ABSTRACT
BACKGROUND: Femoral cartilage thickness has been used as an indicator for immobilization and unloading in patients with spinal cord injury (SCI). However, conflicting results have been reported on this subject. OBJECTIVES: (i) To determine femoral cartilage thickness alterations after prolonged immobilization, (ii) to demonstrate the effect of the daily standing or ambulation time on the cartilage and (iii) to analyze the predictors of the femoral cartilage in patients with SCI. METHODS: A total of 50 patients with SCI and 50 healthy age and sex-matched volunteers were enrolled in the study. A physician scanned both knees of all participants and measurements were taken at three locations: trochlear notch, midpoints of the medial and lateral condyle. RESULTS: The trochlear notch, medial and lateral condyle femoral cartilage thickness of both sides were significantly thicker in the control group (P<0.05). Patients with <1 h daily standing/walking time had higher thickness measurements in all sub parameters than patients with >1 h daily standing/walking time (P<0.05). Daily standing/walking time and the Walking index for SCI score were statistically significant predictors for cartilage thickness. CONCLUSION: SCI patients had thinner knee cartilage compared with healthy individuals in ultrasonographic assessment. More than 1 h daily standing/walking time may have a negative effect on the femoral cartilage thickness. Thus, ultrasonographic evaluation of the femoral cartilage should be considered in clinical practice to detect early cartilage thinning in patients with SCI.
Subject(s)
Cartilage, Articular/pathology , Knee Joint/physiopathology , Spinal Cord Injuries/complications , Spinal Cord Injuries/pathology , Adolescent , Adult , Cartilage, Articular/diagnostic imaging , Case-Control Studies , Female , Humans , Linear Models , Male , Middle Aged , Paraplegia/etiology , Severity of Illness Index , Spinal Cord Injuries/diagnostic imaging , Statistics, Nonparametric , Turkey , Walking/physiology , Young AdultABSTRACT
STUDY DESIGN: Retrospective study. OBJECTIVES: To determine the demographic and clinical characteristics of patients with cervical spinal cord injury (CSCI) admitted to a single Center. SETTING: Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. METHODS: The medical records of all patients with spinal cord injury admitted from January 2009 to December 2013 were screened. Variables of each patient with cervical injury (CSCI), such as age at the time of injury, gender, etiology, degree and level of neurological impairment, associated injuries, surgical stabilization and length of rehabilitation stay (LOS), were analyzed. RESULTS: In all, there were 804 patients with traumatic spinal cord injury (SCI) during the 5-year study period, of which 562 (69.9%) were paraplegic and the remaining 242 (30.1%) had a CSCI (C1-C8) and were included in the study. Among the CSCI patients, 80.6% were male (male:female ratio is 4.15:1), mean age at the time of injury was 32.58±14.71 years (range: 4-79 years), the largest age group was 16-30 years (n=117, 48.3%), followed by 31-45 years (n=70, 28.9%). Motor vehicle accident (MVA) was the most common cause of injury (49.2%), followed by falls (21.5%) and diving accidents (18.2%). Low CSCI (C5-8; 61.2%) and incomplete injury (55%) occured more often than high CSCI (C1-4) and complete injury. In total, 202 (83.5%) patients underwent surgical stabilization. Thirty-seven (15.3%) had associated injuries. CONCLUSION: The present findings show that most of the CSCI patients were aged 16-30 years. In addition, based on the frequency of the causes of injuries we think that prevention efforts should mainly focus on MVA, falls and diving accidents.
