Journal of neurosurgery. Spine
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Case Reports
Less exposure surgery for multilevel anterior cervical fusion using 2 transverse incisions.
Multilevel anterior cervical fusion often necessitates a large extensile incision for exposure and substantial retraction of the esophagus for placing long plates, potentially predisposing patients to complications such as dysphagia, dysphonia, and neurovascular injury. To the authors' knowledge, the use of 2 incisions as an option has not been published, and so it is not intuitive to young surgeons or widely practiced. ⋯ By using the 2-incision technique, the authors made the surgery technically easier and diminished the amount of esophageal retraction otherwise needed through 1 long transverse or longitudinal incision. A skin bridge of 3 cm was safe.
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The aim of this study was to identify the quality of life (QOL) measures commonly used to assess patients with spinal cord injury (SCI) and to summarize studies using common QOL measures that have been validated in SCI populations to compare scores in persons with SCI with those in a control population. ⋯ The SF-36 and WHOQOL-BREF are validated instruments that should be considered for use in SCI QOL studies. Future analysis of deficits in QOL among patients with SCI would benefit from the development of a QOL instrument specifically targeted to SCI. Longitudinal studies to assess the impact of injury level and injury completeness on SCI QOL are also needed.
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The purpose of this paper was to systematically review and critically appraise the evidence for whether there are differences in outcomes or recovery after thoracic spinal cord injuries (SCIs) based on the spinal level, the timing of intervention, or cause of SCI. ⋯ The overall strength of evidence for all outcomes reported is low. Definitive conclusions should not be drawn regarding the prognosis for outcome and recovery after thoracic SCI. From a physiological standpoint, additional methodologically rigorous studies that take into consideration various levels of injury in more anatomically and physiologically relevant form are needed. Use of validated, comprehensive outcomes tools are important to improve our understanding of the impact of thoracic SCI and aid in examining factors in recovery from thoracic SCI.
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The object of this study was to identify, by means of a systematic review of the literature, the acute clinical predictors of neurological outcome, functional outcome, and survival after traumatic spinal cord injury (SCI). ⋯ On the basis on this review, the authors have identified a constellation of acute clinical features that may help to define an individual's profile for recovery and survival after SCI. This study will help to facilitate communication in the clinical realm and assist in classifying subsets of patients within future clinical studies.
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Multicenter Study
Incidence and severity of acute complications after spinal cord injury.
The aim of this multicenter, prospective study was to determine the spectrum, incidence, and severity of complications during the initial hospitalization of patients with spinal cord injury. ⋯ Knowledge of the type, frequency, time of occurrence, and severity of specific complications that occur after spinal cord injury can aid in their early detection, treatment, and prevention. The data are of importance in evaluating and selecting therapy for clinical trials.