ABSTRACT
The National Rehabilitation Center for the Disabled (hereunder abbreviated NRC) in Japan was established in 1979. It consists of four divisions: the hospital, the rehabilitation training center, the research institute, and the information service section. The spinal unit has been functioning and cooperating corelatively with all of these divisions. There were 1047 patients with a spinal cord injury treated in the 15 years from September, 1980 to August, 1994; consisting of 924 males (88.3%), and 123 females (11.7%). The breakdown of causes of injury were traffic accidents 44.9%, having a fall 14.7%, sports accidents 6.7%, and other causes of spinal paralysis 10.5%. The sites of the spinal cord lesions were cervical 372 (35.5%), thoracic 547 (52.5%), and lumbar spinal cord 128 patients (12.3%). The incidence of complete paralysis in those with a cervical spinal cord injury (SCI) was 68.8%, and for thoracic and lumbar SCI 79% each. The time for completion of activities of daily living (ADL) was 12.0 +/- 1.54 months in those with tetraplegia, and 5.6 +/- 1.71 months for those with paraplegia. The rate of employment for reentry into society was 59% in those with a cervical spinal cord injury, and 74% each in those with a thoracic or lumbar spinal cord injury.
Subject(s)
Rehabilitation Centers/organization & administration , Spinal Cord Injuries/rehabilitation , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Japan/epidemiology , Male , Middle Aged , Physical Therapy Modalities , Rehabilitation, Vocational , Spinal Cord Injuries/epidemiology , Spinal Cord Injuries/etiologyABSTRACT
The aim of the present study was to set targets for each spinal lesion level after determining the relationship between the spinal lesion level and movement abilities in patients with tetraplegia following injury to the cervical cord. A total of 109 patients, 96 men and 13 women were included in the study. We mainly examined locomotion and transfer capabilities according to Zancolli's classification. The results of this study showed that 50% of the patients classified as C6A, 75% of C6B1 and 96% of the patients classified C6B2 accomplished bed transfer. The number of patients who could manage toilet transfer was 53% in the group classified as C6B1 and 85% in group C6B2. These results suggest that achievement of those classified as C6B2 is a clue to the assumption that the patient will achieve toilet transfer capability and can perform ADL independently.
Subject(s)
Movement/physiology , Quadriplegia/pathology , Spinal Cord Injuries/pathology , Activities of Daily Living , Adolescent , Adult , Female , Humans , Locomotion , Male , Middle Aged , Quadriplegia/physiopathology , Retrospective Studies , Risk Assessment , Spinal Cord Injuries/physiopathology , WheelchairsABSTRACT
Cerebrospinal fluid (CSF) flow within the syrinx in post-traumatic syringomyelia was studied by cardiac-triggered phase images of magnetic resonance imaging (MRI) to investigate the relationship between CSF flow in the syrinx and patients' symptoms.
Subject(s)
Spinal Cord Injuries/cerebrospinal fluid , Syringomyelia/cerebrospinal fluid , Adolescent , Adult , Child , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Spinal Cord Injuries/complications , Spinal Cord Injuries/pathology , Subarachnoid Space/pathology , Syringomyelia/etiology , Syringomyelia/pathologyABSTRACT
Cerebrospinal fluid (CSF) flow within the spinal canal and syrinx in posttraumatic syringomyelia were studied by cardiac-gated phase images of magnetic resonance imaging in 12 normal volunteers and 8 patients with syringomyelia. The cardiac-gated phase method was simple and useful for detection of CSF flow; 1) phase modulation was in direct proportion to flow velocity, 2) phase modulation was not affected by the T1 or T2 relaxation time. In normal volunteers, CSF flows caudally during systole and cranially during diastole. The maximum caudal CSF flow velocity at C2 level was from 0.45 cm/sec to 1.71 cm/sec, average; 1.27 cm/sec. All of symptomatic posttraumatic syringomyelia patients had the flow in the syrinx.
Subject(s)
Syringomyelia/cerebrospinal fluid , Adolescent , Adult , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Rheology , Spinal Cord Injuries/complications , Syringomyelia/diagnosis , Syringomyelia/etiologyABSTRACT
There has been a great argument in selecting conservative treatment or surgical repair for the spinal cord injury as an early stage treatment. The purpose of medical treatment is to bring a patient back to the society as soon as possible by early intervention and rehabilitation, while preventing complications of the injury. We are faced with a difficulty in determining the superiority between conservative treatment and surgical repair, since no comparative statistical analysis has been available among various rehabilitation methods for the spinal cord injury. We treated 171 patients in the past with traumatic thoracic or lumbar spinal cord injury who were submitted to our hospital for the ADL training purposes. We selected and studied 34 complete paraplegic cases with no complications who started receiving ADL training within 2 months period after the injury from among these cases. (1) Non-ope group was superior in spinal flexibility to internally spinal fused group. (2) Non-ope group reached ADL independence 1.4 months earlier than I.S.F. in case of upper thoracic injury. ADL independence was reached almost at the same time in the lower thoracic injury cases by either treatment. Above all, it is concluded that conservative treatment is more helpful to establish rehabilitation in shorter length of time than surgical repair.
