Incidence of acute spinal cord injury in the Czech Republic: a prospective epidemiological study 2006-2015.

STUDY DESIGN: A prospective study. OBJECTIVES: Analysis of epidemiological data about acute spinal cord injury (SCI) in the Czech Republic over a period of 10 years (2006-2015). METHODS: A data collection system was implemented in the rehabilitation centres which provides care to patients with acute SCI in the Czech Republic. The recorded variables are as follows: age at time of SCI; gender; cause of injury; neurological level of injury (NLI); and its severity (ASIA Impairment Scale (AIS)). Data from 2006 to 2015 were analysed and trends were determined. RESULTS: The overall number of acute SCI ranges between 250 and 300 cases annually. Two-third of the affected population are males. The average age at time of SCI is 49.1 years. The average incidence of traumatic SCI is 15.5 cases per year and is gradually decreasing. The leading cause of SCI are falls (44.5%), followed by traffic accidents (28.2%) and sports injuries including diving into water (19.7%). The incidence of non-traumatic SCI is 8.6 cases per year on average and has an upward trend. Inflammatory lesions account for 26.7% of cases, tumours account for 20.9%, and vascular related injuries make up 17.7%. The NLI occurs most often in the cervical segments (45.3%). The most frequently occurring lesions are motor incomplete: AIS D (33.3%). CONCLUSION: This study shows a stable occurrence of SCI in the Czech Republic, with cervical and motor incomplete cases being the leading ones. Epidemiological data are needed to improve the care of SCI patients and to promote an active life following it.

Carpal tunnel syndrome. Revision of the thenar motor branch?

This paper presents the authors' views and experience with operations of carpal tunnel syndrome. Because of the multifactorial etiology of the disease they cannot recommend a schematic solution using a single surgical procedure for the treatment of all patients. During an operation much depends on the local findings as well as on the neurological ones. Individual steps during an operation are analyzed and discussed with regard to their risks and the authors deal also with the asset from the aspect of causality of the approach. The authors recommend revision of the thenar branch of the median nerve. Between January 1994 and October 1996 the authors investigated 212 patients. EMG examinations were performed prior to surgery in all cases. General evaluations showed favourable postoperative results in 94% of individuals.