UNASSIGNED: This study evaluated the presence of neurologic sequelae among trauma patients after flexion-extension (F/E) radiographs.
UNASSIGNED: Authors of the study conducted a retrospective review of patients (age ≥ 14 years) with a Glasgow Coma Score of 15 who sustained a blunt traumatic injury and received F/E radiographs. Radiographic scans were defined as positive, negative, inconclusive, or incomplete. The neurologic status of each patient was assessed before and after the F/E radiographs, and at discharge and follow-up.
UNASSIGNED: Of the 501 patients included in the analysis, 84.6% (n = 424) had negative F/E radiographs, and 3.2% (n = 16) had positive F/E radiographs. Ten percent (n = 51) of patients had incomplete F/E radiographs, and 2.0% (n = 10) were inconclusive due to the inability to rule out a ligamentous injury. Three patients (0.6%) had MRI-confirmed ligamentous injuries, all of which had initial incomplete F/E radiographs due to pain. No patient had a documented neurological deficit before or after the F/E exam. Three patients with an initial negative F/E radiograph returned to the clinic with symptoms of neurologic sequelae. Two of these patients had symptom resolution with no further issues at future follow-up appointments. The third patient was found to have chronic neurologic symptoms after further evaluation.
UNASSIGNED: The inclusion of F/E exams in cervical spine clearance protocols did not demonstrate any new long-term iatrogenic neurologic injuries. Consideration should be given to performing MRIs on patients with incomplete F/E radiographs that cannot rule out a ligamentous injury.

Traumatic penetrating spinal injuries with wooden objects are rare. A 6-year-old boy presented with history of fall from tree 1 month back. It resulted in a penetrating injury at the lumbosacral area, followed by a discharging sinus without any neurological deficit. Radiological imaging showed a foreign body at the spinous process level traversing L4-5 and is lodged in L3-4 intervertebral body causing listhesis of L3 over L4. The wooden stick was retrieved with a meticulous surgical procedure. Proper imaging and early surgery are necessary to prevent any complications and early recovery.

UNASSIGNED: To determine the impacts to research the impacts of pain\'s Specialized Pain Management Nursing Care in the perioperative period on pain symptoms and life quality of patients experiencing minimally invasive surgery for spinal injury.
UNASSIGNED: Eighty patients with a spinal injury who underwent minimally invasive surgery in the Department of Orthopedics of Baoding No.1 Hospital from January 2018 to December 2021 were retrospectively analyzed. They were split into two groups following different nursing methods (n=40 each group). Specialized Pain Management Nursing Care were given to patients in the observation group. Those in the control group were given treated with routine care. Their pain score and nursing effect were compared, after which their quality of life, daily living ability and complication rate compared and analyzed.
UNASSIGNED: The pain degree in the control group was considerably more than that in the observation group in the 1st postoperative period. The pain degree, which decreased in both groups, slumped more significantly in the observation group on the 2nd and 3rd postoperative days. The postoperative hospital stays and pain duration in the observation group were shorter than those in the control group (P<0.05), and the nursing effect was significantly better than that in the control group (P<0.05). After postoperative nursing intervention.
UNASSIGNED: Minimally invasive surgery integrated with the Specialized Pain Management Nursing Care can remarkably ameliorate pain after spinal injury surgery, reducing complications\' incidence, and improving the life quality for patients.

Incidence of spinal injury is high in the Middle East and North African region (MENA) due to the high incidence of road traffic crashes. A spinal injury may trigger mental health issues. Compared to the general population, people with spinal injury are at higher risk for developing major depression, anxiety, post-traumatic stress disorders, substance abuse, and suicide.
UNASSIGNED: The objectives of the study were to determine depression prevalence; identify relationships between depression and cause and site of spinal injury, sociodemographic factors, and social support; and explore the lived experiences of depression in people with spinal injury in Qatar.
UNASSIGNED: A sequential cross-sectional mixed methods study was conducted. In the quantitative component, the universal sample consisted of 106 consenting individuals presenting with spinal injury at Hamad General Hospital, Doha, Qatar between January and December 2020. The Patient Health Questionnaire-9 was used to assess levels of depression and the Medical Outcomes Study Social Support Survey was used to assess perceived social support. The cause and site of injury were obtained from patient records. In the qualitative component, semi-structured in-depth interviews were conducted with 12 purposively selected participants from the quantitative component.
UNASSIGNED: Spinal injury had a negative impact on participants physical, mental, social, and spiritual wellbeing. In total, 69% of participants had some level of depression: 28% mild, 25.5% minimal, and 15% moderate to severe. Depression was not associated with socio-demographic factors, or the cause or site of spinal injury. Higher levels of emotional/informational support and positive social interaction were associated with milder depression. Social support and religious faith were critical in assisting participants to cope with their new situation.
UNASSIGNED: Depression is prevalent among people with spinal injury attending health services. Early detection, referral, and treatment of depression are recommended. Strategies to enhance emotional/informational support and positive social interaction should be developed and tested with people with spinal injury.

