Prognosis of traumatic spinal cord injury in children: Follow-up of 86 patients / 中华创伤杂志(英文版)

PURPOSE@#The long-term situation of children with spinal cord injury (SCI) was investigated, and suggestions for helping them better return to the society were provided.@*METHODS@#SCI patients less than 18 years old hospitalized in Beijing Boai Hospital from January 2011 to December 2020 were retrospectively analyzed. Information including motor function, complications, characteristic changes, self-care abilities, school attendance and social participation were collected by telephone interview and electronic questionnaire. All the answers were statistically analyzed.@*RESULTS@#A total of 86 cases were enrolled, 77 girls and 9 boys, with a median injury age of 6 years and 2 months. The follow-up time was 3-130 months. The main cause of trauma in these children was sport injury (66.3%), the thoracic spinal cord was involved the most (91.9%), and complete SCIs accounted for the majority (76.7%). In terms of complications, children with complete SCIs were more likely to have urinary incontinence, constipation and characteristic changes (p < 0.05); whereas the incomplete SCIs often have spasticity (p < 0.05). As to the daily living abilities, children with incomplete lumbar SCIs were more capable to accomplish personal hygiene, transfer, and bathing independently than those with complete injuries, or cervical/thoracic SCIs, respectively (p < 0.05). Moreover, children older than 9 years care more able to dress and transfer independently than the youngers (p < 0.05). Wheelchair users accounted for 84.9% and more than half of them were able to propel wheelchair independently, and those who move passively in wheelchairs were mostly introverted kids (p < 0.05). Almost all (93.8%) children with incomplete injuries were able to walk independently. Most (79.1%) children continued to attending school, and 41.9% participated in interest classes. Unfortunately, 67.4% of the children spent less time playing with their peers than before the injury.@*CONCLUSION@#SCIs impair physical structures and function of children, affect their independence in daily living, and restrict school attendance and social interaction. Comprehensive rehabilitation after injury is a systematic work. Medical staff and caregivers should not only pay attention to neurological function, but also help them improve self-care abilities. It is also important to balance rehabilitation training and school work and social participation.

Ultrasound-guided Transforaminal Epidural Injection in Pigs / 中国康复理论与实践

Objective:To observe the feasibility and accuracy of ultrasound-guided transforaminal epidural injection. Methods:Ultrasound-guided injection at L1-2, L2-3, L3-4, L4-5, L5-6 bilaterally was performed in L1-6 spine from two Bama miniature pigs. The position of needles was detected with X-ray and CT, and observed under anatomy. The distance from the puncturing points at skin to the posterior midline, the depths and angles of puncturing between were measured and compared bilaterally. Results:The successful rate was 95% (19/20), out of which, 80% (16/20) were put the needle tips at the lower part of the intervertebral foramen, ventral side, central region or paracentral region. There was no significant difference between sides in the distances, depths or angles in 19 successful injections. Conclusion:It is accurate to transforaminally puncture under ultrasound-guided.

Motor Control Function of Brain in Subacute Complete Spinal Cord Injured Patients: A Functional Magnetic Resonance Imaging Study / 中国康复理论与实践

Objective:To study the changes of brain motor control function in patients with complete spinal cord injury within three to six months. Methods:From January, 2017 to January, 2019, eleven inpatients with complete spinal cord injury and twelve healthy controls were screened with functional magnetic resonance imaging during attempted/executive movement (MA/ME) and motor imagery (MI). The involved area and activation were compared between the groups under tasks. Results:More areas were activated in the patients than in the controls as MA/ME, such as bilateral primary sensorimotor cortex, supplementary motor area, lateral globus pallidus, cerebellum, contralateral thalamus and putamen. During MI, the activation was more in the patients in ipsilateral primary motor cortex, supplementary motor area, dorsal premotor area, contralateral supplementary motor area, insular and basal ganglia. The patients induced more activation as MA than as MI in ipsilateral primary motor cortex, bilateral supplementary motor area and cingulate motor area, and contralateral cerebellum. Conclusion:The activation remains normal in primary motor cortex and supplementary motor area for subacute complete spinal cord injury patients when undergoing motor tasks, but some reorganization may occur in parietal lobe and cerebellum that involve in sensorimotor integration.

Follow-up for Change of Neurological Function and Predict Model of Spinal Cord Injury (review) / 中国康复理论与实践

The treatment and functional rehabilitation of spinal cord injury is globally concerned. It is of significance to study the follow-up since people with different levels and completeness of traumatic spinal cord injury experience different patterns or profiles of both neurological and functional recovery. This review systematically analyzed the assessment scales of spinal cord injury and the selection of follow-up period, the prognostic studies, the prognostic factors and prediction models.

