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@#The incidence of spinal cord injury is becoming higher and higher, of which more than half are cervical spinal injury. The main cause of death in high cervical spinal injury is respiratory function failure. The patients who survived must rely on ventilators to sustain life. In view of the shortcomings of ventilators, many researchers tried to use diaphragm pacing technology instead of ventilator to reconstruct the function of respiratory. This article introduced the application of diaphragm pacing technology in patients with cervical spinal injury.
RESUMO
The incidence of spinal cord injury is becoming higher and higher, of which more than half are cervical spinal injury. The main cause of death in high cervical spinal injury is respiratory function failure. The patients who survived must rely on ventilators to sus-tain life. In view of the shortcomings of ventilators, many researchers tried to use diaphragm pacing technology instead of ventilator to re-construct the function of respiratory. This article introduced the application of diaphragm pacing technology in patients with cervical spinal injury.
RESUMO
@#The incidence of spinal cord injury is becoming higher and higher, of which more than half are cervical spinal injury. The main cause of death in high cervical spinal injury is respiratory function failure. The patients who survived must rely on ventilators to sustain life. In view of the shortcomings of ventilators, many researchers tried to use diaphragm pacing technology instead of ventilator to reconstruct the function of respiratory. This article introduced the application of diaphragm pacing technology in patients with cervical spinal injury.
RESUMO
Objective To investigate the appropriate surgical approach in the management of cervical cord injury following ossification of the posterior longitudinal ligament. Methods The clinical data of 25 patients with cervical cord injury following ossification of the posterior longitudinal ligament who received surgical treatment were retrospectively analyzed. According to Frankel grades, two patients were at grade A, three at grade B, 14 at grade C and six at grade D. The surgical procedures consisted of anterior decompression (12 patients), posterior decompression (8 patients) and combined posteroanterior decompression (5 patients). Results No iatrogenic injury of great vessels, trachea, esophagus or spinal cord occurred. All the patients were followed up for 15-86 months (mean 38.3 months). All segments with anterior fixation attained solid fusion, without implants loosening or breakage. No reelosed open-door was found in patients who received posterior laminoplasty. The spinal function got improved in 21 patients, and a relief of pain or numb of the upper limb was attained in four patients whose spinal cord injury was not cured. Conclusions The surgical outcome of cervical cord injury following ossification of the posterior longitudinal ligament is satisfactory. It is important to select a suitable surgical approach according to the imaging manifestations associated with the general conditions of the patients.
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@# Objective To explore the effect of body-weight support treadmill training (BWSTT)on ambulatory capacity in individuals following incomplete spinal cord injury (ISCI).Methods 36 cases of incomplete SCI patients were divided randomly into control and BWSTT groups who were classified as ASIA C or D.All received comprehensive rehabilitation, and patients in BWSTT group also received BWSTT for 3 months when the physical condition was permitted.They were assessed before and after treatment.The evaluation items included measurement of ASIA lower-extremity motor assessment, functional independence measure (FIM) ambulatory function measure, 10meter ambulatory velocity and modified Barthel Index.Results The scores of ASIA lower-extremity motor assessment, FIM ambulatory function, the ambulatory 10-meter velocity in BWSTT group improved significantly when compared with the control group (P<0.05).The scores of modified Barthel Index were no difference between two groups before and after treatment (P<0.05).Conclusion BWSTT could improve ambulatory capacity for incomplete SCI patients
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Objective To evaluate the effectiveness of rehabilitative treatment for severe cervical spondylotic myeiopathy after combined posterior-anterior surgery. Methods Fifty-four patients (mean age, 59.5) who had undergone combined posterlor-anterior surgery of the cervical spine due to severe cervical spondylotic myelopathy were studied with an average follow-up of 38.7 months. All the patients were allocated into either a rehabilitation treatment group (28 patients) or a control group (26 patients). Neurological function in the two groups was assessed using the Japanese Orthopedic Association (JOA) grading system. In addition, the status of axial symptoms, wound healing and post-operative complications were also evaluated. Results The bone grafts completely fused in both groups. All of the wounds in the rehabilitation treatment group healed without any infection. Three wounds were infected in the control group, but were cured by prompt treatment. Two patients in the rehabilitation group and 9 in the control group suffered laryngeal edema. There was no significant difference between the two groups before the operation with regard to their JOA scores, which significantly increased postoperation in both groups. In the rehabilitation treatment group, the postoperation JOA scores were significantly higher than in the control group. At the same time, there were significantly fewer patients with neck axial symptoms in the rehabilitation treatment group than that in the control group (25.0% versus 69.2% , P < 0.01 ). Conclusions Systematic rehabilitation treatment pro-and post-operation of patients with severe cervical spondylotie myelopathy can accelerate neurological recovery and help prevent postoperative complications and neck axial symptoms.
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Objective To summarize the experience of microendoscopic discectomy (MED). Methods A retrospective analysis was made on causes and the management of complications following 115 cases of MED in this hospital from April 2001 to April 2003. Results A conversion to open surgery was required in 13 cases. There were 2 cases of endoscope displacement and 7 cases of dural abruption intraoperatively. Postoperative hematoma pressing on neighbouring nerves was seen in 2 cases but no nerve root injuries were found. All the patients were followed for 3～12 months (mean, 7 5 months). According to the Nakai scale, 70 cases were classified as “excellent”, 36 cases “good”, 7 cases “fair”, and 2 cases “poor”, the “good” or “excellent” rate being 92.2% ( 106/115 ). Conclusions Proper selection of patients, intraoperative localization by “C”-arm X-ray examination, removal of the ligamenta flava and the lamina, detachment of adhesions surrounding the nerve root to obtain a complete exposure, and thorough hemostasia are crucial to minimize the incidence of complications.