The Wilderness Medical Society reconvened an expert panel to update best practice guidelines for spinal cord protection during trauma management. This panel, with membership updated in 2023, was charged with the development of evidence-based guidelines for management of the injured or potentially injured spine in wilderness environments. Recommendations are made regarding several parameters related to spinal cord protection. These recommendations are graded based on the quality of supporting evidence and balance the benefits and risks/burdens for each parameter according to American College of Chest Physicians methodology. Key recommendations include the concept that interventions should be goal-oriented (spinal cord/column protection in the context of overall patient and provider safety) rather than technique-oriented (immobilization). An evidence-based, goal-oriented approach excludes the immobilization of suspected spinal injuries via rigid collars or backboards.

UNASSIGNED: Bibliometric analysis.
UNASSIGNED: This study aimed to highlight the 200 most influential articles related to traumatic spinal cord and spinal column injuries and provide an insight of past and current global trends in spinal trauma research.
UNASSIGNED: The Web of Science database was used to identify the top 200 most cited articles on the topic of traumatic spinal cord injury (SCI) and spinal column injuries between using a prespecified algorithm. The articles were manually reviewed; bibliometrics were collected on title, first and corresponding authors\' country, institution, journal, publication year, and citation data.
UNASSIGNED: The search string yielded 30,551 articles during 1977-2019. The average time from the publication was 19.5 years. A total of 1356 authors contributed to 67 different journals, the top 200 most cited articles amassing a total of 88,115 citations and an average 440.6 citations. The United States of America (USA) contributed the most with 110 articles; the top institution was the University of Toronto with 34 publications. Most studies focused on basic science research on SCI. Keyword analysis revealed the most commonly used keywords: SCI, inflammation, apoptosis, incidence/prevalence, and regeneration; four word-clusters were identified. Institutions from the USA and Canada collaborated the most and two major and two minor institutional collaboration subnetworks were identified. Co-citation analysis detected three main clusters of authors.
UNASSIGNED: This overview of the most cited articles on traumatic spinal cord and spinal column injuries provides insight into the international spinal trauma community and the terrain in this field, potentially acting as a springboard for further collaboration development.

UNASSIGNED: Persons with tetraplegia rank improved upper extremity (UE) function as the most important rehabilitation outcome because it allows them greater independence in activities of daily living (ADL). The aim of this study was to describe UE status in patients with tetraplegia using the International Spinal Cord Injury Upper Extremity Basic Data Set version 1.1 (ISCI-UE 1.1) and to determine differences in UE status between tetraplegic individuals with traumatic and non-traumatic SCIs.
UNASSIGNED: This cross-sectional study was conducted among patients with tetraplegia who attended the SCI rehabilitation clinic of a tertiary hospital from September 2021 to August 2022. Both upper limbs were assessed using ISCI-UE 1.1.
UNASSIGNED: One hundred patients were included in this study, of whom 80 were men. The mean (SD) age of the patients was 54.30 (16.95) years old. In these patients, most SCIs (62%) were of traumatic origin. Two hundred UEs were evaluated, of which 109 showed good hand function (level 5) and 10 had the poorest hand function (level 1). Meanwhile, 130 UEs showed good shoulder function (level D) and 10 had the poorest shoulder function (level A). A statistically significant association with UE status (reach-and-grasp ability and shoulder function) was found in both the non-traumatic and traumatic SCI groups, with better hand and shoulder functions in the non-traumatic SCI group (right-hand, P = 0.004 and left hand, P = 0.001; right shoulder, P < 0.001 and left shoulder, P = 0.002).
UNASSIGNED: ISCI-UE 1.1 is a feasible tool for documenting UE function in patients with tetraplegia. Compared with the individuals with traumatic SCI in this study, those with non-traumatic SCI demonstrated better upper extremity functionality.

UNASSIGNED: The aim was to study functional recovery in experimental animals (rabbits) with transected spinal cords treated with a combination of photo-cross-linked chitosan in a homogeneous mixture with polyethylene glycol (PEG-chitosan).
UNASSIGNED: 20 rabbits (n = 10 experimental and n = 10 controls) were submitted to complete spinal cord transection at T9. The experimental group received an intraoperative injection of PEG-chitosan. Neurological recovery was assessed using the modified Basso, Beattie, and Bresnahan scale.
UNASSIGNED: In the experimental group, partial recovery of movements, sensory function, and sphincter control were all observed by postoperative day 30. Paraplegia and anesthesia persisted in the control group; 4 controls died versus none in the test group.
UNASSIGNED: PEG-chitosan is a candidate for neurological restoration after spinal paralysis.