Advance in Whiplash-associated Disorders (review) / 中国康复理论与实践

Whiplash-associated disorders usually appear as symptoms of neck pain, headache, and limited cervical spine activities, etc. Its mechanism is complicated, which is related with the sudden acceleration-deceleration mechanism conducted to the cervical vertebral joint, ligaments, muscles and nerves. Recently, it was found that low capacity of cerebrospinal fluid, fibromyalgia, and injury of central nervous system are also associated with those symptoms. The focus of exercise on equal length contraction and endurance of neck deep muscles can significantly improve the symptoms of patients without neurological injury. Ultrasound can be used to dynamically detect deformation and deformation rate patterns of both deep and shallow muscle in the exercise group and the conservative observation group. It is suggested that exercise can improve muscle movement patterns and repair damaged neck muscles at the same time.

Frequencies of CGT52TGT, GGC54GAC and GGA57GAA point mutations in MBL gene in Chinese Uyghur population / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the frequencies of three point mutations, CGT52TGT, GGC54GAC and GGA57GAA, in exon 1 of mannan-binding lectin (MBL) structural gene in Chinese Uyghur population.</p><p><b>METHODS</b>Blood samples were collected from a Uyghur population in Xinjiang Uyghur Autonomous Region, and the genomic DNA was extracted from the leucocytes and the target gene fragment amplified by PCR. The three point mutations in exon 1 of MBL gene were detected by fluorogenic probe hybridization technique with visual monitoring.</p><p><b>RESULTS</b>In 95 Uyghur individuals, 2 were identified as homozygous for codon 54 mutations, 28 were heterozygous for codon 54 mutation, and no CGT52TGT and GGA57GAA point mutations were found.</p><p><b>CONCLUSION</b>The frequencies of CGT52TGT, GGC54GAC and GGA57GAA mutant alleles in exon 1 of MBL structural gene are 0, 0.168 and 0 respectively in the Chinese Uyghur population.</p>

Neurological Prognosis of Spinal Cord Injured Patients Using ASIA2000 Scale / 中国康复理论与实践

@#ObjectiveTo investigate the application of ASIA2000 classification in prognosis of spinal cord injury patients' neurological function. MethodsConsecutive observation was done to the 42 patients using ASIA2000 classification 1 month, 3 months and 12 months after injury respectively. ResultsTo the incomplete SCI patients, motor score, pin prick score and light touch score were significantly improved 3 months after injury compared with that in 1 month after injury (P<0.05), but no significant improvement was observed in the complete ones, nor did in all the patients between 3 months and 12 months after injury. ConclusionThe Standard Neurological Classification is more sensitive than Standard Impairment Classification in ASIA2000. Individuals within 3 months after injury got better neurological recovery than those more than 3 months after injury. Incomplete injuried individuals may get better neurological prognosis than complete ones.

Test-retest Reliability and Inter-rater Reliability of ASIA2000 Scale / 中国康复理论与实践

@#ObjectiveTo investigate the test-retest reliability and inter-rater reliability of ASIA2000 scale.MethodsTwenty-five hospitalized spinal cord injury volunteers were chosen according to the selective criteria. The items were retested by the same examiner one week later to determine the scale's test-retest reliability. Another doctor did the same work 24 h later to determine the scale's inter-rater reliability.ResultsThe Pearson correlation coefficients of the pin prick score, light touch score and motor score of the test-retest reliability were all above 0.90 (P<0.05), and the Kappa values of the ASIS impairment scale (AIS) and completeness of the injury were 0.787 and 0.756 (P<0.05). The Pearson correlation coefficients of the pin prick score, light touch score and motor score of the inter-rater reliability were all above 0.85 (P<0.05), and the Kappa values of the AIS and completeness of the injury were 0.802 and 0.764 (P<0.05).ConclusionThe ASIA2000 scale has good test-retest reliability and inter-rater reliability.

Characteristic of diagnosis and treatment of spinal cord stab injury / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics of the incidence, diagnosis, treatment and prognosis of stab injury of spinal cord.</p><p><b>METHODS</b>Retrospective study of the clinical materials of 42 stab spinal cord injury patients who were treated in our hospital from 1992 to 2004.</p><p><b>RESULTS</b>Among the patients, 38 were male, and 4 were female. 80% of the cases were thoracic spinal cord injury patients. Incomplete injury cases accounted for 71.4% of all the cases. Of all the 30 incomplete injury cases, 14 had the sign of standard Brown-Sequard syndrome, 6 had the sign of non-standard Brown-Sequard syndrome and 10 do not have the sign of Brown-Sequard syndrome. Magnetic resonance image was very useful to the diagnosis and treatment of the disease. Debridement was a routine to do in acute stage. Operations such as scrutinization of the spinal canal, clean-up of the hematoma, extraction of foreign bodies were optional according to different conditions. After treatment, most of the patients got good recovery as far as ASIA scale and ADL scale were concerned.</p><p><b>CONCLUSION</b>According to the results above, it is recommended that enough attention should be given to the unique aspects of the disease to effectively facilitate recovery of such cases.</p>