices compared with injured slices. Although no change in cell viability was observed between time-points in stab- and contusion-injured OSCs, a reduction in cell viability was observed over time in transection-injured OSCs. Taken together, ex vivo SCI models are a useful and reliable research tool that reduces the cost and time involved in carrying out animal studies. The use of OSC models provides a simple way to study the cellular consequences following SCI, and they can also be used to investigate potential therapeutics regimes for the treatment of SCI.

Matched MeSH terms: Spinal Cord Injuries*

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