Modern approaches to intensive care and anesthesiology make it possible to save patients with various severe traumas. Prolonged mechanical ventilation allows stabilizing the patient\'s status, but can result severe complications including tracheoesophageal fistula. Our patient received severe combined injury after road accident, i.e. compression-comminuted fractures of DIV, DV, DVI vertebrae with spinal cord compression, ThIII compression fracture, compression-comminuted fracture of bodies and arches ThIV, V, VI with ThVI dislocation, lower paraplegia and pelvic organ dysfunction, left-sided laryngeal paresis, brain concussion and contusion of both lungs. Mechanical ventilation has been performed for 1.5 months. The patient suffered inflammatory complications: bilateral pneumonia complicated by right-sided pleural empyema, sepsis, tracheostomy suppuration followed by cervical soft tissue abscess. Pleural drainage and debridement, as well as drainage of abscess were performed. At the same time, we diagnosed external esophageal fistula at the CVII level. Tracheoesophageal fistula closure via cervical access was carried out at the first stage. Postoperative period was uneventful. After 20 days, we performed spondylosynthesis ThI-ThVII, and decompression laminectomy ThIV-ThVI. Spine stabilization by metal elements has a beneficial effect even without spinal cord recovery regarding better conditions for neurological and social rehabilitation. Thus, treatment was performed in a highly specialized multi-field hospital by thoracic surgeons and vertebrologists. We realized the treatment plan and obtained favorable results with minimal risk of postoperative complications.
Достигнутый уровень реаниматологии и анестезиологии позволяет спасать пациентов с разнообразной тяжелой травмой. Проведенная длительная искусственная вентиляция легких дает возможность стабилизировать состояние пациента, но может привести к тяжелым осложнениям в виде формирования патологического соустья трахеи с пищеводом. Больной Б. после дорожно-транспортного происшествия получил тяжелую сочетанную травму — компрессионно-оскольчатый перелом тел DIV—DVI позвонков со сдавлением спинного мозга, компрессионный перелом тел ThIII, компрессионно-оскольчатый перелом тел, дужек ThIV—THVI с вывихом ThVI, нижнюю параплегию с нарушением функции тазовых органов. Левосторонний парез гортани. Сотрясение головного мозга. Контузия обоих легких. Лечение больного было осуществлено в высокоспециализированном многопрофильном учреждении, в котором имелись специалисты с опытом трахеальной хирургии и вертебрологии. Это позволило осуществить план лечения и получить ожидаемые результаты с минимальным риском послеоперационных осложнений.

Currently, there is no effective method of treating complete spinal cord intersection. One of the promising experimental approaches is substances promoting repair and fusion of axonal membranes.
To study clinical and functional recovery in experimental animals with transected spinal cord after management with photo-cross-linked chitosan in a homogeneous mixture with polyethylene glycol.
We studied 20 rabbits with a model of complete spinal cord transection at the level of Th9. There were control and experimental groups (n=10; n=10). In the experimental group, we intraoperatively injected photo-cross-linked chitosan in a homogeneous mixture with polyethylene glycol. Neurological status was assessed using the modified Basso Beattie Bresnahan scale. Histological examination was performed after removing the animals from the experiment.
In the experimental group, significant regression of neurological disorders was accompanied by partial recovery of movements, sensitivity and control of pelvic functions by the 30th day of the experiment. There was no mortality in the experimental group. Paraplegia and anesthesia persisted in the control group while mortality was 40% (n=4). Histological analysis in the main group revealed axonal «bridges» in the area of injury and spread of DiI dye through this area.
These phenomena confirm the positive effect of chitosan and polyethylene glycol on functional recovery after experimental spinal cord injury. These data are consistent with histological findings.
В настоящее время не существует эффективного метода восстановления функций спинного мозга после его полного повреждения. Одним из перспективных экспериментальных направлений является применение веществ, способствующих репарации и слиянию аксональных мембран.
Изучить клинико-функциональное восстановление у экспериментальных животных с пересеченным спинным мозгом после применения фотосшитого хитозана в гомогенной смеси с полиэтиленгликолем.
Использованы кролики (n=20) с моделью полного поперечного пересечения спинного мозга на уровне сегмента Th9. Были сформированы контрольная и опытная группы (n=10; n=10). В опытной группе животным интраоперационно вводили препарат фотосшитого хитозана в гомогенной смеси с полиэтиленгликолем. Уровень неврологического дефицита у животных исследовали по модифицированной шкале Basso Beattie Bresnahan (BBB). После выведения животных из эксперимента выполняли гистологическое исследование.
У животных из опытной группы к 30-му дню эксперимента отмечался значительный регресс неврологического дефицита с частичным восстановлением двигательной активности, чувствительности и контроля за тазовыми функциями. Летальных исходов в опытной группе не было. У животных из контрольной группы неврологический дефицит сохранялся в виде параплегии, анестезии. При этом летальность в контрольной группе достигла 40% (n=4). Гистологическая картина в основной группе показала наличие аксональных «мостиков» в области травмы и распространение трассировочного красителя DiI через эту область.
Наблюдаемые в эксперименте явления подтверждают положительное влияние препарата хитозана и полиэтиленгликоля на функциональное восстановление после экспериментальной травмы спинного мозга. Полученные данные согласуются с гистологической картиной.